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A prominent American thoracic surgeon, Leo Eloesser, while serving with UNICEF, contributed significantly to the health care of the Chinese people in the late 1940s, during the final years of the civil war and before the establishment of the People's Republic of China. The concepts he developed, especially concerning rural health service in poor, medically deprived nations, and the factors he felt must be taken into account in developing a health care system in any nation had lasting value. The story of the origin of his plan and his efforts to implement it is briefly related.

Graduating in 1951 and up-to-date, I have been engaged in hospital practice. It is appropriate at this juncture, the year of the Silver Jubilee of the Academy of Medicine, to recollect and record the changes and progress of medicine in Singapore, during the last three decades, 1951 to 1980.

There were many forms of club or contract practice in the nineteenth century, but the friendly societies were the most important. A brief history of the friendly societies is given. As they grew in numbers and importance so did the dissatisfaction of the doctors who worked with them. Discontent among the doctors led at the end of the century to a battle between the medical profession and the clubs. The issues which divided the clubs and the doctors were clearly defined but, although the battle was protracted, the doctors did not win or manage to change the system of medical provision for the poor. The club system was ended by Lloyd George when he introduced his National Insurance Act, 1911.

This article is concerned with the establishment and extension of health care and medical services in British colonial Malaya. Initially, medical care was provided for the colonial elite and those in their direct employment. With the expansion of colonial control beyond trade centers into the hinterland and with the growth of agriculture and mining. Western medicine was extended both to labor involved in these export industries and to others whose ill health might jeopardize the welfare of the colonists. Public health programs in the twentieth century continued to focus on medical problems that had direct impact on the colonial economy, but programs were extended to ensure the reproduction as well as the maintenance of the labor force. This article develops the notion of a legitimation vacuum, and the role of the state provision of social services, including medical services, in legitimizing colonial presence and control.

The major trends and issues in the historical development of Indian health services in Canada since Confederation are discussed according to: (1) the legislative bases, including the BNA Act, the Indian Act, Indian Treaties, landmark court decisions and post-War national health legislations; (2) the policy statements of the federal government regarding services to Indians, culminating in the Indian Health Policy of 1979; (3) the changes in the organization and delivery of health services from the appointment of the first chief medical officer in 1904 to the multi-million operations of the Medical Services Branch in the 1980s; and (4) the reaction of Indian communities and political organizations to government-sponsored health care and the recent trend towards their increasing participation.

The historical development of Mauritius and in particular the early developments in health care are crucial to an understanding of the contemporary health system. The introduction of major epidemic diseases through the movements of French soldiers to and from India and the immigration of indentured laborers from India account for the high mortality and morbidity rates in the 18th and 19th centuries and later. The colonial economy created and fortified the dependence on a single cash crop and on imported food. It also contributed toward the impoverization of large sections of the Mauritian population. The colonial era is also responsible for initiating a three tier system of health care.

This paper examines the health care policy and program of the Chinese Communists in their earliest stages of development. An assessment of 1) political policy, 2) public health campaigns, 3) medical services, 4) public health education, and 5) medical education, indicates that the role of the health delivery scheme was primarily to mobilize mass support for the government, and to change popular health behavior, thereby improving the health of the people and lessening demand on scarce medical facilities. An analysis of the Border Region's health program from 1936 to 1949 gives us an insight into the strategy of a revolutionary government to win popular support and to effect social change.

There has been a shift in the fundamental values placed by society on its health care system, as reflected by public insistence on greater accountability, a more influential role in policy decisions, and a more effective use of system resources. This change in values will profoundly influence the future of dental specialization. The role of the generalist, expanding as a result of various public and internal pressure, will shape the future role of the specialist more than anything else. No new dental specialties are likely to emerge, but there will be changes in emphasis and consolidation among the specialties. Graduate dental education will require a reorganization and a variety of sharing arrangements for its survival. Some form of demonstrating continuing competence will be required for maintenance of specialty status.

The events leading to the establishment of the King County Medical Service Corporation, now King County Medical-Blue Shield, were varied and complex. Under pressure, the King County Medical Society redefined its code of ethics, expanded its view of acceptable practice and gave birth to a major provider of prepaid health care services.

Over the last ten years arrangements for the provision of health care in Australia have changed frequently even in comparison with the UK. In this article Anne Crichton sketches the background. In the next she will describe the last ten turbulent years.

In the pre-State era, Israeli society displayed an "ascetic" orientation with emphasis on austerity and egalitarianism. The medical profession was influenced by the basic philosophy of the country and coped successfully with the country's health problems, mainly by lowering morbidity and mortality rates. With the emergence of the State of Israel, mass immigration of people with different backgrounds, cultures, and values occurred, and health problems of the disability, dissatisfaction, and discomfort type arose. The existing medical organizations were unable to handle them. The story of three such organizations is detailed in brief: the first medical school in Jerusalem, the greatest supplier of curative services--the workers' sick fund (Kupa Holim), and the Ministry of Health. Their impact on the health services of the country is described. These services are splintered into numerous self-contained authorities and an understanding of the overall needs is lacking. This state of affairs reflects the antagonistic interests of the political powers behind the various health agencies. A concensus within the health field on the nature of the problems and their solution could be reached if the health organizations accepted a broader philosophy of health, comprising its somatic, mental, and social aspects, and if they commit themselves to applying this philosophy in their activities. This may lead to considerable changes in medical education, more attention being focused on the social functions of medicine than on medical technology; health care would become more comprehensive and would cover all aspects of health in its preventive, curative, and rehabilitative stages. Failure to meet the health needs of the changing society will constitute a false reading of the public pulse. Of late, the voices demanding the conquest of social diseases and the attainment of health in its broadest sense are becoming more and more audible.