Healthcare commercialisation erodes professional integrity

Economic, political and technological forces have transformed healthcare into a formidable for-profit industry dominated by corporations, pharmaceutical giants and complex insurance systems.

This transformation alters access to care, the definition of illness and treatment priorities, forcing a critical examination of the balance between profit and patient welfare.

Today, healthcare operates as a complex business and a massive industry.

Services are increasingly provided by for-profit organisations—from large investor-owned hospital chains to specialised clinics—where generating profit often competes with, and sometimes supersedes, patient care.

This business model is unique; unlike other sectors, healthcare is bound by a complex web of regulations, ethical obligations and pre-negotiated contracts that limit financial flexibility.

This commercialisation is evident in the rise of private hospitals that now engage in marketing to attract “customers” and build brand loyalty. The industry is also expanding globally through medical tourism and international hospital projects.

Furthermore, large-scale government payment systems, like Kenya’s Social Health Authority (SHA), have created predictable revenue streams and new profit-making opportunities that did not previously exist.

Health is not a product to be bought; it is a foundational human necessity that must be protected from corporate exploitation.

The commodification of healthcare—framing it as a purchasable good governed by market forces—represents one of the most profound ethical distortions in modern medicine.

While physicians and the pharmaceutical industry share an interest in advancing medical knowledge, their goals often diverge. The physician’s primary duty is to the patient, while the industry’s goal is profitability.

Treating healthcare as a commodity has profound consequences.

When market logic prevails, access to care is distributed according to ability to pay, entrenching disparities and excluding the vulnerable. Profit-driven incentives marginalise essential but less lucrative services like palliative care, primary care and mental health.

This environment erodes professional integrity. Clinicians face pressure to meet financial targets, reducing their autonomy and compromising patient-centred care. Aggressive billing and unnecessary procedures become commonplace.

By navigating the current environment with integrity, we can work to dismantle the predominantly market-driven model that creates systemic inequalities and ensure that patient welfare remains the central, unwavering focus of the healing arts.

A stark example is the rising rate of medically unnecessary cesarean sections in Kenya. The national C-section rate has doubled in a decade to over 18 percent, far exceeding the WHO’s 10-15% recommendation. In private facilities, this rate can be as high as 80 percent, driven largely by profit and convenience.

Wealthier, urban women are far more likely to have a C-section, a trend fueled by factors like scheduling and “C-section on request.”

This example illustrates the broader challenges within the Kenyan healthcare market, where providers also grapple with high operating costs, heavy taxation on equipment, and a heavy reliance on out-of-pocket payments that challenge equitable access.

The growth of the for-profit sector is a development of major significance, yet its meaning remains debated.

Does it represent a fundamental change in the goals of medical professionals, or merely a change in the methods used to pursue traditional goals of service? Does it signify a decline in the ideals that morally anchored the profession, or does it embody a more honest acknowledgment of economic realities? These questions lie at the heart of the conflict between viewing health as a human right versus treating it as a commodity.

While healthcare is increasingly viewed as a business, the core values of altruism, fidelity, and service must remain vital. The future of the industry is shifting toward a proactive, technology-driven model focusing on wellness, remote care, and data analytics, with a growing emphasis on value-based over volume-based care.

This evolving landscape calls for a deliberate balance between business interests and professional ethics. Medical professionals must advocate for a return to the foundational spirit of medicine, prioritizing ethical standards and service over commercial interests.

Dr Aluoch is a Consultant Physician