Cancer, Radiation Therapy, and the Market

Description

Appraising cancer as a major medical market in the 2010s, Wall Street investors placed their bets on single-technology treatment facilities costing $100-$300 million each. Critics inside medicine called the widely-publicized proton-center boom "crazy medicine and unsustainable public policy." There was no valid evidence, they claimed, that proton beams were more effective than less costly alternatives. But developers expected insurance to cover their centers' staggeringly high costs and debts. Was speculation like this new to health care? Cancer, Radiation Therapy, and the Market shows how the radiation therapy specialty in the United States (later called radiation oncology) coevolved with its device industry throughout the twentieth-century. Academic engineers and physicians acquired financing to develop increasingly powerful radiation devices, initiated companies to manufacture the devices competitively, and designed hospital and freestanding procedure units to utilize them. In the process, they incorporated market strategies into medical organization and practice. Although palliative benefits and striking tumor reductions fueled hopes of curing cancer, scientific research all too often found serious patient harm and disappointing beneficial impact on cancer survival. This thoroughly documented and provocative inquiry concludes that public health policy needs to re-evaluate market-driven high-tech medicine and build evidence-based health care systems. Cover Half Title Series Page Title Page Copyright Page Table of Contents List of Figures Chapter 1 Medical Care as Trade Markets and the Medical Business System Medical Specialties and High-Cost Procedure Units Building a Radiation Therapy Industry Science and Practice Cancer and Radiation Therapy in the United States Markets and Policy Outline of the Book Notes Part 1 Radiation Enterprise, 1895 to World War II Political and Economic Environment Notes Chapter 2 The Medical Radium Industry Radium Pioneering The Standard Chemical Company A Public–Private Joint Venture Geopolitics and Medical Radium Questions of Radium Use and Its Clinical Effectiveness Notes Chapter 3 The General Electric Company Dominates X-ray A New Therapy Tube Brings GE Back into the X-Ray Business GE Escalates Voltage and Builds a Product Line The Company Promotes Business Strategies in Medicine (and Beyond) Notes Chapter 4 Competing Research Universities Supervoltage Treatment at Caltech Academia and Industry at the University of California MIT Enters the Megavoltage Race Research on the Use and Therapeutic Effectiveness of Radium and X-ray Notes Part 2 Competitive Megavoltage, World War II to the 1970s Political and Economic Environment Notes Chapter 5 Megavoltage Competition in Academia and Industry General Electric Tries Everything High Voltage and Venture Capital at MIT The Most Powerful of All at California Notes Chapter 6 Medicine’s Nuclear Arms Race Ontario versus Saskatchewan The Rise of the Texas Medical Center Entrepreneurship in Practice and Research Cobalt Treatment Booms Effectiveness Research Notes Chapter 7 An Economic Success Story at Stanford Higher Education: A Highly Competitive Business A Technology, a Company, and an Industrial Park Technology Development at a Self-Financing Medical School Commercializing the Medical Linear Accelerator Money and Power in the Radiology Department Kaplan Takes On Hodgkin’s Notes Chapter 8 Radiation Therapy Politics Data and Discourse Politics and Policy Notes Part 3 Financializing Medicine, 1970s to the 2010s Political and Economic Environment Notes Chapter 9 Speculating on Proton Therapy Raising the Stakes Management Company/Manufacturing Alliances Proton Manufacturing Accelerates Practice versus Science The Case of the Prostate Gland Public and Private Health Policy The Insurance Industry Challenges Proton Therapy Globalizing Particle Centers Notes Chapter 10 Rationalizing Radiation Therapy, Reforming Health Care Taking the Measure of Cancer and Radiation Therapy Health Care Reform Notes Chapter 11 Choosing Health Over Wealth Market Strategies Re-Forming Health Care Notes Acknowledgments Selected Bibliography Archival Collections Books, Chapters, Dissertations, Journal Articles, and Reports Index