AANS Neurosurgeon | Volume 29, Number 1, 2020


CODE BLUE: Inside America’s Medical Industrial Complex – A Review

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CODE BLUE: Inside America’s Medical Industrial Complex
Mike Magee, MD
Grove Atlantic
New York

Compared to other industrialized nations, our healthcare system delivers mediocre results at exorbitant costs. Here is a book that makes it painfully clear why we are doing so poorly. Mike Magee, MD, claims that we do not care about results; we care about the bottom line. Big Pharma, insurance companies, hospitals and the American Medical Association make up the Medical Industrial Complex (MIC) that rules health care in the U.S.

Dr. Magee should know. He has been an executive in the drug industry, hospitals and physician organizations.

Hospitals account for one-third of all annual U.S. health care costs. Their billing procedures are difficult to decipher and filled with human error, which seriously undermine patient trust. In addition, avoidable hospital errors are the third most common cause of death in America! Death rates in hospitals have nearly quadrupled in the past 15 years. The performance of hospitals is especially dire for women. Pregnancy-related death rates in the U.S. have more than doubled in the past 25 years. Three times as many mothers die in childbirth in the U.S. as do women giving birth in Canada or England.

Now, more than half of all physicians are employees of hospitals. These doctors average less than $300,000 per year in salary, although the executive of their non-profit organization often makes more than $10 million per year. Physicians, however, have a central role in generating the greatest part of all health care costs in America, since we are the ones ordering many of the things that cost money.

Dr. Magee reports that the MIC is now equal parts politics and science. It has been successful at dramatically increasing profits for pharmaceutical companies by dismantling regulatory checks and balances to speed drug approval and the releasing of government patents. The development of Pharmacy Benefit Managers (PBMs) has been a disaster. PBMs are now the Grand Central Terminal of the legal trade of drugs and are responsible for negotiating the deals for each and every drug. Four-and-a-half billion prescriptions are filled each year. Fifty percent of everyone in the U.S. has filled a prescription in the past month!

The U.S. has embraced the culture of big-ticket research and development as if it were a substitute for rational health planning and delivery. As a result, we now have academic health systems and industry centers of innovation that are reaping huge profits. So, in the U.S. we spend more on health care than all other social services combined.

So what is Dr. Magee’s solution to this terrible situation? He thinks the only conceivable solution is a single-payer system. He points to the fact that, at the end of World War II, the U.S. military built out national health systems for both Germany and Japan. Both of these countries provide better results at half the cost. So, Dr. Magee closes his book with a remarkable statement:

“Rather than resisting this approach, once seen as ‘un-American,’ our citizens are beginning to see single-payer oversight/multi-plan universal access to affordable and effective care as the essential next step toward ensuring what should be every American’s birthright – life, liberty and the pursuit of happiness.”

Read this book and see if you agree!


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Chuck Fahey | January 4, 2020 at 6:04 pm