ABSTRACT
A highly-capitalized, high-volume, cost-cutting, anti-union management style took advantage of the large resulting discrepancy between costs and revenue at the margin, especially when the hospital chains could benefit from the growing base of charge-paying patients in Sun-belt and suburban locations. Wohl rejects the view that vertical and horizontal integration of health care produces high volume economies of scale. Even academic medical researchers, long subsidized by the National Institute of Health's supposedly altruistic basic science grants, have recently begun to be coopted by the medical industrial complex. Wohl's main explanation for the success of the corporate physician takeover is the so-called physician "glut". Medical school enrollments have doubled over the last decade, there has been a large influx of foreign medical graduates, and the ratio of active physicians per capita has been steadily growing. Wohl frequently refers to physicians' historic role in limiting hospitals' ability to operate on purely profit-maximizing criteria.
