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This book is an eloquent, well-documented damning appraisal of the historical marriage between medicine and capitalism and its impact on shaping the kind of health care system we have today.
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Rockefeller Medicine Men Medicine and Capitalism in America by E. Richard Brown Excerpts from Abraham Flexner, Abraham Flexner: An Autobiography, copyright © 1940 by Abraham Flexner and © 1960 by Jean Flexner Lewison and Eleanor Flexner, reprinted by permission of Simon & Schuster. University of California Press Berkeley and Los Angeles, California University of California Press, Ltd. London, England Copyright © 1979 by The Regents of the University of California First Paperback Printing 1980 ISBN 0-520-04269-7 Library of Congress Catalog Card Number: 78-65461 Printed in the United States of America CONTENTS Preface Introduction Doctors Other Interest Groups Foundations and the State 1. "Wholesale Philanthropy": From Charity to Social Transformation Creating Private Fortunes and Social Discontent Driving the Reluctant Poor from Poverty Training Scientific Heads to Direct America's "Hard Hands" Carnegie's Gospel of Wealth" Reverend Gates Introduces "Wholesale Philanthropy" Rockefeller to The Reverend Frederick T. Gates: The Making of a Rockefeller Medicine Man The General Education Board: S129 Million for Strategic Philanthropy Social Managers for a Corporate Society 2. Scientific Medicine I: Ideology of Professional Uplift American Medicine in the 1800s Incomplete Professionalization Medicine as Science Gaining Public Confidence Reducing Competition Technical Requirements of Scientific Medical Education "Nonsectarian" Medicine Undermines the Seels Specialization: Less Competition for the Elite Gains and Losses 3.Scientific Medicine 11: The Preservation of Capital Medical Technology and Capital Welch: A Rockefeller Medicine Man Rockefeller Money and Medical Science: A Social Investment Homeopathy: The Conflict Simmers Scientific Medicine and Capitalist Gates Healthier Workers Ideological Medicine Gates' Digression 4.Reforming Medical Education: Who Will Rule Medicine? Practitioners Gain a Foothold Council on Medical Education Money for Medical Education: Who Will Pay? Help from the Carnegie Foundation The "Flexner Report" The General Education Board: Education Gets a Different Drummer Medical Full Time: "Gold or Glory" Selling the Full-Time Proposal Boston Brahmins Resist Fear and Trembling in the Board Room Slate Universities: Professionals, the State, and Corporate Liberalism Summing Up 5.Epilogue: A Half-Century of Medicine in Corporate Capitalist Society Frederick T. Philanthropies Gales and the Rockefeller RATIONALIZING THE MEDICAL MARKET The Committee on the Costs of Medical Care Doctors and the Capita I-Intensive Commodity Sector The Slate: Rationalizing the Private Market The Growth of Capital-Intensive Commodities The "Corporate Rationalizers" The Stale and Capitalist Medicine Up Against the Medical Market National Health Insurance: More of the Same TECHNOLOGICAL MEDICINE Scientific Medicine: Beliefs and Reality Life, Death, and Medicine Tapping the State Treasury A "Superacademic General Staff" The Corporate Class The Medical-Industrial Complex Technology in Crisis Blaming the Victim: New Prominence for an Old Ideology Notes Index PREFACE When Rockefeller Medicine Men was first published in 1979, it proved to be a controversial work. In reviewing histories of medicine from 1962 to 1982, Ronald L. Numbers called it "the most controversial medical history of the past decade."' This reprinting of the book provides an opportunity to respond to some of the book's critics as part of a continuing dialogue about the issues it raises. Part of the controversy generated by the boo