Severed Trust: Why American Medicine Hasn't Been Fixed

Severed Trust: Why American Medicine Hasn't Been Fixed

Severed Trust: Why American Medicine Hasn't Been Fixed

Severed Trust: Why American Medicine Hasn't Been Fixed

Synopsis

This no-holds-barred book includes a new chapter presenting a comprehensive, politically achievable, private-public solution to the health care dilemma -- one that preserves the best of the present system, eliminates the worst current problems, and represents our nation's last best chance to contain costs without a government takeover of medicine.

Excerpt

In October 1998, I WAS in Hong Kong as an invited speaker at an international medical congress. Several hundred researchers were there, representing many countries, languages, cultures, and institutions. As the editor of the Journal of the American Medical Association, I was assigned to a panel on medical ethics, specifically the ethics of medical journals.

The topic was close to my heart. During my seventeen years as editor of JAMA, many of the articles and studies that I published on health and social issues also had ethical overtones. These included calls for gun controls, seat belt and motorcycle helmet legislation, curbs on drunken driving, a total ban on boxing, and challenges to the process of how medical journals work. Some of my positions on these and other issues took me outside the mainstream medical establishment, but all were mediated by ethical considerations.

At the Hong Kong conference, a fellow panelist was Poul Riis, a former editor of the Danish Medical Journal who had retired after twenty-five years of service. Poul also happened to be a member of the JAMA editorial board. During a panel break, he asked me how things were going with the American Medical Association. "Not well," I had to confess. An outcry over an agreement to endorse commercial products manufactured by the Sunbeam Corporation had led to top management turnovers. The problem with Sunbeam had been solved when the AMA backed away from the deal, but as might be expected, the resulting mood was uneasy. My relationship with senior management was affected, I told Poul, for several rea-

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