Part 4: The Medical industrial complex, post Rockefeller interference, where we are now, and how do we fix it?
In 1961, President Eisenhower warned us that the people of the world face serious danger from the global power of what he called the “military-industrial complex”, which is the influence of the powerful multi-national corporations that are driven only by the quest for profit and power. The danger persists today, and it is represented globally in the medical arena by what Dr. Arnold Relman, the former editor of the New England Journal of Medicine, referred to as the “medical-industrial complex” of medical companies. These medical companies focus on profit and power without regard for patient and public health outcomes.
Let’s have a look at what the medical industrial complex has done. Lets go back a few decades. Do you remember what going to the “doctor” looked like? It was usually a private clinic, with a handful of providers and nurses, maybe a pharmacy and a lab on site, with old magazines and sliding glass doors at the front desk. Wall to wall patient charts behind them in wall cubbies. They usually knew your name when you walked in the door. But the providers in the office were getting older. The cost of healthcare was going up. Technology is expensive. The local hometown doctors were getting close to retirement age, their kids raised and gone, and then POOF…..in walks a fancy suit and tie requesting a business meeting. “We have an offer you cannot refuse”. The big hospital system down the road wants to buy out your practice. For a large sum of money. They bought your practice, your patients, your reputation. And gave it a face lift, with fancy new technology, an electronic charting system, and its now the sign out front says “Big Healthcare System South Bend Olive Street” branch instead of “Olive Street Family Care”. The friendly faces at the front desk retired with “their doctors”, and are replaced by young faces that you don’t know. Big corporate healthcare swallowed up another. This has been happening over and over and over in small towns, rural areas, urban cores, suburbs, EVERYWHERE. You would be hard pressed to find a physician office that is run independently, versus a satellite office of some big healthcare conglomerate. Here in Kansas City, everything is owned by KU Health, Advent, St. Lukes, or HCA. I can count on maybe 2 hands the number of private practices I know of that are independent practices with no hospital affiliation. I am thankful to work as a provider in an independent practice. When you remove the small fish competition (much like Flexner did when he flattened medical schools that did not match his agenda), you form a monopoly on healthcare. Every hospital offers the same price for treatment. Expensive. Monopoly.
Welcome to the machine. The medical industrial complex. What is their goal? Profit profit profit. Who pays for it? You and your insurance company. Which, by the way, your insurance company does not work for you, they already negotiated WITH the big fancy corporate hospital how much they are willing to pay for anything you need to have done, so the hospital knows WHAT they need to order/test you for in order to make as much money as possible from those negotiated rates. Sickening, isn’t it. Did you know your insurance company also negotiated pharmacy contracts and drug prices? Why do you think you are only allowed to fill meds at CVS or Walgreens with certain insurance plans? The insurance company negotiated a cheaper price for THEM, and the cost was passed on to the PATIENT.
https://jtd.amegroups.com/article/view/3004/html
This article says it very well.
Western medicine is an increasingly corrupt business model that utilizes an expensive health care business model, whose goal is maximizing profit by overusing high-priced procedures and diagnostic tests and forcing patients to take expensive, unnecessary medications through-out the rest of their lives. In this model, the losers are the patients. Physicians are trained to use fancy expensive high priced brand name drugs instead of cost effective (and equally efficacious) generic medications. In the ideal world, physicians and providers have autonomy to choose what medications they prescribe you. Until their corporate c-suite bosses tell them nope, you will prescribe what we TELL you to. Because the c-suite is out for profit, and they just struck a billion dollar agreement with pharma company A to promote and use their drug.
Western medicine also has a new love affair high-price diagnostic and therapeutic approaches whether or not they benefit the patient and public health. Oh your depression is treatment resistant? Well talk to your doctor about doing TMS treatment on this fancy new Neurostar TMS machine. Oh your insurance won’t cover the treatment? Well you can cash pay for that. And then when you cannot afford to pay for your treatment, we will gladly send you to collections, rack up attorney fees, and then you can file medical bankruptcy to pay off that treatment. A treatment or test is only as good as the affordability of it. It may be the best treatment ever, but if it is not affordable, who will use it? “The problem has become so pervasive that experts have advocated that high cost of medicines be listed as a side effect of their product”.
