Ch. 6

I'll admit that this chapter confuses me. In it, Starr tackles the questions of capitalism's role in shaping or motivating the American medical movement. In my interpretation of the chapter, Starr takes a stance that refutes the belief that capitalism was the driving force behind the medical movement.

I find this inconsistent. If anything, Starr's examples in previous chapters seems to support the idea of capitalism's driving hand behind the vehicle of expanding the influence of medical profession. True, Starr refutes the concept of corporate capitalism's influence (and that seems consistent, in that physicians still demanded individual autonomy) but he continues in the chapter describing alternate motivations that seem, if anything, to be technicalities.

For example, he claims that "the main function of medical licensing was not so much to exclude rival practitioners as to cut down on the number of regular physicians by making medical education unprofitable." The same actions sought to eliminate the number of rival practitioners in order to maintain soverignty with their patients. What does it matter if the action was direct or indirect? The action of compromising commercial medical schools seems to have the same effect at reducing the total number of physicians as licensing would have.

And while medicine "played an insignificant role in sustaining democratic capitalism in America," it's clear that the spirit of capitalism was maintained in scientific medicine. As Starr seems to outline the motivations of the medical movement, every action seemed to work toward sustaining the influence, status, power, and commercial authority of the medical professional. Competition was eliminated, particularly those efforts that compromised the charges made by professionals (see the previous entry on disbanding health clinics). Eliminating competition, eliminating the expression or threats of capitalism, seem paradoxically capitalistic to me. It demonstrates reverence to the system and the utilization of its principles to reach top-dog status. Once they obtained the level of control and authority, they attempted to disengage the system to keep others from threatening what they had achieved.

Destroying the ladder once they reached the top doesn't erase their history of using it to get there.