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July 26, 1995

Radical Surgery: What's Next for America's Health Care

Author Affiliations

Miami Beach, Fla

JAMA. 1995;274(4):352-353. doi:10.1001/jama.1995.03530040080051

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables.


Joseph Califano, Jr, has been an administrator, attorney, and seasoned Democratic federal bureaucrat. His latest entry into the health care reform contest begins to make penance for the decades of liberal federalist policies to which Mr Califano himself has contributed heavily since he assisted the Johnson administration in spawning Medicare in 1965 and, as the Secretary of Health, Education, and Welfare during the Carter administration, helped create the Health Care Financing Administration in 1977. His broad perspective provides a valuable historical lesson and some insight into why centrally controlled programs are fraught with hazard: Homo bureaucraticus has an amoral agenda. A recurring analogy to the nuclear arms race reminds us that we have developed the technology but not the philosophy.

A relatively easy read, this volume is amusing and enlightening in its recitation of indictments and listing of criticisms of the corruption of health care delivery as it has evolved

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