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November 3, 1999

Ten Encounters With the US Health Sector, 1930-1999

Author Affiliations

Author Affiliation: The Eisenhower Center for the Conservation of Human Resources, Columbia University, New York, NY.

JAMA. 1999;282(17):1665-1668. doi:10.1001/jama.282.17.1665

Many US citizens believe that history can teach them very little, but I disagree. Accordingly, in this article, I identify and discuss 10 major encounters that I, a political economist and government consultant, have had with the US health care sector over the last 70 years in the hope that my reactions to these encounters may be of interest and of value to those whose disciplines and experiences differ from mine.

These encounters had nothing to do with any personal need on my part to seek medical or surgical treatment. I have had the good fortune of spending only 1 night in a hospital when my tonsils were extracted at the age of 31—in hindsight, a questionable procedure. Given this good genetic endowment, which enabled my mother to live an active life until 1 day short of her 94th birthday, it might be asked why I have had ongoing relations with the health care sector throughout most of these last 7 decades, especially since World War II. The answer is simple: the 3 years that I spent in the Medical Department of the US Army between late 1943 and mid-1946 had an important influence in shaping my post–World War II career. Although my primary interest continued to be centered on human resources and employment, health policy became a strong secondary focus and after 1980 was my primary area of research.

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