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273 Annals Am. Acad. Pol. & Soc. Sci. 1 (1951)

handle is hein.cow/anamacp0273 and id is 1 raw text is: The Problem of Medical Care By FRANz GOLDMANN and HUGH R. LEAVELL I T IS generally agreed that medical care of highest qualitative and quan- titative standards should be available to everybody. How this objective can best be attained in a democratic society is much debated. The papers assem- bled in this volume are designed to pro- vide factual information necessary for the evaluation of both existing programs and proposals for future development. They express the opinions of the au- thors and not necessarily those of the organizations involved or of the editors. Conscious effort has been made to ob- tain competent, objective, and detached presentations of the various subjects and to avoid discussions contributing more heat than light. MEANING OF MEDICAL CARE The term medical care requires in- terpretation. Actually it has three quite dissimilar meanings. In the administra- tive language of many governmental and voluntary agencies medical care refers to the services of physicians as distin- guished from surgeons. In the usage of many public health workers it signifies care of sick people in contrast to pre- ventive services for healthy persons. From the viewpoint of social organiza- tion of health service, the term denotes the systematic organization of all the personal services by members of the various health professions and all the clinic, hospital, and related facilities necessary to attain the highest level of health, prevent disease, cure or mitigate illness, and reduce if not prevent dis- ability, economic insecurity, and de- pendency associated with illness. This broad interpretation distinguishes per- sonal services to the individual from mass prevention through such measures as sanitation of man's environment and from group contact as used for mass in- formation on healthful living and health resources. It expresses the concept of a unified service for the individual in health and sickness in place of separate approaches, one confined to prevention of illness and the other to treatment of the sick. It points to the bearing of comprehensive medical care on the eco- nomic conditions of the individual, the family, the community, and the nation. For these reasons the broad interpreta- tion of medical care, whatever it may be worth, seemed to us to offer a suit- able basis for determination of the sub- ject matter to be treated in this volume. Medical care is not static. The Greek saying, Nothing is permanent except change, applies especially to medicine, its underlying sciences, and its social use. Medical care needs constant im- provement in order to arrive at stand- ards representing both the best scien- tific thinking and the most advanced application of knowledge. Further progress in medical care, then, is con- tingent upon three factors: broad and deep research in medicine, its under- lying sciences, and its social use; well- rounded, balanced, and sufficiently financed undergraduate, graduate, and postgraduate education for all the health and related professions; and con- tinued adaptation of medicine and re- lated sciences to social needs and uses through comprehensive service programs meeting high standards. Organization of the best possible medical care for the greatest possible 1

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