Rising healthcare costs are often erroneously blamed on the escalating costs of nursing care, new technologies, development of new drugs and an aging population. In his newest book, The Corrosion of Medicine: Can the Profession Reclaim its Moral Legacy, Dr. John Geyman presents well documented proof that the real cause of escalating healthcare costs is free market capitalism.

Over the past 40 years, healthcare has evolved from a morals and service-based, social contract into a marketplace controlled by corporations to create profit for shareholders. Like pork bellies and wheat, healthcare has been reduced to a commodity for sale on the open market. Geyman quotes Richard Scott, co-founder, chairman, CEO and president of Columbia/HCA Healthcare Corporation,

"Do we have an obligation to provide healthcare for everybody? Where do we draw the line? Is any fast-food restaurant obligated to feed everyone who shows up?"

Kickbacks, referral income, profits from investing in their own facilities, financial incentives for cutting costs and gifts from drug, medical device and medical supply companies have lulled the majority of physicians into complacency. The Hippocratic oath has been rewritten to read, "First, do make profits." Geyman cites seven HMO CEOs who, in 2003 alone, earned up to a healthy $50.9 million.

Private insurance industry lobbyists have managed to limit the government's healthcare debate to an argument over which insurance corporations will receive the biggest windfall.

Meanwhile, lower-income people needing care are increasingly marginalized and left behind, as hospitals and specialty medical centers make their escape to affluent suburbs and insurance carriers find ways to cherry-pick people without high-dollar health risks.

"The costs of care have become increasingly unaffordable for at least one-half of the US population. The Institute of Medicine has found that 8 million uninsured people with chronic disease have increased morbidity and worse outcomes, that 18,000 Americans die prematurely every year, and that the costs of diminished health and shorter life spans amounts to between $65 and $130 billion each year," Geyman writes.

This profiteering has also gutted public health programs throughout the nation. Geyman writes, "... more affluent insured Americans will find themselves as vulnerable as their lower-income and uninsured counterparts when trauma and burn centers have closed due to lack of funding or when a newly drug-resistant infectious disease spreads throughout the entire population without regard to socioeconomic groups."

Geyman concludes that the only solution to America's healthcare woes is a single-payer system of health insurance, i.e. national health insurance or Medicare for all.

Geyman organizes and substantiates his arguments within four sections:

I. How medicine arose as a moral enterprise.
II. The invasion of the business ethic.
III. How conflicts of interest sell patients short.
IV. Reclaiming medicine's moral credibility.

Geyman ends the lengthy, well-documented work on a note of hope. However, the writer of this review has little expectation that the industrial healthcare complex will revert to an equitable, morals-based enterprise as long as free market capitalism reigns as the underlying economic force within these United States.

John Geyman, The Corrosion of Medicine: Can the Profession Reclaim its Moral Legacy, (Common Courage Press, 2008).