Rockefeller Medicine Men

https://ia800902.us.archive.org/10/items/rockefellermedic00browrich/rockefellermedic00browrich.pdf

Notes

• Walter McNerney, president of the Blue Cross

Association, argues. We must stop throwing an array of technological processes and systems at lifestyle problems and stop equating more health services with better health. . . . people must have the capability and the will to take greater responsibility for their own health.

• Historical epidemiological evidence overwhelmingly supports

the conclusion that medical science has played a relatively small role in reducing morbidity and mortality. Thomas McKeown^^ argues very convincingly that improved health and the great decHne in Western Europe's total death rate from the eighteenth century to the present were due to four factors. First, nutrition improved because food supplies increased from the early eighteenth century, due initially to the reorganization of agriculture rather than improved chemical or mechanical technology. Second, environmental sanitation measures—cleaning up the accumulated filth of the cities, assuring uncontaminated water supphes, and so forth—instituted by the late nineteenth century added to improved nutrition and further reduced mortality, particularly of children. These measures were well underway by the middle of the century, before either the concept of specific 220 I Epilogue causes of disease or the germ theory was widely accepted. Third, these improvements in the standard of Hving caused a substantial increase in population, which would have overrun the gains in health if birth rates and family size had not soon sharply declined. Finally, specific preventive and therapeutic medical measures gradually introduced in the twentieth century sUghtly accelerated the already substantial decHne in mortality and also improved physical health. While science greatly extended the original nontechnological advances in agriculture, hygiene, and birth control, the contribution of medical science to the overall reduction in death rates and improved health was relatively quite small.

• 1973 - This leaves the United States with

only sixty primary care physicians per 100,000 population, far below the ratio of 133 such doctors per 100,000 persons recommended as necessary to provide adequate primary care.^°

• A congressional report estimated

that in 1974 approximately 2.4 million unnecessary operations were performed in this country, resulting in 11,900 avoidable deaths and a cost of $3.9 billion.'*