|
|
|
| Current Issue |
|
|
| Resources |
|
|
|
The Doctor and I: Old Roles and New Realities
| Article
# : |
17068 |
|
|
Section : |
MODERN THOUGHT
|
| Issue
Date : |
8 / 1990 |
7,251 Words |
| Author
: |
E. Haavi Morreim
E. Haavi Morreim is associate professor in the College of
Medicine at the University of Tennessee in Memphis. She is the
author of Medicine's Economic Revolution: Rewriting Medical
Ethics and has written numerous articles on the ethical and
legal implications of health care's changing economics. |
It hardly takes an astute observer of national affairs to figure out that extraordinary things have been happening in medicine. The technological advances are obvious enough. We can literally peer inside our organs and joints with laparoscopes, arthroscopes, colonoscopes, gastroscopes, and assorted other "oscopes.” With positron emission tomography (the PET scanner) we can almost "watch" someone think and see and hear, as we see which parts of his brain metabolize glucose during these processes. With chorionic villus sampling and genetic screening we can learn much about our future children's health, months before they are born. Infectious diseases that formerly wiped out large populations are now treated as routine minor illnesses. And some of those diseases, such as smallpox, are themselves wiped out.
Though hardly heralded with the same enthusiasm, medicine's economic changes are no less extraordinary. Indeed, as I will try to show through the rest of this essay, the time has come to change fundamentally the ways in which we view the relationship between physician and patient, and in turn between them and the "economic agents" of health care - the institutional payers and institutional providers, such as governments, business corporations, insurance companies, health maintenance organizations (HMOs), and hospitals who have an enormous financial stake in the health care industry.
The signs of economic upheaval are evident everywhere. The news media regularly carry stories about the medically "homeless" - the thirty million-plus Americans who have no health insurance, and who regularly find themselves dumped from private hospitals emergency rooms into crowded public hospitals that do not have the resources to care for them. And we hear about the bitter disputes between labor unions and management over corporations attempts to curtail the soaring costs of health care fringe benefits. in the corner grocery store we see tin cans collecting coins for some neighborhood child who needs, but whose parents cannot afford, an organ transplant. Though the signs of medicine's economic upheaval are obvious enough, we need to take a closer look at where we are, how we got here, and what these changes mean for our health care both now and in the future.
Where We Are, And How We Got Here
Probably the single largest fact about American health care economics is the exponential growth of health care expenditures over the past several decades. Per capita health care costs have trebled since 1950, rising from 5 percent to nearly 12 percent of
...
Read Full Article
Look for this article in Ask.com
|
|
