Private Medicine and Public Health: Profit, Politics, and Prejudice in the American Health Care Enterprise

241 Pages·1997·13.795 MB·English

by  Lawrence D Weiss

Private Medicine and Public Health

Private Medicine
and Public Health
Profit, Politics, and Prejudice in the
American Health Care Enterprise
Lawrence D. Weiss
Routledge
Taylor & Francis Group
New York London
First published 1997 by Westview Press
Published 2018 by Routledge
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Library of Congress Cataloging-in-Publication Data
Weiss, Lawrence David.
Private medicine and public health: profit, politics, and
prejudice in the American health care enterprise/ Lawrence D.
Weiss.
p. cm.
Includes bibliographical references and index.
ISBN 0-8133-3350-4 (he.)—ISBN 0-8133-3351-2 (pbk.)
1. Medical policy—United States. 2. Medical economics—United
States. I. Title.
RA395.A3W445 1997
362.r0973—dc21 96-40916
CIP
ISBN 13: 978-0-8133-3351-9 (pbk)
To those who have suffered or died as
victims of a health care system dedicated to
maximum profit rather than universal access

Contents
List of Acronyms xi
Preface xv
The Perspective, xvi
Organization of the Text, xviii
Acknowledgments, xx
Reference, xx
1 The Big Picture 1
The Development of Health Care in an Emerging
Capitalist System, 1
Sidelining Public Health, 6
Summary and Discussion, 12
References, 14
2 Access to Health Care 15
Health Status in the United States, 16
Minorities and Access to Health Care, 17
Historical Obstacles to Health Care Access in
African-American Communities, 18
Hispanic Access to Health Care, 24
Access to Health Care for the Uninsured, 25
Women and Access, 29
Summary and Discussion, 32
References, 33
3 Physicians 35
The American Medical Association, 36
Self-Referral, 41
Fee-for-Service Versus Salary, 43
Medical Malpractice, 46
Summary and Discussion, 52
References, 53
vii
viii Contents
4 Nurses 56
History of the Profession, 56
Theories Explaining Cyclical Nursing Shortages, 57
Registered Care Technologist: AMA Response to the
Nursing Shortage, 58
Nurses in Unions, 60
Nurses as Entrepreneurs and Independent
Practitioners, 61
Changing Composition of the Nursing Labor Force:
Blacks, Men, and Immigrants, 63
Summary and Discussion, 65
References, 66
5 Hospitals 67
Brief History of Hospitals, 68
Investor-Owned Hospital Chains, 70
For-Profits Versus Nonprofits, 71
Trends in Vertical Integration, 74
Hospital Costs, 75
Public Hospital Emergency Rooms, 77
Hospitals Can Be Dangerous Places, 81
Summary and Discussion, 82
References, 83
6 Managed Care 84
Brief History of HMOs, 85
Current Overview of HMOs, 87
Managed Care Does Not Appear to Reduce Health
Care Costs, 88
When HMOs Go Belly-Up, 89
Quality of Care and Consumer Protection Issues, 90
HMOs and Advertising, 92
Summary and Discussion, 92
References, 93
7 Alternative Health Care Industry 95
Brief History of Alternative Practitioners, 95
Alternative Health Care in the United States
Today, 99
Huckstering, Fraud, Deception, Misrepresentation,
and Unproven Alternatives, 101
Vitamins and Amino Acids, 104
Summary and Discussion, 107
References, 107
Contents ix
8 The Drug Industry 109
Prescription Drug Prices, 109
Prescription Drug Marketing, 115
Prescription Drug Research, 120
Politics of Drug Manufacturing, 122
Drug Misadventuring, 124
Summary and Discussion, 127
References, 129
9 Medical Services 131
Dialysis Industry, 131
Laboratories, 137
Diagnostic Imaging Equipment, 141
Summary and Discussion, 145
References, 146
10 Federal Government 148
GRAMPUS, 149
Indian Health Service, 151
Medicare, 152
Public Health Enforcement I: Environmental Protection
Agency, 157
Public Health Enforcement II: Occupational Safety and
Health Administration, 165
Public Health Enforcement III: Food and Drug
Administration, 168
Summary and Discussion, 172
References, 174
11 Medicaid and the States 177
Medicaid, 177
Summary and Discussion, 187
References, 188
12 Conclusion 190
The American Public Health Association, 192
Looking North for Inspiration: The Canadian Health
Care System, 194
Summary and Discussion, 199
References, 200
Glossary 201
About the Book and Author 207
Index 209