Pharmaceutical companies have been one of the most profitable industries on the planet, with a business model that is constantly churning out a “new fantastic amazing blockbuster drug” that are heavily marketed, and sold at huge mark-ups during the period of their patent protection. For example, you can treat ADHD with generic Adderall XR (dextroamphetamine) for about $20 per month cash pay, or cheaper with insurance coverage. But if you want to use VYVANSE, the drug that I swear to Jesus will NEVER GO OFF PATENT and has been on the market for damn near a decade,🙄, it will cost you $300 out of pocket and good luck getting insurance to pay for it. Pharma LOVES to target patients with chronic diseases that are not curable, and their medications are designed to just keep the severe effects of the diseases at bay, or to reduce symptoms enough that they feel a little better. These medications ARE NOT CURATIVE. The companies’ goal is to have patients take their expensive medicines through-out their lives. When one goes off patent, well no problem we have a “NEW AND IMPROVED” version of that drug we will put you on now. Heaven forbid we keep you on that now generic drug!! Big pharma agenda is to “falsify clinical trial data, conceal serious drug side effects, fail to release patient-level clinical trial data, bribe physicians to prescribe the drugs, pay to have false and misleading information released in medical communications, pay to prevent cheaper generic drugs from being available, market the drugs heavily during their early release to maximize profit before side effects and other problems are discovered following longer use, and provide payoffs to politicians to pass legislation that will increase company profits without benefiting patients “. Politicians are deep in the pockets of big pharma as well, most US Senators receive money from corporate interests. Politicians vote in the interest of their big dollar corporate interests, NOT in the favor of their constituents, because pharma pays them to “side” with corporate healthcare and NOT the people that elected them. In the US, the FDA’s criterion for approval of a new drug is not improved patient benefit, but is that new drug is merely “not inferior” to other drugs on the market for the same medical condition. How dirty is THAT!!!!!
As if that was not bad enough, Big Pharma will also pay generic drug companies to PREVENT them from producing inexpensive versions of their drugs that come off patent. This continues the money gauging monopoly on the drugs and they can force patients to continue to pay artificially high prices. A great example of this is Abilify, or Aripiprazole. Otsuka only allowed TWO generic companies to make generic Abilify when it came off patent, and it was a whopping $50 cheaper than the brand version was. Which means it was $750 per month. I wonder if Otsuka owned those generic manufacturers………or what kind of business relationship they had……….
It is apparent that the policies of the global medical-industrial complex are not only cost-ineffective, but they harm patients. We must oppose the policies of the medical-industrial complex worldwide and its corruption of physicians, governments, and health care systems that lead to patients’ suffering and death. How do we fix this?
We need to start with ending the proverbial “pissing contest” that physicians are the gold standard of healthcare. It is time to end the God complex that physicians are trained to have. I have mad respect for ANYONE who embarks on a healthcare education. Because it is not easy. However, the Rockefeller medical complex has the funding, the lobbies, the PAC’s to hamstring anyone who is a medical provider that is NOT an MD. That needs to stop. Missouri had a law on the books to allow a med school grad with ZERO RESIDENCY to train for 5 years with a MD and then have full licensure. I don’t disagree with that route. But then on the flip side, it is time to stop requiring a physician be attached to a PA and in some states an APRN. Again, it is all political and part of the Rockefeller indoctrination. It is high time we end the required collaboration agreement that PA’s licenses require in all 50 states, and that APRN’s require in 24 states. Stop with the physician mentality that anyone who did not earn an MD is a “mid level provider”. Because I know some fantastic PA’s and APRN’s that could run circles around a physician in experience and knowledge and patient care. I also know some fantastic physicians that are brilliant and know their stuff and don’t subscribe to the Rockefeller indoctrination philosophy. We have to realize that the end goal is smart and educated providers! We all take the same healthcare classes and curriculum when it comes to patient care. They are all from a different approach, but the end game is honestly the same. We all have to have the same knowledge to sit for a board certification exam! If you don’t know