Healthcare in America: Let That Tapeworm Grow

Dr George Lundberg in 1966 (left) by Marita Bitans and in 2019 (right) by Mary Heersink

In my most recent column, 'They All Laughed When I Spoke of Greedy Doctors,' I attempted to provide a global understanding of some of the economic forces that have made American medicine what it is, how that happened, and why it is still happening.

I did not propose a fix. I have been proposing fixes for more than 30 years, on the pages of JAMA until 1999 and then on Medscape, most recently in 2019 with Healthcare for All in a Land of Special Interests.

Where you stand depends a lot on where you sit.

Is this good news or bad news? When William Hubbard was the dean of the University of Michigan School of Medicine in 1969, he said that "an academic medical center is the most efficient energy and resource trapping device that has ever been created" (Personal communication, 1969).

To me as a faculty member of an academic medical center for many years, that was great news. We could grow faculty, erect buildings, take the best care of sick people, churn out research papers, mint new physicians and specialists, and get paid well in the process for doing "the Lord's work." What's not to like? At that time, the proportion of the country's GNP expended for medical and healthcare was about 7%. And the predicted life span of an American at birth was 70.5 years.