Lanny Smith

The past two decades have seen a rapid expansion of the corporate agenda in the field of health and health care. Rather than moving toward a system of universal access to medical care in the United States, the access to and quality of clinical services is being turned over increasingly to the insurance industry. Patients are now “clients” and clinical services are “product lines.” More clinical research is now funded by the pharmaceutical industry than the National Institutes of Health; pharmaceutical dollars pay the salaries of top academics and set the national research agenda. Clinicians and patients alike are wooed by sophisticated advertising campaigns (often disguised as education) that promote expensive drugs of dubious efficacy. The insertion of “market rationality” into health care has not brought the hoped for curbing of health care costs. The United States, despite spending more per capita on medical care than any other country in the world, continues to perform poorly on many health indicators, with a life expectancy at birth that ranks twenty-seventh in the world… | more |