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Author: Marc A. Rodwin
Publisher: Oxford University Press
ISBN: 0198024266
Category : Medical
Languages : en
Pages : 432
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Book Description
Marc A. Rodwin draws on his own experience as a health lawyer--and his research in health ethics, law, and policy--to reveal how financial conflicts of interest can and do negatively affect the quality of patient care. He shows that the problem has become worse over the last century and provides many actual examples of how doctors' decisions are influenced by financial considerations. We learn how two California physicians, for example, resumed referrals to Pasadena General Hospital only after the hospital started paying $70 per patient (their referrals grew from 14 in one month to 82 in the next). As Rodwin writes, incentives such as this can inhibit a doctor from taking action when a hospital fails to provide proper service, and may also lead to the unnecessary hospitalization of patients. We also learn of a Wyeth-Ayerst Labs promotion in which physicians who started patients on INDERAL (a drug for high blood pressure, angina, and migraines) received 1000 mileage points on American Airlines for each patient (studies show that promotions such as this have a direct effect on a doctor's choice of drug). Rodwin reveals why the medical community has failed to regulate conflicts of interest: peer review has little authority, state licensing boards are usually ignorant of abuses, and the AMA code of ethics has historically been recommended rather than required. He examines what can be learned from the way society has coped with the conflicts of interest of other professionals --lawyers, government officials, and businessmen--all of which are held to higher standards of accountability than doctors. And he recommends that efforts be made to prohibit and regulate certain kinds of activity (such as kickbacks and self-referrals), to monitor and regulate conduct, and to provide penalties for improper conduct. Our failure to face physicians' conflicts of interest has distorted the way medicine is practiced, compromised the loyalty of doctors to patients, and harmed society, the integrity of the medical profession, and patients. For those concerned with the quality of health care or medical ethics, Medicine, Money and Morals is a provocative look into the current health care crisis and a powerful prescription for change.
Author: Marc A. Rodwin
Publisher: Oxford University Press
ISBN: 0198024266
Category : Medical
Languages : en
Pages : 432
Get Book Here
Book Description
Marc A. Rodwin draws on his own experience as a health lawyer--and his research in health ethics, law, and policy--to reveal how financial conflicts of interest can and do negatively affect the quality of patient care. He shows that the problem has become worse over the last century and provides many actual examples of how doctors' decisions are influenced by financial considerations. We learn how two California physicians, for example, resumed referrals to Pasadena General Hospital only after the hospital started paying $70 per patient (their referrals grew from 14 in one month to 82 in the next). As Rodwin writes, incentives such as this can inhibit a doctor from taking action when a hospital fails to provide proper service, and may also lead to the unnecessary hospitalization of patients. We also learn of a Wyeth-Ayerst Labs promotion in which physicians who started patients on INDERAL (a drug for high blood pressure, angina, and migraines) received 1000 mileage points on American Airlines for each patient (studies show that promotions such as this have a direct effect on a doctor's choice of drug). Rodwin reveals why the medical community has failed to regulate conflicts of interest: peer review has little authority, state licensing boards are usually ignorant of abuses, and the AMA code of ethics has historically been recommended rather than required. He examines what can be learned from the way society has coped with the conflicts of interest of other professionals --lawyers, government officials, and businessmen--all of which are held to higher standards of accountability than doctors. And he recommends that efforts be made to prohibit and regulate certain kinds of activity (such as kickbacks and self-referrals), to monitor and regulate conduct, and to provide penalties for improper conduct. Our failure to face physicians' conflicts of interest has distorted the way medicine is practiced, compromised the loyalty of doctors to patients, and harmed society, the integrity of the medical profession, and patients. For those concerned with the quality of health care or medical ethics, Medicine, Money and Morals is a provocative look into the current health care crisis and a powerful prescription for change.
