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Health industrial complex?

HEALTH INDUSTRY / Can Eisenhower's warning against neoliberalism be transmitted to today's health care industry?


In his farewell speech to the American people in January 1961, Dwight Eisenhower launched the term military-industrial complex as an attempt to describe a public-private collusion he believed existed between the weapons industry and US military policy. Eisenhower's points are somewhat more complex than direct charges of simple corruption. Among other things, he points out a form of industrialization and bureaucratization of research that is at the expense of free intellectual thought and which, in consequence, runs counter to the development of good and sensible solutions of public tasks. Not without reason, Eisenhower's concept has become part of the concept canon of political science. Eisenhower predicted, and warned against, what we today know as neoliberalism and "New Public Management".

service Industry

Can Eisenhower's points be transferred to today's situation, where we see exponentially rising spending and a galloping service industry around the health care professions? I thought I had come up with an original idea when I formulated the concept for myself health-industrial complexbut a search on Google found, not surprisingly, that this concept was launched in academia as early as 1969. There is extensive literature on the subject, most of it about what we know today about the pharmaceutical industry's impact on medical thinking and development. Are we now seeing a new dimension in the health-industrial complex, where the industry sells services, thinking and management systems?

Dialectic – for some reason I hesitate to use the term dialectical materialism – has taught us that we need to look for paradoxes and obvious contradictions if we want to understand processes where power, interests and knowledge formation are intertwined. George Orwell embedded this insight into his concept new speech, which has not surprisingly gained a renewed interest in recent times. One element of the news talk is that words for confusion are used in such a way that one would think they had the diametrically opposite meaning of what they seem to have.


patient safety is a word that is increasingly being heard in connection with health research, health administration and health policy. The medical study teaches patient safety in a subject called knowledge management, management and quality improvement, which is shortened to the acronym KLoK. Most sensible medical students shun this subject like the plague. Patient safety is largely about introducing registrations, standardizations and algorithms in order to minimize human error that can harm patients or reduce the benefits of treatment. This is, by and large, the introduction of the Toyota method in the health professions, but with a stated good intent behind it. The problem is that humanity disappears in the suction with human error. And that large resources are switched from patient-oriented activities to monitoring, registration, documentation and administration. The Solberg Government is investing heavily in patient safety, and the guidelines are laid down in the regulations on management and quality improvement in the health and care sector from 2016.

The strengthening of home nursing and home care usually consists in the introduction of management, efficiency and quality improvement measures.

At the same time as the focus on patient safety has been increasing for a long time, for example, the number of nursing home places has been reduced in most Norwegian municipalities. The safety of the elderly and the sick will then be safeguarded by a compensatory reinforcement of home nursing and home care. It might be thought that this led to increased resources for these services, but as a rule, the strengthening is seen only in the implementation of measures in the fields of management, efficiency and quality improvement. The paradoxes and contradictions are then up in the day.

Patient Safety Conference 2019 will be held on September 26 and 27 at the congress center The Qube at Gardermoen. There are among others Bernt Reitan Jenssen from Ruter and philosopher Øyvind Kvalnes from BI Norwegian School of Economics. The event's website gives the impression that a high atmosphere is expected.
Næss is a doctor and philosopher. Regular commentator in Ny Tid.

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