Main 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.

Contents:

1. Medical Care as Trade

PART I

Radiation Enterprise, 1895 to World War II

2. The Medical Radium Industry

3. The General Electric Company Dominates X-ray

4. Competing Research Universities

PART II

Competitive Megavoltage, World War II to the 1970s

5. Megavoltage Competition in Academia and Industry

6. Medicine's Nuclear Arms Race

7. An Economic Success Story at Stanford

8. Radiation Therapy Politics

PART III

Financializing Medicine, 1970s to the 2010s

9. Speculating on Proton Therapy

10. Rationalizing Radiation Therapy, Reforming Health Care

11. Choosing Health Over Wealth

Selected Bibliography

Index