Author: David M. Cutler
Publisher: Oxford University Press
ISBN: 9780195181326
Category : Health & Fitness
Languages : en
Pages : 180
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Book Description
Publisher Description
Author: Thomas E. Getzen
Publisher: Oxford University Press
ISBN: 0197573266
Category :
Languages : en
Pages : 361
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Book Description
"This book frames the evolutionary path of medicine and provides a useful forecasting model. Tracing health spending from ancient times to the present with a single ratio, health expenditures as a share of income, reveals an s-shaped growth curve, rising rapidly after science made therapies more effective and more expensive, inflecting as the rate of expansion peaked with the coalescence of national health systems in the 1960s, and decelerating after 1975. Medicine became qualitatively different as it scaled up along therapeutic, organizational, financial, and moral dimensions. The development of health insurance and changes in the flow of funds made macro effects on total spending different from micro determinants of allocation. Institutional inertia and lags require a span of observation long enough to distinguish temporary fluctuations from shifts in trend"--
Author: Edgar Villanueva
Publisher: Berrett-Koehler Publishers
ISBN: 1523097914
Category : Business & Economics
Languages : en
Pages : 215
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Book Description
Decolonizing Wealth is a provocative analysis of the dysfunctional colonial dynamics at play in philanthropy and finance. Award-winning philanthropy executive Edgar Villanueva draws from the traditions from the Native way to prescribe the medicine for restoring balance and healing our divides. Though it seems counterintuitive, the philanthropic industry has evolved to mirror colonial structures and reproduces hierarchy, ultimately doing more harm than good. After 14 years in philanthropy, Edgar Villanueva has seen past the field's glamorous, altruistic façade, and into its shadows: the old boy networks, the savior complexes, and the internalized oppression among the “house slaves,” and those select few people of color who gain access. All these funders reflect and perpetuate the same underlying dynamics that divide Us from Them and the haves from have-nots. In equal measure, he denounces the reproduction of systems of oppression while also advocating for an orientation towards justice to open the floodgates for a rising tide that lifts all boats. In the third and final section, Villanueva offers radical provocations to funders and outlines his Seven Steps for Healing. With great compassion—because the Native way is to bring the oppressor into the circle of healing—Villanueva is able to both diagnose the fatal flaws in philanthropy and provide thoughtful solutions to these systemic imbalances. Decolonizing Wealth is a timely and critical book that preaches for mutually assured liberation in which we are all inter-connected.
Author: Donald Drake
Publisher: Andrews McMeel Publishing
ISBN:
Category : Business & Economics
Languages : en
Pages : 136
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Book Description
Prescription drug prices rose three times faster than inflation in the last decade. Here, two Philadelphia Inquirer reporters show how the industry has circumvented every governmental effort to bring prices under control. Drug companies raise prices when faced with competition, are granted monopoly markets, and profit from research breakthroughs by government and academic scientists.
Author: Bernhard Bierlich
Publisher: Berghahn Books
ISBN: 9781845453510
Category : Business & Economics
Languages : en
Pages : 256
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Book Description
Based on long-term medical anthropological research in northern Ghana, the author analyses issues of health and healing, of gender, and of the control and use of money in a changing rural African setting. He describes the culture of medical pluralism, so typical for neo-colonial states, and people's choices of "traditional" (local) medicine (plants and sacrifices), Islamic medicine (charms and various written solutions) and "modern" therapy (biomedicine, in particular western pharmaceuticals). He concludes that the rural-urban divide is a fiction, that demarcations between these areas are frequently blurred, linked by a postcolonial, capitalist discourse of local markets, regional economies and national structures, which frequently emerge in local African settings but often originate in global and multinational markets.
Author: Maggie Mahar
Publisher: Harper Collins
ISBN: 0061873829
Category : Business & Economics
Languages : en
Pages : 823
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Book Description
Why is medical care in the United States so expensive? For decades, Americans have taken it as a matter of faith that we spend more because we have the best health care system in the world. But as costs levitate, that argument becomes more difficult to make. Today, we spend twice as much as Japan on health care—yet few would argue that our health care system is twice as good. Instead, startling new evidence suggests that one out of every three of our health care dollars is squandered on unnecessary or redundant tests; unproven, sometimes unwanted procedures; and overpriced drugs and devices that, too often, are no better than the less expensive products they have replaced. How did this happen? In Money-Driven Medicine, Maggie Mahar takes the reader behind the scenes of a $2 trillion industry to witness how billions of dollars are wasted in a Hobbesian marketplace that pits the industry's players against each other. In remarkably candid interviews, doctors, hospital administrators, patients, health care economists, corporate executives, and Wall Street analysts describe a war of "all against all" that can turn physicians, hospitals, insurers, drugmakers, and device makers into blood rivals. Rather than collaborating, doctors and hospitals compete. Rather than sharing knowledge, drugmakers and device makers divide value. Rather than thinking about long-term collective goals, the imperatives of an impatient marketplace force health care providers to focus on short-term fiscal imperatives. And so investments in untested bleeding-edge medical technologies crowd out investments in information technology that might, in the long run, not only reduce errors but contain costs. In theory, free market competition should tame health care inflation. In fact, Mahar demonstrates, when it comes to medicine, the traditional laws of supply and demand do not apply. Normally, when supply expands, prices fall. But in the health care industry, as the number and variety of drugs, devices, and treatments multiplies, demand rises to absorb the excess, and prices climb. Meanwhile, the perverse incentives of a fee-for-service system reward health care providers for doing more, not less. In this superbly written book, Mahar shows why doctors must take responsibility for the future of our health care industry. Today, she observes, "physicians have been stripped of their standing as professionals: Insurers address them as vendors ('Dear Health Care Provider'), drugmakers and device makers see them as customers (someone you might take to lunch or a strip club), while . . . consumers (aka patients) are encouraged to see their doctors as overpaid retailers. . . . Before patients can reclaim their rightful place as the center—and indeed as the raison d'être—of our health care system," Mahar suggests, "we must once again empower doctors . . . to practice patient-centered medicine—based not on corporate imperatives, doctors' druthers, or even patients' demands," but on the best scientific research available.
