This version of health care is purely a business

This version of health care is purely a business | KevinMD | by Jeff Kane, MD | Physician | September 23, 2016

Many of us harbor an archaic view of what health care is, so let me offer a little history. During the past century, it’s changed from Healthcare 1.0 to 2.0, and now it’s Healthcare 3.0.

In the early twentieth century, Healthcare 1.0 was a service, though it amounted more to personal contact than effective medicine. At best, medications and procedures were hit-and-miss, so doctors relied heavily on their relationship with their patients  

After 1910, health care began to change as medical education became standardized and based on science. That style — call it Healthcare 2.0 — proved hugely successful.

Sometime mid-century, we began to realize that development of space-age drugs, equipment, tests, and procedures can’t be done without major capital investment, with the cost, understandably, passed on to the patient.

Thus bloomed health insurance and the myriad other businesses attracted to medicine’s growing profitability.

Slowly, Healthcare 2.0, health care as science, morphed into today’s Healthcare 3.0, health care as business.

Business increasingly penetrated medical practice until it totally swallowed and digested it.

So now the institution is owned and directed not by physicians and patients, but by people who are familiar with commerce but clueless about what occurs in an examining room.

The institution is no longer geared to anyone’s health.

It isn’t a service.

And considering its inherent web of payola and conflicted interests, it isn’t objective science.

It’s Healthcare 3.0, business.

Author: Jeff Kane is a physician and is the author of Healing Healthcare: How Doctors and Patients Can Heal Our Sick System.

This is exactly what I’ve been seeing. As the population ages and healthcare needs increase, more and more middlemen are inserting themselves into the process, trying to get a piece of the profit.

Institutions ostensibly devoted to healing have become corporations devoted to profit. Most are now run by experts in management and finance, not healthcare.

Hospitals and healthcare services have become a 21st Century gold rush.

Because they are beholden to stockholders, these managers are responsible for shareholder value (profits), not the welfare of their medical staff or patients. In hospitals, this leads to medical absurdities like these:

  • Funding decisions are based on profitability, not on medical or life-saving value.
  • Providers of diagnostics, imaging, or medications charge as much (or more) than the market can bear, not what their services are worth.
  • Customer opinions are more important than those of their doctors because pleasing the customer is seen as better for business.
  • Instead of hiring more nurses or providing better benefits to their overworked workers, money is spent on trivial matters, like better coffee, fancy chefs, or nicer plants in nicer flowerpots, all to please customers (patients) and get their good ratings (which lead to better Medicare reimbursements).

Running an essential social service, like healthcare, as a purely profit-oriented business will only be affordable for the wealthy. All the rest will become burdens on society, disabled by the poor health of their bodies and minds.


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