CLINICAL LAB SCIENEC

CHAPTER 7: MEDICAL ECONOMICS AND LABORATORY EQUIPMENT 157
Medical departments where patient care is rendered are usually managed by
specialists from various departments in the health care facilities.
Medical care consumes a large portion of our national gross domestic product
(GDP) annually. The medical industry is now larger than the federal Department
of Defense. The costs of medical care have risen from a modest 5% of the GDP
in 1960, to 14% in 1998, and to an estimated 16% currently! Blame has been
laid at the doorstep of many offices within the medical care system. It has been
popular for many years to blame the physician for the rise in health care costs.
But the rise in health care costs cannot be blamed on any individual or group of
individuals, but possibly on the mismanagement of resources and the lack of a
prudent use of available technology. Perhaps George Bernard Shaw, Irish dramatist,
literary critic, and socialist spokesman, was attempting to focus on
preventive medicine in a backhanded manner, when he defended physicians as
follows:
It is not the fault of our doctors that the medical service of the community,
as presently provided for, is murderously absurd ... to give a surgeon
a pecuniary interest in cutting off your leg, is enough to make one despair
of political humanity ... and the more appalling the mutilation, the more
the mutilator is paid. He who corrects the ingrown toe-nail receives a few
shillings; he who cuts your inside out receives hundreds of guineas, except
when he does it to a poor person for practice.
George Bernard Shaw (1856–1950)
The Medical Consumer
In the beginning, the services of physicians were mostly directed toward the more
affluent in communities. Those with less money and influence relied on folk remedies
and subjective diagnoses by members of the community who often had selfappointed
curative abilities. Most of the ill had to get well on their own without
the benefit of the medical profession, or to suffer the alternative fate of death.
Delivering babies was left to the skills of either midwives or female relatives who
had the practical experience of having their own babies and then assisting with
others. “Native healers” such as Native American medicine men or priests provided
some medical care, and religious orders sometimes built hospitals as part of
their mission to their parishioners and the poor. Surgery was sometimes performed
by barbers and most anyone could set a broken bone, no doubt leading to a great
number of bone deformities.
Medicine gradually and all-too-slowly evolved into what it is today. But
still, many common ailments such as the common cold and other viral infections
have resulted in few advances in the arsenal of the physician for effective treatment.
However, medical care for a variety of conditions has greatly improved,
and some advanced procedures fall just short of the miraculous. Treatments of
illnesses associated with aging and techniques to deal with injury and infectious
diseases have advanced so much that the physician of the past bears little
resemblance to the physician of the present. Today, medical care is considered by
most to be a right of everyone, and if a patient has no money or insurance, care
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