THE MEDICAL INDUSTRIAL COMPLEX

A straightforward, alarming description of the giant profit-making corporations that are fast becoming the major force in American health care. Wohl himself is involved in both the public and private sector: he is on the Stanford U. Medical Center staff, and president of InfoMed Systems, Inc., a health care services company. One of his concerns is that the new medical-industrial complex (MIC) has wrested financial and decision-making power from physicians; in that case, says Wohl, quality of care must suffer. But Wold does not chiefly argue such points of view, or rigorously examine how the present situation came to be (as did Harvard's Paul Start in The Social Transformation of American Medicine). Rather, Wolff simply and clearly depicts the extent to which the medical care industry has infiltrated the health care system during the last 10 years. This term no longer refers as it did in the Sixties to the alliance between the powerful drug/pharmaceutical industry and university-based research centers; the new MIC is made up of ""corporate health care providers""--fast-food-like chains of hospitals, nursing homes, free-standing clinics and emergency-care facilities that hire physicians as employees, operate mainly in well-insured suburbs, and rely on overutilization of services to maintain their enormous profits and rates of growth. The MIC, now growing faster than the computer industry (it is one of Wall Street's plums), still receives little public attention: while government, physicians, and consumer groups were battling over who should control health care, the MIC stepped in and took over. To fill out this general picture, Wold profiles 35 or so of the most influential MIC corporations--among them Humana, Connecticut General Insurance, Lifemark, and Hospital Corporation of America. The description of their individual growth and holdings is astounding. For an eye-opener, this is fine. For the reasons why, go back to Starr.