The medical–industrial complex is the network of corporations which supply health care services and products for a profit. The term is analogous to "military–industrial complex" and builds from the social precedent of discussion on that concept. The medical–industrial complex is often discussed in the context of conflict of interest in the health care industry.
Term
The concept of a "medical–industrial complex" was first advanced by Barbara and John Ehrenreich in the November 1969 issue of the Bulletin of the Health Policy Advisory Center in an article entitled "The Medical Industrial Complex" and in a subsequent book, The American Health Empire: Power, Profits, and Politics. The concept was widely discussed throughout the 1970s, including reviews in the New England Journal of Medicine. It was further popularized in 1980, Arnold S. Relman while he served as editor of The New EnglandJournal of Medicine. in a paper titled "The New Medical-Industrial Complex." Relman commented, "The past decade has seen the rise of another kind of private "industrial complex" with an equally great potential for influence on public policy — this time in health care..." Oddly, Relman added, " In searching for information on this subject, I have found no standard literature and have had to draw on a variety of unconventional sources..." Subsequently, this paper and the concept have been discussed continually. An updated history and analysis can be found in John Ehrenreich, "Third Wave Capitalism: How Money, Power, and the Pursuit of Self-Interest have Imperiled the American Dream".
Characteristics
Manufacturers of medical devices fund medical education programs and physicians and hospitals directly to adopt the use of their devices. The management of health care organizations by business staff rather than local medical practice is one of the trends of the increasing influence of the medical-industrial complex. Another trend is that increased pressure to generate profit for providing services can decrease the influence of creativity or innovation in medical research. In the 1970s profit-seeking companies became significant stakeholders in the United States healthcare system. The influence of economic policy on the practice of medicine has a long history. Because the General Agreement on Trade in Services regulates international marketplaces, in countries where the industrial-medical complex is more strong there can be legal limitations to consumer options for accessing diverse healthcare services. Because the industrial-medical complex funds continuing medical education, this education has a bias to promote the interests of its funders.
