There are 2 completely different aspects to these changes. One of them highly positive, and another that means a problem that can invalidate in a certain way the great advances mentioned.
- The positive change refers to the advancement of an organized medicine for the individual treatment of patients, towards a social medicine, which tries to organize it for the benefit of the community, that is, medicine organized to serve all the inhabitants of a country or a group.
- The negative change in the paradigm of medicine is the conversion of an eminently humanistic and social benefit profession, which for centuries has been aimed only at trying to benefit the patient, to a medicine conceived as an industry, where the disturbing element is that it must also seek the benefit of the investors who have created this industry.
In the positive change, that of social medicine, to organize group care, there are also differences: some countries have developed it through large public institutions, organized by the State for the care of their inhabitants.
This was the purpose of the creation of the Mexican Social Security Institute (IMSS) in Mexico in the middle of the 20th century; Consistent with this decision, the country had to extend this coverage to all its inhabitants during the second half of the 20th century, if not as social security, at least as an extension of health care coverage. It didn’t happen that way.
Other countries, including the United States of America, have decided to offer health care to their inhabitants through private medical insurance, whether supported in part by the State, or by employers, or by the citizens themselves.
This decision has not only turned medicine into a large industry in that country
It is also responsible for the negative change in the paradigm, with many consequences that have deteriorated the practice of medicine and have made it the most expensive in the world. , and not in the best quality.
In some way, some of the great advances in medicine have led to its conversion into an industry. The resources for diagnosis and treatment are so numerous and complex that it has not been possible for doctors alone to organize care centers.
- This situation has aroused the interest of investors, who naturally seek returns on their investments; This means that the sole purpose of medicine, which is the good of the patient, must now be shared with the productivity of the investment, that is, the good of the investors.
- If only in the United States this negative change occurred, it would not be a cause for our concern. What happens is that since medicine has been organized as an industry, there is a tendency to export it and this is partly responsible for the fortunately isolated occurrence of some of the events that constitute this change in our environment.
- This has changed the paradigm of medicine: from being an eminently socially beneficial profession that does everything solely for the benefit of the sick, and that with the great scientific and technological advances it has today it could do better, now, with the change from profession to industry (which in part nullifies the great advances), these advances are limited to privileged strata of society.
This analysis of change aims to point out the dangers that have appeared in the practice of medicine in the United States; It is very important to state without haggling that the aforementioned achievements, in knowledge and in medical technology, also come from this medicine;
However, the problems that will be analyzed also arise from that medicine, not ours, which for the most part remains faithful to the postulates, to the paradigm of a humanitarian medicine, which takes advantage of the great advances in science and technology of American medicine. and European, but retains its social service profile. As some areas of our medicine copy the profile of that of the northern country, this preventive analysis is worth its growth.