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Edition: first, 340 pages
The Corrosion of Medicine shows that "We do not have to passively accept the role of being workers in an industry controlled by market entrepreneurs. ..." --Don McCanne, M.D. See his full message at end of this web page.
"The medical profession and health care in the U.S. are in trouble, but the political ground is shifting in favor of a solution that can rescue both: single-payer health care," stated said Dr. John Geyman, author of The Corrosion of Medicine: Can the Profession Reclaim its Moral Legacy? and Past President of Physicians for a National Health Plan. In December of 2007, the American College of Physicians endorsed the plan. "The ACP endorsement of single payer is an important step forward for the medical profession. Instead of ideology and unbridled self-interest, they are putting patients' needs first," Dr. Geyman stated.
In The Corrosion of Medicine, John Geyman, M.D., a renowned expert in primary care and health policy traces the sea change in U.S. health care over the last 40 years which has engulfed the profession in a marketplace now controlled by corporate and business interests. The profession's long history of service-based ethics and its social contract have been called into question as the business "ethic" of bottom-line profits has spread throughout the system. The deregulated health care marketplace, now one-sixth of the nation's economy, has had damaging impacts on health of the public as well as the profession itself.
In Part I, Geyman shows how medicine arose as a moral enterprise. Part II details the invasion of the business ethic. In Part III, Geyman dissects the conflicts of interest medicine has with business, showing how patients get sold short. In the final section, Geyman shows that major reform is inevitable, and provides a roadmap for how professionals and laypeople together must renew medicine's social contract and reclaim its moral legacy.
About the Author
John Geyman is Professor Emeritus of Family Medicine at the University of Washington School of Medicine in Seattle, WA. He has spent 25 years in academic family medicine.. He is President of Physicians for National Health Insurance, PNHP, and author of Falling Through the Safety Net: Americans Without Health Insurance and Shredding the Social Contract: The Privatization of Medicare
What people are saying about The Corrosion of Medicine
"As public demand grows for thoroughgoing reform of our disastrous system, physicians must play a constructive role. No reform can work if they continue to be part of the problem, not the solution. It is for this reason that I am enthusiastic about Dr. Geyman's fine new book. He shows clearly that physicians are central to any health system, and offers a powerful argument that they need to reclaim their moral commitment to put patients' needs first." --from the Foreword by Marcia Angell, senior lecturer at Harvard Medical School and former editor-in-chief of the New England Journal of Medicine
"John Geyman shines a bright light on the challenges to professionalism in the 21st century. If our profession can respond to his call to action, both physicians and patients will be the better for it." --Christine K. Cassel, M.D., President of the American Board of Internal Medicine
"Everyone recognizes that our health care system is in crisis. Geyman uncovers the fundamental source of that crisis, in the decades-long attempt to impose market values on the practice of medicine. He shows that only by resisting the pressure to turn medical care into just another market commodity can medicine be restored as a profoundly moral and caring profession. This comprehensive look at the commercialization of medicine reveals, too, why physicians must take the lead, supported by the patients who depend on them for our care. We and our doctors should read it, and heed it." --Leonard Rodberg, Professor of Urban Studies, Queens College, City University of New York
" John Geyman has once again taken on one of the essential moral issues of our time--money and medicine. The Trojan horse of American business has brought money into medicine in ways doctors of an earlier epoch could never have imagined. Market principles have everywhere seduced physicians and left the profession compromised, weakened, and frustrated. Geyman's diagnosis is instructive and his prescription lucid. Corrosion is a major contribution to the reform movement in American health care." --Fitzhugh Mullan, MD, Murdock Health Professor of Medicine and Health Policy, The George Washington University
What people are saying about Shredding the Social Safety Net
"Dr. Geyman is a modern day Paul Revere. He warns America--with a stirring mixture of evidence and passion--of the wrecking ball the apostles of greed are taking to Medicare, a national treasure under attack." --Robert Hayes, President, Medicare Rights Center
"John Geyman has written a trenchant and timely contribution to the important debate on the future of Medicare--a debate that should engage families as well as policymakers." --Christine K. Cassel, M.D. President, American Board of Internal Medicine
