Donald M. Berwick
JAMA. 2017;318(21):2081-2082.
Here is an excerpt:
Hospitals today play the games afforded by an opaque and fragmented payment system and by the concentration of market share to near-monopoly levels that allow them to elevate costs and prices nearly at will, confiscating resources from other badly needed enterprises, both inside health (like prevention) and outside (like schools, housing, and jobs).
And this unfairness—this self-interest—this defense of local stakes at the expense of fragile communities and disadvantaged populations goes far, far beyond health care itself. So does the physician’s ethical duty. Two examples help make the point.
In my view, the biggest travesty in current US social policy is not the failure to fund health care properly or the pricing games of health care companies. It is the nation’s criminal justice system, incarcerating and then stealing the spirit and hope of by far a larger proportion of our population than in any other developed nation on earth. If taking the life-years and self-respect of millions of youth (with black individuals being imprisoned at more than five times the rate of whites), leaving them without choice, freedom, or the hope of growth is not a health problem, then what is?
The article is here.
