Abstract
. . I [do] not infer . . . that the choice is between a humane caring for the chronically ill and disabled on the one hand and public-health interventions on the other. Neither are doing well at present (in the United States 18 million children are not protected from poliomyelitis) and there is no need to worsen their case by implying that they are competitive. The voracious competitor to them both is high-cost technology, centered on the doctor-hospital complex. Even in developed countries, it is losing touch with the real biology of need. By reason of its intramural psychology, its control on education, and its autonomous costing, it curbs the invention and development of the medium and low cost technology services which are required to support the well-being of communities and the personal care of their large, needy minorities, whether they be rural villagers or urban elderly. Given infinite time and money, the doctor-hospital complex will never of its own extend outwards towards them. For it is a kind of black hole in the medicosocial sky: more resources only make it denser.
- Copyright © 1978 by the American Academy of Pediatrics
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