Profits Vs. Patient Outcomes In The Healthcare Industry

I’ve been thinking about the difficulty of maintaining honest ethics in the U.S. healthcare marketplace due to predominance of for profit and ROI driven providers. I joined the pharmaceutical industry in the 1970s because I believed industry and the private practice physicians who were predominant in providing care then were all interested in providing new, improved treatments and improving health care for our citizens. I knew that companies had to make profits to pay for their research and development costs but never have understood why salaried doctors working for managed care corporations are thought to provide better care than private practice doctors or salaried government funded staff. To me we added a new layer of bureaucracy that added additional costs but also added need to provide stock market value profits for shareholders in addition to payments for medical staff. Their focus on profits always worried me and seemed in conflict with a focus on delivering the best medical outcomes for all patients.

In my exposure to healthcare delivery worldwide, I learned that this basic ethic of improving the healthcare of all citizens was not universally accepted by industry and providers globally. Cheating on clinical trials, denying health care to large segments of the population due to cultural bias and politicians twisting the rules of reimbursement to maintain the same false share of medical costs for drugs even if their lowered and offset previous government expenditures for hospitalization and morbidity. The math was never accurately done to show how usage of new improved drugs lowered health care costs overall because of resulting reductions elsewhere in the system. There developed a strait jacket for the outlays for drugs being restricted to an historic lower share of costs prior to discovery of improved pharmaceuticals...