Critical Condition

How Health Care in America Became Big Business — and Bad Medicine

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Hippocrates said: “First, do no harm.” The first rule of Wall Street, however, is: Make money. Critical Condition, by the investigative team of Barlett and Steele, is a story about how health care in modern America has become a racket: A few profit handsomely while doing the rest of us significant harm.

The United States, the authors write, took a fateful turn during the Reagan Revolution of the 1980s, when faith in the free markets ushered in policies that transformed not-for-profit hospitals, HMOs, and nursing homes into money-making operations. The marketplace was supposed to make America healthier by delivering preventive care to the masses while controlling costs; instead, patient care has suffered and costs have skyrocketed.

Americans are now saddled with “a second-rate system that doesn’t adequately cover half or more of the population,” the authors write. “Almost everyone involved is unhappy—patients, doctors, nurses, aides, technicians,” everyone but the financiers and select CEOs who continue to get rich.

But in reading Critical Condition, the buccaneers of medicine — such as HealthSouth CEO Richard Scrushy — aren’t nearly as scary as the corporate bureaucracy that kills: by losing MRIs that show cancer, by placing desperately ill patients in call-waiting hell, by allowing vital medical decisions to trickle down to clerks in call centers.

Barlett and Steele describe countless avoidable tragedies that they ultimately blame on “Wall Street Medicine.” The nation, they argue, would be far better served by a broad, single-payer system, like Medicare, and an agency that would oversee health care much as the Federal Reserve manages financial policy. But the authors also make a safe diagnosis: American health care will get worse before it gets better.

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WHO DOESN’T LOVE A POSITIVE STORY—OR TWO?

“Great journalism really does make a difference in this world: it can even save kids.”

That’s what a civil rights lawyer wrote to Julia Lurie, the day after her major investigation into a psychiatric hospital chain that uses foster children as “cash cows” published, letting her know he was using her findings that same day in a hearing to keep a child out of one of the facilities we investigated.

That’s awesome. As is the fact that Julia, who spent a full year reporting this challenging story, promptly heard from a Senate committee that will use her work in their own investigation of Universal Health Services. There’s no doubt her revelations will continue to have a big impact in the months and years to come.

Like another story about Mother Jones’ real-world impact.

This one, a multiyear investigation, published in 2021, exposed conditions in sugar work camps in the Dominican Republic owned by Central Romana—the conglomerate behind brands like C&H and Domino, whose product ends up in our Hershey bars and other sweets. A year ago, the Biden administration banned sugar imports from Central Romana. And just recently, we learned of a previously undisclosed investigation from the Department of Homeland Security, looking into working conditions at Central Romana. How big of a deal is this?

“This could be the first time a corporation would be held criminally liable for forced labor in their own supply chains,” according to a retired special agent we talked to.

Wow.

And it is only because Mother Jones is funded primarily by donations from readers that we can mount ambitious, yearlong—or more—investigations like these two stories that are making waves.

About that: It’s unfathomably hard in the news business right now, and we came up about $28,000 short during our recent fall fundraising campaign. We simply have to make that up soon to avoid falling further behind than can be made up for, or needing to somehow trim $1 million from our budget, like happened last year.

If you can, please support the reporting you get from Mother Jones—that exists to make a difference, not a profit—with a donation of any amount today. We need more donations than normal to come in from this specific blurb to help close our funding gap before it gets any bigger.

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