The Patient is the Grass

...Getting Trampled On

How do you deliver care in a profit driven system? That is the real question!!!!

From Bill Moyers Journal: MONEY DRIVEN MEDICINE

August 28, 2009

The film MONEY-DRIVEN MEDICINE reveals how a profit-hungry "medical-industrial complex" has turned health care into a system where millions are squandered on unnecessary tests, unproven and sometimes unwanted procedures and overpriced prescription drugs.

In this broadcast we will share with you a film based on Maggie Mahar's work. The book and the film couldn't be more timely as our country wrestles with what to do about money-driven medicine.

MAGGIE MAHAR: It's interesting how hospitals advertise. Who would make a decision about where to have their baby or where to be treated for cancer based on an ad they saw on TV?

Hospitals are not advertising to the patient. Hospitals are advertising to doctors. Hospitals don't have patients, doctors have patients. And hospitals want doctors to bring their well-healed, well-insured patients to that hospital.

Hospitals have engaged in, what many call, a "medical arms race".

Typically, 4 or 5 hospitals within a 5 mile, 10 mile, 15 mile radius will all buy the same technology because they're competing with each other.

One time Dr. Donald Berwick called a hospital in Texas and said, "We've heard you have a very good procedure for treating a particular disease. We'd like to learn more about your protocol so other hospitals can use it." And the hospital said, "We can't tell you that. It's a competitive advantage in our market that we're better at treating this disease and it is very lucrative. So this is proprietary information."

The patient isn't the center of a collaboration. The patient is the victim of a competition. There's a saying in Swahili, "When the elephants fight the grass is trampled." The patient is essentially the grass.

A physician takes an oath to put his patient's interests ahead of his own. A corporation is legally bound to put its shareholders' interests first. And this is part of the inherent conflict between health care as a business, part of our economy, and health care as a public good and part of our society. Health care has become a growth industry. That means higher health care bills. That means more and more middle class people cannot afford health care in this country

BILL MOYERS: MONEY-DRIVEN MEDICINE, a film produced by Alex Gibney, Peter Bull and Chris Matonti; directed by Andy Fredericks; and based on Maggie Mahar's book of the same name.

Take a look at this recent cover of BUSINESS WEEK. Reporters Chad Terhune and Keith Epstein write that the CEO's of the giant insurance companies should be smiling - their lobbyists have already won. Quote: "no matter what specifics emerge in the voluminous bill Congress may send to President Obama this fall, the insurance industry will emerge more profitable."

And remember that television ad Barack Obama made as a candidate for president?

BARACK OBAMA: The pharmaceutical industry wrote into the prescription drug plan that Medicare could not negotiate with drug companies. And you know what, the chairman of the committee who pushed the law through went to work for the pharmaceutical industry making $2 million a year. Imagine that. That's an example of the same old game-playing in Washington. I don't want to learn how to play the game better. I want to put an end to the game-playing.

BILL MOYERS: Now look at this recent story in the LOS ANGELES TIMES. Lo and behold, since the election, the pharmaceutical industry's $2 million dollars a year superstar lobbyist Billy Tauzin has morphed into President Obama's pal. Tauzin says the President has promised not to pressure the drug companies to negotiate with the government for lower drug prices and has agreed not to allow cheaper drugs to be imported from Canada or Europe - contrary to the position taken by candidate Obama…

Each of these stories illuminates the scarlet thread that runs through Maggie Mahar's book - the story of how today's market-driven medical system gives Wall Street investors life and death control over our health care, turning medicine into a profit machine instead of a social service to meet human need. That's the conflict at the heart of next month's showdown in Washington.

I'm Bill Moyers. See you next time.