Gilded Age of Medicine : Dhruv Khullar / The New Yorker

Article shared by John Gilmartin

To my surprise The New Yorker published one of the clearest and potent pieces on how healthcare in the USA has changed in recent years. Many of us on this message have heard about the Seward health issues, but this piece makes it very clear. The current governor of MA was the attorney general who originally blessed the deal that enabled Cerebus to pull off this debacle.

Is the Seward collapse having an impact? My pulmonary doc was one of 11 physicians in his group before Seward, he's now one of three, his patient total in his care has doubled. All his other colleagues have either retired or left the practice. My primary care doc, now must log into every session with a patient and cannot exceed her allotted talking time. Since I like to talk a lot, she has to gently tell me she can't, and move on. She's told me she counts the days to her retirement, and can't encourage her med school students to follow in her career choice. My previous internist was asked to leave his practice partly because he complained he no longer practiced medicine, "now I work for insurance companies." Both of his children are in med school today, but he is disillusioned. A friend who was head of anesthesia for a local hospital told me regularly supervises multiple surgeries in a day. But, he has no idea who or how much he will be paid for any of these procedures, his medical group administrator receives payments from at least five different organizations. A senior urologist with over 20 years surgical experience described receiving $2,000 per procedure that he performed 20 years ago. The same procedure now pays him $500 for the same work. He's not going broke by any means, but he's not happy with how his work is paid.

I continue to be very grateful for the quality of care that I'm fortunate to receive. But, the administration of how we manage and pay for our care now attention.

John Gilmartin

Click here for the article


"Health insurers and hospitals increasingly treat patients less as humans in need of care than consumers who generate profit."

Summary

Private equity's growing influence in U.S. healthcare has led to worsening patient care, declining hospital conditions, and rising corporate profits. Cerberus Capital Management’s acquisition of Steward Health Care resulted in hospital closures, staffing shortages, and patient neglect. Studies show that private-equity ownership of hospitals and nursing homes increases mortality rates, while insurers like UnitedHealth gamify diagnoses to maximize Medicare payments. Medicine has shifted from a mission-driven profession to a profit-driven industry, prioritizing revenue over patient care. Physicians are increasingly constrained by administrators, and healthcare systems cut essential services to boost financial performance. Efforts to curb corporate dominance are growing, but the healthcare system remains dangerously commodified.

Key Quotes:
“We are being picked clean by private equity,” a radiologist warned, as hospitals owned by private-equity firms reported worse patient outcomes and overcrowded emergency rooms. “Patients are forced to sleep in hallways, and doctors who speak out are threatened with termination.” Private insurers, meanwhile, incentivize doctors to inflate patient diagnoses for profit. “Insurance companies are pouring tremendous resources into coding patients to get more money from Medicare.” Physicians lament that hospitals now treat patients as revenue generators rather than people in need. As one doctor put it, “I don’t get out of bed at 2 a.m. for consumers—I do it for patients.” Yet amid cuts to essential services, a reminder remains: “No money, no mission, but no mission, no need for money.”