I recently read “The Biomedical Empire” by Barbara Katz Rothman, an American sociologist. An astonishing book. She calls it “Empire”, whereas I prefer “Medical Industrial Complex”. The cooperation between patient organizations, doctors, researchers, government industry and payers that work for patients but do not necessarily benefit the quality of life of the patient. Rothman: “Whenever you save on costs, you’re also cutting down on income generated. The Biomedical Empire needs sick people, dying people, consuming people”. Now that’s a statement. And it’s true. The worst thing that can happen in the Empire is for us to prevent sickness…

Healthcare has drifted away from its essence. We used to think about health in terms of clean air and water, exercising, eating healthy food, helping people and caring for patients. But instead, health is now defined as a set of beliefs in biomedicine, with rules, regulations, supervisors and hospitals. Healthcare nowadays always means medical services. And hospitals have turned into industries that need to be filled with patients.

We used to do this internally, but with new technology, we move towards virtual consultations and more and more virtually executed diagnoses. The story is; “All for the benefit of patients” but in practice we see most benefit in terms of revenue and profit. Diving into this we see, for example, that banks are making the most revenue and profit in healthcare because of all the necessary financing. A good study on this is from Gupta Strategists: “The cost of opportunity”.

The conclusion that I share with Rothman is that the more you are distracted from the essence of your work (“Why am I doing this?”), the easier it is to go for the money. Whereas banks make the most from it, nurses have the lowest salaries. Because they are with the patients for 10 hours a day.

Rothman continues: “Marx was right, that the state has become essentially the committee for managing the affairs of the bourgeoisie…we need to look directly at biomedical imperialism: how a set of beliefs, the religion of biomedicine, working with governments and laws, created a climate hospitable to its industrial, economic goals”. Again, quite a statement. But looking outside our windows we see a good marriage between governments and industry working hand in hand to get the pandemic under control and they have so much focus on this that they don’t see the collateral damage done to (for example) cancer patients.

So how can we do something about this? Close the distance between the patient and those working in the Medical Industrial Complex. Work with each other and cooperate. Show governments the results of their ways and work together to improve that. Show the payers and the banks the effect of their way of working and demand cooperation. Because the only way to do good is to contribute to other people and make them flourish. Whether you’re a patient, a nurse, a researcher or working in industry, it’s all about “We”. How can we contribute and make each other flourish?

Peter Kapitein
Patient Advocate Inspire2Live