"Everyone knows that the Medicare program is in trouble. The problem is how to fix it. Many politicians advocate further privatization of the program as a solution. John Geyman concludes that this is the wrong solution. He comprehensively and persuasively reviews the evidence, including both published research and the experiences of many of Medicare's beneficiaries, to support this conclusion. We rather need, Doctor Geyman argues, a renewed commitment to the original vision of social insurance on which the program was based. This readable and practical account should be read by anyone who is concerned about the Medicare program and its future, which should be all of us." --Timothy Stoltzfus Jost, Robert L. Willett Family Professor, Washington and Lee University Law School
"A passionately argued and powerful counterweight to the claptrap about 'modernizing Medicare' from the current Administration. Historically informed, this work by a doctor/advocate is well worth reading for its understanding of the assault Medicare actually faces by those who claim to be improving it. " --Ted Marmor, author of The Politics 0f Medicare
What people are saying about Falling Through the Safety Net
This is a most important book by one of America's leading experts. We are paying dearly in health system inefficiency and unnecessary pain and suffering because of the cracks in our safety net. Without attention to this issue as illustrated in this text, we will never eliminate disparities in health among different racial and ethnic groups in this nation. --David Satcher, 16th U. S. Surgeon General, Director, National Center for Primary Care at Morehouse School of Medicine
A compelling description of our dysfunctional health care system, a reasoned analysis of its problems, and a persuasive argument for a single-payer insurance plan as the best solution--written by someone with real understanding and first-hand experience. A much-needed lesson that ought to change a lot of minds. I recommend it strongly. --Marcia Angell, M. D. Senior Lecturer in Social Medicine, Harvard Medical School
Former Editor-in-Chief, New England Journal of Medicine
Falling Through the Safety Net provides a brilliant road map to this nation's patchwork of medical coverage for the uninsured. As a practitioner, teacher, and medical leader, John Geyman has learned his way around the safety net first hand. His book reflects that knowledge as well as his resolve to move beyond the safety net and put a firm floor of medical care in its place. Falling Through the Safety Net is an intelligent instruction manual for dealing with our present dilemmas and a vital prescription pad for moving beyond them. Powerful reading for all." --Fitzhugh Mullan, MD, author, Big Doctoring in America: Profiles in Primary Care
Once again, the legendary master of family medicine addresses with clinical compassion the widespread concerns about "unsurance" and uncovered medical costs. Geyman's well-researched recommendations should be read by everyone. --Donald Light, Professor of Comparative Health Care Systems, Princeton
This book elegantly reveals how our current system goes so wrong and then provides a ray of hope as it shines a light on the only logical solution to the health care crisis. It is a must read for any one who care about providing care to patients in need. --Claudia M. Fegan, MD President of Physicians for a National Health Program
A Note to Doctors from Don McCanne, M.D.:
This book was very difficult to read, not because of the complexity of the topic, but rather because of the anguish felt over what has happened to our profession.
Although physicians have been complicit in the processes leading to the corrosion of medicine, their blame lies not with an active role in commercializing health care, but rather with passive acceptance of their role in our current model of health care that is controlled by business and market interests.
When you ask a physician what his/her occupation is, he/she does not say that I am a businessperson in the health care industry. Almost without exception, the response is, "I'm a physician." That has much greater meaning than merely being engaged in an occupation that takes care of sick people. It is difficult to put into words, but every health care professional knows what I mean.
Although it was painful to be reminded of the compromises being made on behalf of the business of medicine, there is also real hope in the message in this book. You realize that it doesn't have to be this way. We do not have to passively accept the role of being workers in an industry controlled by market entrepreneurs.
We can become active advocates of reform that places our patients first. If we take health care financing out of the hands of the MBAs and place it under the control of our own universal public financing system, the patients and physicians will be able partner together in achieving the best health care possible within the confines of our finite resources.
Financing reform is only the first step, but it makes the other necessary reforms possible. Not only will we restore our pride in ourselves when we say, "I am a physician," our patients will once again understand the special meaning of medicine as a profession rather than as a mere business. --Don McCanne, M.D. Quote-of-the-Day, Daily Health Policy Update, February 21, 2008, pnhp.org