FOR-PROFIT HEALTH CARE: UNDER ATTACK BY PHYSICIANS
More than 2,000 Massachusetts doctors and nurses have signedThis is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
a "Call To Action" published in today's issue of the Journal of
the American Medical Association, that urges their colleagues to
fight for the end of for-profit health care, the Boston Globe
reports. In addition, the Ad Hoc Committee to Defend Health Care
dumped "symbols of market-driven care such as annual reports of
for-profit hospitals" into the Boston Harbor yesterday in a
reenactment of the Boston Tea Party (Kong, 12/3). The letter in
JAMA criticizes for-profit health concerns for treating "patients
as profit centers," and the authors contend that some doctors
"risk being fired or 'delisted' for giving, or even discussing,
expensive services." They write, "Listening, learning, and
caring give way to deal-making, managing, and marketing." In
addition, the authors contend that the pace of the shift to for-
profit health care is increasing "rapidly" (12/3 issue). David
Himmelstein, an associate professor of medicine at Harvard and an
author of the letter, said, "The soul of our profession is being
taken from us and from our patients. This is not a system that
Americans decided on. It was imposed by the wealthiest and most
powerful forces."
FIVE PRINCIPLES
The Globe reports that although the authors "differ on ways
to reform the system, they agree on five principles: [m]edicine
and nursing must not be diverted from the relief of suffering and
the prevention and treatment of illness"; "[p]ursuit of corporate
profit and personal fortune has no place in caregiving";
"[f]inancial incentives that weaken patient-caregiver bonds
should be prohibited"; "[a] patient's right to choose a physician
must not be curtailed"; and "[h]ealth care access must be a right
for all" (12/3).
INITIAL ACTION
Saying that only a large "public outcry can reclaim
medicine," the authors of the report have taken three initial
steps. In addition to the reenactment of the Tea Party, they
have "petitioned [the] governor, legislature, and attorney
general for a moratorium on for-profit takeovers of hospitals,
insurance plans, HMOs, physicians' practices, and other health
care institutions," and will "launch an ongoing series of teach-
ins and meetings in hospitals, clinics, HMOs, offices, and
nursing and medical schools to discuss the health care crisis."
The authors are also asking nurses and physicians in other parts
of the country to endorse the letter (JAMA, 12/3 issue).
ALL IN FAVOR
Globe reports that about 2,300 Massachusetts doctors and
nurses have signed the statement, and more have signed on since
the article went to press (12/3). In addition, approximately 70
doctors joined together at Pennsylvania Hospital in Philadelphia
yesterday to hear about the "dangers of corporate medicine" from
Walter Tsou, a Pennsylvania area organizer for the Call to Action
and the deputy director of the Montgomery County Health
Department (Burling, Philadelphia Inquirer, 12/3). Others who
endorsed the Call to Action include University of California at
San Francisco Chancellor Dr. Haile Debas and UCSF-Stanford Health
Care chief executive Peter Van Etten (Russell, San Francisco
Chronicle, 12/3).
CRITICISM
However, Washington Post reports that there was criticism of
the statement as being "simplistic and misguided." Ronald
Pollack, executive director of Families USA, said, "A good number
of the nonprofit hospitals don't do any better in serving the
uninsured than do for-profit hospitals." Post reports that other
health care industry representatives noted that "HMOs have played
a crucial role in containing health care costs and improving
accountability for doctors, who once treated patients with
virtual carte blanche." Tom Scully, president of the Federation
of American Health Systems, said, "I have five physicians in my
family, and the last time I checked none of their practices were
nonprofit" (Hilzenrath, 12/3). Kit Costello, president of the
California Nurses Association, which endorsed the statement,
noted that there is not much difference between nonprofit and
for-profit health systems. She said, "If I could have edited the
document, I would have indicated that there is not that much
difference in behavior" (Chronicle, 12/3).