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July 20, 1970

A Revolution in Medical Care

JAMA. 1970;213(3):448-451. doi:10.1001/jama.1970.03170290044008

I am sure that all of us were fascinated in our youth by Washington Irving's story of Rip Van Winkle. When I first read it, I thought the amazing part was that Rip could sleep for 20 years. Now I know the really amazing part was that he slept through a revolution. When Rip went to sleep, we were a British Colony. When he awakened, the nation was a republic.

We are living through a revolution in health care, and I am sure that physicians, the press, and the community are well aware of it. In this address I shall consider some of its causes and effects, and propose some fundamental possible solutions to the problems this revolution has created. Medical care changed from an art to a science during the transition from the preantibiotic days before World War II, to the gradual emergence of antibiotics in abundance.

The famous