Contents - IADR/AADR

100 percent decline in the death rate from polio over the years 1951-1962, an 87 percent decline in the death
rate from tuberculosis in eighteen years, 88 percent for influenza, 85 percent for maternal deaths, 90 percent for
acute rheumatic fever: it showed an increase in life expectancy for Americans of almost seven years, marked
reduction in the incidence of various diseases, and significant improvement in the treatment of others.
While these successes were being recorded, other events were shaping changes for the support of
medical research. Among them were a growing public bewilderment and dissatisfaction with the quality and
cost of health care. It has been estimated that 30 million Americans are without medical services except under
extreme or acute circumstances. The cost of care nevertheless is $63 billion and could rise to $200 billion by the
early 1980's. Costs per patient-day in hospital have risen about 250 percent in twenty years. Average costs rose
from $48.15 per day in 1966 to $67.60 in 1969. In some medical centers they run as high as $166.00 a day. In
spite of the high costs and in spite of research, the average stay in hospital is a day longer than it was eight years
ago. 6 At the same time, many cannot get a doctor. Half the deliveries in New York's voluntary hospitals are
preceded by not one single prenatal visit. Soldiers injured in Vietnam receive more prompt and better-organized
care than do the victims of collision on American highways.
The result is the emergence of a new priority—that of designing better systems for the delivery of health
care. Resources are being diverted to this important purpose—not, of course, without alarm being expressed
over the new difficulties in obtaining research support. The point is made by nationally known figures, such as
Michael DeBakey, that only 3 percent of the total national health bill went to research in 1968; 7 but many of
those concerned about the health care of the nation wonder gloomily whether increased research expenditure
will lower or raise the cost of care. They might ask, too, whether a doubling or tripling of the cost of care in the
next few years represents a rational reason for doubling or tripling the level of research expenditure in the same
period—just to maintain the percentage. In short, the concern for a satisfactory delivery system has become an
important priority.
Delivery of health care is not the only new priority. Other issues are assuming greater significance in the
public mind and are moving up the priority list. Problems of overpopulation, environmental pollution, poverty,
the quality of the cities, and crime are receiving more attention, although not nearly enough, in the judgment of
many thoughtful observers. The urgency and seriousness of these issues is bound to result in more attention
being devoted to them.
Thus the public view and political decisions have sharply slowed the rate of growth for support of health
sciences research, and it seems likely that competing priorities will continue to limit growth to levels much
lower than those of the fifties and sixties, regardless of the course of the Vietnam entanglement, space projects,
and defense expenditures.
INTERNATIONAL ASSOCIATION FOR DENTAL RESEARCH (IADR) – THE FIRST FIFTY YEAR HISTORY PAGE 288