Abstract

Commercialism first became a major problem for medicine in the decade of the 1970s, when huge quantities of new money began to flow into the healthcare system, as a result of Medicaid and Medicare, and the rapid expansion of private, employer-based insurance. Of course, physicians benefited, but most of this new money went to insurance plans and medical care delivery institutions, like hospitals, nursing homes, diagnostic services, and ambulatory care facilities of many kinds. Many of these were newly established for-profit businesses. A vast number of satellite enterprises sprang up to serve the growing needs of the new businesses by providing services like marketing and advertising, brokering, consulting, information technology, financial services, case and disease management, billing and collecting, and so forth