your sauce, you will not pass. It is time to recognize the strengths of patient care providers and stop playing the hierarchy game. When I tally up the hours of patient care and the total years I spent in school, I have more patient care hours and years of school than any other provider in my office. The argumentative hierarchy pissing contest needs to end. We all need to be allowed to practice autonomously and work TOGETHER as patient care providers in the branch of healthcare we spent years in school for. Respect the assets we all bring to the table. The only reason we have this division is med schools and hospitals create it and propagate it. Hospitals are who work the hardest to make sure this never happens. They do not want to lose control of the golden goose hierarchy. They want to restrict the practice ability of anyone who is NOT an MD. In 2019, Kansas was THISCLOSE to passing the full practice authority for APRN’s. Which meant APRN’s would no longer require a physician collaboration agreement. The bill made it through the house and senate and was slated to pass on a Tuesday afternoon in March. Until. A Wyandotte county Kansas state house representative WHO IS ALSO A VP LEVEL EXECUTIVE at the University of Kansas Health Systems (also located in Wyandotte county) pulled a “gut and go” on the bill! (Go research what a gut and go is, very few states even allow this to happen). Took the bill that was ready to pass, and took ALL of the proposals out of it, and replaced it with Medicaid reform instead. All of us who are licensed as APRN’s in the state of Kansas were absolutely furious and devastated. Why did this Wyandotte state rep do this? One, to try to sneak in a bill that had previously died in committee. Two, it would directly benefit her EMPLOYER to get more Medicaid reimbursement. And three, it would continue to “hamstring” the hundreds/thousands of APRN’s that worked for KU and require them to continue working in subservient roles that were beneath their education level and scope of practice. It was a level of dirty and shady for which there are no words. Hospital executives should not be in the state government. Corrupted massive healthcare systems do not care about patients or their employers. Only the bottom line revenue generation. One piece of good news here? Kansas was able to pass that full practice authority bill for APRN’s this last week. It is just sad that it was delayed 3 years due to the shenanigans of a corporate hospital state representative. Kansas is now a full practice autonomy state for APRN’s. This is going to change the landscape big time Missouri is one of THE MOST restrictive states for APRN’s. The AMA stranglehold is strong in the state. The passage of full practice authority in Kansas is going to have a profound effect on accessibility to healthcare in Missouri, because if an APRN can practice autonomously in one state and not in the other state, yet a major city sits right on those two state lines……which state will draw more APRN’s to practice in? Kansas will. Which leads me to the next point.
We need to bring healthcare back to Mainstreet, not the 15 story corporate medical complex. Providers need to take healthcare back. They need to open their own private practice where they can treat patients as they choose, with cheaper medications, less insurance and corporate mandated care. Stop selling out to big pharma, and focus on health not just disease. Start having the difficult conversations about lifestyle modification. Refer to chiropractors, nutritionists, physical therapists, mental health providers, holistic functional medical providers……start looking at how to fix underlying problems not slapping a medication bandaid one things. Western medicine is not the answer for everything. Start promoting health rather than a cure in a pill bottle that just subdues the symptoms but does not fix the problem. We need less CEO’S, corporate compliance committees that dictate the algorithms we MUST use to treat a patient illness (the ol one size fits all philosophy), less big pharma lunches, less $5,000 unwarranted MRI tests, and we need more autonomy and real conversations between a provider and a patient. We need to reduce the cost of pursuing a healthcare degree, so that providers aren’t forced to “sell out” and work for the corporate healthcare machine to earn the salary needed to pay back their student debt. If education was cheaper, physician salaries could be lower, and the consumer saves money. Providers would then have the capital and finances to OPEN their own practice and STOP the corporate healthcare complex. It starts with all of us IN healthcare to say stop, we are not going to do this anymore. Rockefeller and Flexner may have started this snowball down the hill, but its time we strap our ski shoes on and grab the shovel to dig ourselves out. We owe it to ourselves, and we owe it to every patient that comes to see us for care.