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The United States is facing a severe public health crisis. The financialization of medical care has created a public health emergency which cuts across all economic strata of the population.
According to a study released last month by the Physicians Advocacy Institute (PAI), a stunning 78% of physicians in our country are now corporate employees, rather than independent doctors. The negative effect on the quality of healthcare for our population has been dramatic. The Hippocratic Oath has been hobbled by Wall Street's focus on their bottom line. Doctors are being forced to choose between working for these corporations or going bankrupt, shutting down, and finding other employment. The demoralizing effect on the doctors follows: their calling to serve mankind is reduced to a job.
Over the past several decades, hospitals, insurance companies and large pharmacy chains have bought out the practices of doctors and independent medical groups. Private equity firms, seeing a cash cow to be milked, have now become the largest owner of these practices. spending more than $1 trillion in the past decade to buy up these practices, labs, and other aspects of patient care.
The PAI study reports “Over half of employed physicians reported that changes in practice ownership reduced the quality of patient care, citing an erosion in clinical autonomy and a greater focus on financial incentives. Almost half of physicians reported a deterioration in relationships with patients, seen mainly in decreased visit time and communication.”
General practitioners, your family doctors, have been particularly hard hit. They are, by far, the lowest compensated doctors, even though they are the crucial front line of medical care and public health.
In rural USA, there is a severe shortage of family doctors. In cities, the urban poor are often forced to use a clinic, or the hospital emergency room for their medical care. Even with insurance, they are often forced to see a nurse practitioner or physician's assistant, rather than their own medical doctor. The net effect of this fractured continuity of care is obvious. The PAI study described the problem as, “a deterioration in relationship with patients.” In plain English, this describes the destruction of trust between the patient and the doctor.
The essential characteristic of a family doctor is that he or she sees the patient over an extended period of time. The doctor monitors changes over time. A symptom in one person may signify something different than the same symptom in another. Continuity is key. Otherwise, we are left with the parable of the blind men and the elephant.
The looting of our medical care by Wall Street must be stopped. It is a life and death issue. It is a policy issue. In much the same way that Congress enacted the Hill-Burton Act in 1947, the Executive and Congress can and must address our essential health care infrastructure.
Do we really want Black Rock and Apollo to determine our health care?
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