Author: Marty Makary
Publisher: Bloomsbury Publishing USA
ISBN: 1635574129
Category : Health & Fitness
Languages : en
Pages : 305
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Book Description
New York Times bestseller Business Book of the Year--Association of Business Journalists From the New York Times bestselling author comes an eye-opening, urgent look at America's broken health care system--and the people who are saving it--now with a new Afterword by the author. "A must-read for every American." --Steve Forbes, editor-in-chief, FORBES One in five Americans now has medical debt in collections and rising health care costs today threaten every small business in America. Dr. Makary, one of the nation's leading health care experts, travels across America and details why health care has become a bubble. Drawing from on-the-ground stories, his research, and his own experience, The Price We Pay paints a vivid picture of the business of medicine and its elusive money games in need of a serious shake-up. Dr. Makary shows how so much of health care spending goes to things that have nothing to do with health and what you can do about it. Dr. Makary challenges the medical establishment to remember medicine's noble heritage of caring for people when they are vulnerable. The Price We Pay offers a road map for everyday Americans and business leaders to get a better deal on their health care, and profiles the disruptors who are innovating medical care. The movement to restore medicine to its mission, Makary argues, is alive and well--a mission that can rebuild the public trust and save our country from the crushing cost of health care.
Author: Elisabeth Rosenthal
Publisher: Penguin
ISBN: 0698407180
Category : Medical
Languages : en
Pages : 434
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Book Description
A New York Times bestseller/Washington Post Notable Book of 2017/NPR Best Books of 2017/Wall Street Journal Best Books of 2017 "This book will serve as the definitive guide to the past and future of health care in America.”—Siddhartha Mukherjee, Pulitzer Prize-winning author of The Emperor of All Maladies and The Gene At a moment of drastic political upheaval, An American Sickness is a shocking investigation into our dysfunctional healthcare system - and offers practical solutions to its myriad problems. In these troubled times, perhaps no institution has unraveled more quickly and more completely than American medicine. In only a few decades, the medical system has been overrun by organizations seeking to exploit for profit the trust that vulnerable and sick Americans place in their healthcare. Our politicians have proven themselves either unwilling or incapable of reining in the increasingly outrageous costs faced by patients, and market-based solutions only seem to funnel larger and larger sums of our money into the hands of corporations. Impossibly high insurance premiums and inexplicably large bills have become facts of life; fatalism has set in. Very quickly Americans have been made to accept paying more for less. How did things get so bad so fast? Breaking down this monolithic business into the individual industries—the hospitals, doctors, insurance companies, and drug manufacturers—that together constitute our healthcare system, Rosenthal exposes the recent evolution of American medicine as never before. How did healthcare, the caring endeavor, become healthcare, the highly profitable industry? Hospital systems, which are managed by business executives, behave like predatory lenders, hounding patients and seizing their homes. Research charities are in bed with big pharmaceutical companies, which surreptitiously profit from the donations made by working people. Patients receive bills in code, from entrepreneurial doctors they never even saw. The system is in tatters, but we can fight back. Dr. Elisabeth Rosenthal doesn't just explain the symptoms, she diagnoses and treats the disease itself. In clear and practical terms, she spells out exactly how to decode medical doublespeak, avoid the pitfalls of the pharmaceuticals racket, and get the care you and your family deserve. She takes you inside the doctor-patient relationship and to hospital C-suites, explaining step-by-step the workings of a system badly lacking transparency. This is about what we can do, as individual patients, both to navigate the maze that is American healthcare and also to demand far-reaching reform. An American Sickness is the frontline defense against a healthcare system that no longer has our well-being at heart.
Author: Paul Starr
Publisher:
ISBN: 9780465079353
Category : History
Languages : en
Pages : 532
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Book Description
Winner of the 1983 Pulitzer Prize and the Bancroft Prize in American History, this is a landmark history of how the entire American health care system of doctors, hospitals, health plans, and government programs has evolved over the last two centuries. "The definitive social history of the medical profession in America....A monumental achievement."—H. Jack Geiger, M.D., New York Times Book Review
