. "Appendix D: Education of Public Health Professionals in the 21st Century." Who Will Keep the Public Healthy? Educating Public Health Professionals for the 21st Century. Washington, DC: The National Academies Press, 2003.
The following HTML text is provided to enhance online
readability. Many aspects of typography translate only awkwardly to HTML.
Please use the page image
as the authoritative form to ensure accuracy.
Who Will Keep the Public Healthy?: Educating Public Health Professionals for the 21st Century
BIOMEDICAL FUNDING IN THE POST-WAR ERA
The war had demonstrated the success of an organized federal effort in financing scientific research; the wartime Committee on Medical Research could point to many successes: the development of atabrine, an effective new treatment for malaria, the therapeutic use of blood derivatives such as gamma globulin, and most notably, the production of huge stocks of the “miracle drug,” penicillin. After the war, responsibility for the wartime projects still underway was transferred to the Public Health Service and the National Institute of Health (which became the National Institutes of Health in 1948). In the post-war period, the budget of the National Institutes of Health grew from $180,000 in 1945, to $4 million in 1947, to $46.3 million in 1950, to $81 million in 1955, to $400 million in 1960. The budget continued to grow dramatically, especially under the influence of Mary Lasker and Florence Mahoney as wealthy and persuasive lobbyists, and James Shannon, the forceful and impressive Director of NIH between 1955 and 1968.
In 1944, Thomas Parran, the Surgeon General, had drawn up a grand 10-year plan for his agency, the Public Health Service. Parran envisioned a remarkably complete health service, including public health and medical care, as well as health professional education and medical research:
When peace returns, this country should so reorganize and develop its health resource that there will be available to everyone in the population all health and medical services necessary for the preservation and promotion of health, the prevention of disease, and the treatment of illness... .It is believed that the use of public funds is fully justified in developing the physical plant for health, in training professional personnel, in supporting both public and private medical and scientific research of broad public interest, and in reducing the individual financial burden resulting from catastrophic illness or chronic disability.
The principle is accepted that no one in the United States should be denied access to health and medical services because of economic status, race, geophysical location, or any other non-health factor or condition. It is a duty of governments—local, State, or Federal—to guarantee healthful living conditions and to enable every person to secure freedom from preventable disease.37
Only part of this grand vision was to be realized. Because of the hostility and deep pockets of the American Medical Association and their allies, neither the comprehensive expansion of the public health service nor the institution of national health insurance would prove politically
Thomas Parran, “Proposed Ten-year Postwar Program. The United States Public Health Service,” November 1, 1944. Parran Papers, Modern Manuscripts, History of Medicine Division, National Library of Medicine.