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December 16, 1974

The Department of Health, Education, and Welfare

Author Affiliations

University of Missouri Columbia

JAMA. 1974;230(11):1586. doi:10.1001/jama.1974.03240110072030

This is an excellent review of the Department of Health, Education, and Welfare (HEW) from the standpoint of an experienced administrator and should be required reading for any newly appointed administrative person within HEW as well as all health resources people in the field of public service who have substantial, direct dealings with that department.

While I would not have selected the same way to describe the "five social revolutions" that the author uses, nevertheless, accepting those descriptions, the narrative is lucid, persuasive, and internally consistent. Its greatest contribution lies in the analysis of the impossibility of administering a government department in the same manner that one can and should administer an industrial institution. Mr. Miles' detailed understanding of the underlying principles reveals very clearly the benefit of his many years of experience within the government.

Readers should be prepared, however, to understand the bias in personal conviction that the