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

During the twentieth century, the issue of health care burst out of the private confines of the physician's office to become a monumental contentious social issue. Giant multinational corporations scooped up proprietary hospitals and nursing homes and assembled them into vast chains crisscrossing America. The incomes of entrepreneurial fee-for-service physicians grew several times faster than the rate of inflation year after year, while the cost of health care swelled to consume 14 percent of the gross domestic product and continues to climb higher. The government gingerly applied cost containment strategies while hospitals expanded capacity and filled multiple "profit centers" with expensive high-tech equipment. Health care administration emerged as the fastest growing segment of all health-related occupations.Meanwhile, infant mortality in the United States is increasingly excessive compared with other industrialized countries, and the gulf of health status disparities between white Americans and minorities soars. Tens of thousands of Americans each year die from complications due to unnecessary but profitable surgeries, while millions suffer from medical neglect because they cannot pay for health care. The cost of malpractice insurance skyrockets while the fraternity of physicians pretend to discipline one another.Health care is a nation-wide problem, and the social devastation in its wake is a tragedy of national scope. Existing assumptions, power structures, political and economic interests, and social organizations have contributed to the crisis. InPrivate Medicine and Public Health,Lawrence Weiss dispassionately questions and analyzes the many issues of the health care crisis in search of much-needed solutions.

Lawrence D. Weiss is associate professor in the Department of Sociology at the University of Alaska at Anchorage.