WE are in the midst of a corporate revolution in healthcare, and it is changing the lives of everyone involved in healthcare. The current changes are spreading rapidly across the country and represent the greatest upheaval in healthcare since the Flexner reforms of 80 years ago. Those reforms established medicine as a science, by locating training and research in medical schools and universities. The current corporate revolution is transforming healthcare from a cottage industry of small group practices to a big business dominated by highly competitive regional and national corporations. It is impossible to overestimate the impact of these changes.
Unlike Clinton’s unsuccessful efforts at healthcare reform, the corporatization of healthcare is being driven entirely by cost considerations. Businesses and governments are no longer willing to pay rising healthcare costs. However, at a recent meeting out west, major corporations pledged that once healthcare costs come under control, as they have in some areas of the country, the benefits offices of these companies will pay more attention to quality of care.
This new healthcare system will be dominated by large, vertically integrated, regional healthcare systems that are fully capitated, that is, providers are paid for managing patients’ overall
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