#19---Corporations and Health Care

These writing assignments are meant to help you think about the readings and to prepare you for class discussions. For that reason, when you write a response it is important that you give your opinions and that you relate your thoughts to the reading. Remember that these are exam questions and that they are graded as such. You ought to write them as though you are writing questions on a midterm or a final exam.

Respond to one of the following questions by writing a response on the class Discussion Board on Blackboard at least one hour before class on the date the question is listed. Put your name in the text of the question and give the question number as listed below. Without these I can't tell who wrote the question or what you are responding to. You then have until Midnight on the following Sunday of that week to revise your response if you wish to do so and to submit it for grading. To submit your responses, send them via email to milofsky@bucknell.edu.

Your final version of this question is due by midnight, Sunday, November 8.

19-1. Why must medical care be based on trust?

Relating to Mahar's discussion, one part of your answer should talk about the market as an alternative system for making medical care decisions to a system based on trust. What assumptions are built into the market? Why don't these discussions apply to health care and work to properly govern decisions about what care to provide or to give us confidence that the system is efficient and accountable?

19-2. Why, historically, have doctors resisted corporate control of medical practice?

Mahar gives two answers to this question. One has to do with power and the other has to do with complexities inherent in the doctor/patient relationship. You need to explore both of these answers in some detail and tell which how you balance them in terms of figuring what is true.

19-3. Why did health care costs expand rapidly between 1965 and 1990?

Do not simply relate the history that Mahar provides, athugh that is the focus of her discussion. Many people believe health care cost increases have to do with advances in technology, the aging of the population, and unnecessary medical care. While these are important factors, Mahar gives an explanation that is more structural, talking about health policy and the way institutions were set up or were changed so that health costs increased rapidly.

19-4. Is "the corporation" bad for medicine?

You need to consider doctors' claims, assertions about economic self-interest that guides big health care institutions (like the drug industry), on one hand, and shortcomings inherent in a system organized around autonomous doctors on the other. What are short cominghs of the doctor-based system? How might coporate medicine reduce those problems? Having done this analysis and looking at Mahar, how would you talk about whethe corporate medicine is a net positive or a net negative influence on medical care?