How Money Shapes Medicine

Health care is a billion dollar industry in the U.S. — one of the biggest in the country. The business aspect of medicine is an invisible force in the doctor’s office that shapes treatment decisions and care. As patients, financial worries can affect whether we go to the doctor in the first place, make us suspicious of expensive procedures, or even cause us to turn down necessary care. And patients aren’t the only ones worrying about money — on the provider side, everyone from doctors to hospitals to insurance companies are also weighing the costs and benefits of expensive tests and treatments, along with whether or not patients can pay.

On this episode, we explore the complicated relationship between medicine and money, and how it affects patient care. We learn about the history of medical debt and why some patients end up in court over unpaid bills; we find out how financial incentives affect pharmaceutical companies’ decisions about what treatments to develop; and we hear about a controversial practice that some are calling medical deportation.

Also heard on this week’s episode:

• We talk with medical historian and emergency room physician Luke Messac about how medical debt became a big business in the U.S., its effects on patient care, and what doctors are doing to fight back. Messac is an instructor of emergency medicine at Harvard Medical School and an attending physician at Brigham and Women’s Hospital in Boston. His most recent book is Your Money or Your Life: Debt Collection in American Medicine.