Big Government and Big Business have worked together for decades to block reforms to the healthcare system
The U.S. government’s involvement in healthcare after World War II shifted financing from charities to the state, but unlike Europe, it rationalized healthcare under private ownership, embedding corporate interests into the system.
Bureaucratic professionals, medical industries like hospitals and insurance companies and the corporate class aligned to expand the medical market, maintaining private control over healthcare.
The American Medical Association has historically been the central figure opposing any changes to the status quo that could harm corporate interests.
Pharmaceutical, hospital, and insurance industries now dominate healthcare lobbying and have in recent years become far more influential in health policy than the AMA.
The commodification of healthcare has led to unequal access, soaring costs and systemic issues like poverty and pollution being overlooked in favor of blaming individuals and lifestyles for health problems.
The intervention of the federal government in healthcare post-World War II led to American healthcare becoming intrinsically tied to capitalist interests that promoted centralization, privatization and the prioritization of profit over care.
This is according to physician and author E. Richard Brown in his seminal book “Rockefeller Medicine Men: Medicine and Capitalism in America,” published in 1979, which lays out in detail the history behind government encroachment upon healthcare and how this allowed corporate interests to sneak in and slowly take over.
According to Brown, following World War II, the government became the primary financier of healthcare for a time, replacing charities and other private entities like the Rockefeller Foundation. The goal of the state was to rationalize the medical system, but instead of going the way of Europe, where state-controlled health systems were established and care and insurance was nationalized, the U.S. chose to rationalize healthcare under private ownership, leading to a situation wherein medical care became capital intensive.
Three groups further helped rationalize medicine under corporatism: Bureaucratic professionals, medical industries like hospitals and health insurance companies, and the larger corporate class. Their interests aligned with the expansion of the medical market and allowed them to maintain private control over healthcare.
American Medical Association instrumental in corporations maintaining control over U.S. healthcare
But in recent years, the AMA’s influence in health and healthcare politics has eroded, making way for more wealthy and powerful forces like pharmaceutical, hospital and health insurance industries who have commanded formidable lobbying operations in recent years to rise to power. Nevertheless, the approval of the AMA is still seen as a necessity for any state or federal elected official to pass any kind of health-related policy.
“There’s a cultural authority here,” said political scientist Jacob Hacker.
The commodification of American healthcare under special interest groups including the AMA led to massive distortions of care, including unequal access to decent care, poorer Americans receiving less care relative to their needs and the concentration of general practitioners and doctors with specialized skills and decent health institutions into centers of economic and political power, namely large cities and urban areas.
The distortions in the market have led to health costs soaring, and instead of rightly blaming special interest groups, policymakers have instead shifted the blame to individuals for their own health problems, claiming that all that is needed is for Americans to make lifestyle changes, and systemic issues that affect public health like poverty, pollution, occupational hazards and institutional barriers that prevent people from seeking care like costs are unnecessary.
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