Managed Care

By C. Norman Shealy, MD, Ph.D.

As I see it, managed care really is mangled care. We are in a period which is perhaps the Armageddon of medicine in the United States. In the city of Springfield, Missouri, 90% of physicians are now owned lock, stock and gonads by the two large hospitals. The two hospitals are competing within themselves not only to own the physicians in town, but also to own every rural clinic within any kind of reasonable commuting distance.

Young physicians coming out of training are in debts of 150,000 or more. If they try to go into regular practice, 90% of the offerings will be to become part of the salaried, totally controlled, mafia driven hospital/managed care/HMO complex. If the physicians choose to go with that, with interest at price plus 3%, it could take them many, many years to pay off their debt. If they choose to go into one of the rural clinics where the government will assist them in repaying the debt, they are thrown into an extremely high tax bracket by the “gift” of the government of part of their loan each year, so they still wind up being owned and controlled by the mafia.

As I define the mafia in my book, Third Party Rape, it consists of the hospitals working in cahoots with the medical insurance industry, working in cahoots with the federal government, working in cahoots with lawyers. At this point, the battle has shifted so that hospitals are beginning to battle with the insurance companies but still remain in cahoots with the legal profession and the federal government.

It is fascinating that at a time when the public already wants alternative medicine, at least as much as they have wanted conventional primary care, the source of primary care is drying up and the attack upon alternative practitioners is growing. Only those physicians and alternative practitioners with intense strength are likely to survive. Those who become pawns of the system have already lost their freedom and to a large extent their medical integrity.