The role of the state governments in educating the public about health

Fifty years ago health care was a private matter between a physician and his patient. Doctors practiced medicine; people could and did pay for their own health care; and legislators did not need to concern themselves much with health problems. In the meantime, instigated by a massive scientific knowledge explosion, we have spent billions on monstrous complexes to house ultramodern equipment and technology to fight acute, dreaded diseases. Doctors, who once treated human body as an entity, are so specialized that none seems to know any more that the head bone is still indirectly connected to the great toe. People, who incidentally are plagued with essentially the same chronic maladies that visited their predecessors five decades ago, are in real trouble if their complaint is simply a boil on the backside. First they must determine who specializes in this particular area. Next they are lucky if they can obtain an appointment before the boil bursts. Finally, they probably cannot afford to pay for the services rendered. The lawmaker steps in and pours more money into erecting more buildings and providing more specialists. We will not solve the dissonance between the mutually dependent group if we isolate ourselves, forgetting to listen, forgetting to educate, forgetting to communicate. Let me close with Sir William Osler's metaphor: How common the experience to enter a cold cheerless room in which the fire in the grate has died down, not from lack of coal, not because the coal was not alight, but the bits, large and small, falling away from each other have gradually become dark and cold. Break them with a poker, get them together, and what a change in a few minutes.