Preface

In the United States, we expect 1994 to be a watershed year in the development of medical care and public health policy and reform of health services throughout the country. The President and the Congress are finally ready to grapple with the need for universal access with a credible plan for cost containment and emphasis on prevention. Most key players recognize that prevention—or health promotion and disease prevention—requires a complementary investment in population-oriented, community-based programs (public health) and in office- or clinic-based-preventive services (preventive medicine). Implementation beginning in 1995, at least in vanguard states, would support the long-cycle theory of major advances in public policy—with Social Security in 1935, Medicare and Medicaid in 1965, and Health Care Reform in 1995!