Even assuming that we decide to undertake the effort, it would probably take at least a decade to achieve. And yet without major health reform we are not likely even to preserve the present quality of medical care or extend benefits to all our citizens. The good news is that the major hurdle is not lack of financial resources. That is almost certainly more than enough to provide decent acute and chronic care for everyone and adequate support for medical education, if the money were spent in a different, more socially responsive, and better organized manner. The problem lies in generating the political will to reform the present system.
Medical care is an essential human service.
It must be responsive to needs and be governed by ethical values. It cannot be successfully distributed, therefore, by unregulated market forces. Medical education is a vital prerequisite for good medical care. It, too, as Kenneth Ludmerer's masterful history so persuasively demonstrates, cannot thrive in a market-dominated system. Two From Spain Stanley Kauffmann reviews Solas and Goya in Bordeaux.