Message-Id: <3.0.5.32.19980331213634.007e5e20@osf1.gmu.edu>
Date: Tue, 31 Mar 1998 21:36:34 -0500
To: MedSoc@csf.colorado.edu
From: "Jeanne A.B. Calabro" <jcalabro@osf1.gmu.edu>
Subject: Re: modernization & medicine: need help on concept
In-Reply-To: <Qp8MWzK00iWT0=IXw0@andrew.cmu.edu>
References: <3.0.5.32.19980331173452.007f0100@osf1.gmu.edu>
 <3.0.5.32.19980331173452.007f0100@osf1.gmu.edu>
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This was really my own extension of someone else's argument that came
pretty close. A Harvard historian wrote a paper (I don't have the reference
readily available, but I can get it for you) about three-four years ago,
discussing the context that would permit someone trained to preserve life
and have compassion for sick people to subject anyone to the medical
experimentation that occurred at the hands of German/Nazi doctors during
WWII. She also brought that discussion up to the present by saying that we
need to be wary about trends in modern medical practice that might also
transform people into "cases".  "Managed Care" could itself be viewed as an
experiment in the field of medical care practice, with very high stakes for
the welfare and health of whoever gets swallowed up in its path. Managed
care also seems to give momentum to the trend to devalue anyone without
perfect health, perhaps because they detract from the profit margins, or
perhaps just because everyone has been converted into a "case" by the "case
management" approach to giving care, and that the people most likely to
suffer from this approach are those most subjected to it because they need
care.
	The latter observation comes from experience and observation. In
fee-for-service health care, people were spoken of as the subjects of
medical care. Under managed care, they are spoken of as the recipients or
objects of care. It does tend to make a difference, not only in the
abstract, but in actual practice.

Jeanne Calabro
By the way, the reference I referred to is a brilliant analysis and really
sparked my thinking, for sure. I will try to dig the paper out again (I've
been moving back and forth between Massachusetts/Brandeis and
Virginia/George Mason University and everything is in boxes still) and send
you the reference.


At 07:22 PM 3/31/98 -0500, you wrote:
>Excerpts from mail: 31-Mar-98 Re: modernization & medicin.. by Jeanne A.
>Calabro@osf1.g 
>>         Also interesting is this trend of market-driven health care to
>transform
>>  
>> people into cases. This was the same trend (transforming people into cases)
>> that German physicians cited as the reason why Nazi doctors could perform
>> medical experiments on concentration camp residents.
>
>
>
>This is quite an interesting analogy.  
>
>Is there a citation for the argument that market-driven health care
>transforms people into cases in contrast to traditional, fee-for-service
>medicine (I assume that market-driven health care refers to managed
>care)? 
>
>
___________________________________________________________________
Jeanne A.B. Calabro		Home Phone:  703/450-5460
104 Norwood Place		E-mail:      jcalabro@osf1.gmu.edu
Sterling, Virginia 20164-8503	Affiliation: Brandeis University
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"Sociology changes the world." Personal opinion
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