Ly Wir Grete

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q t q t t T

1900 1910 1920 1930 1940 1950 1960 1970 1980 1990
Year .
Figure 1.

 

Life expectancy for the United States. 1900-1981. contrasted with the proportion of
‘the Gross National Product expended for health care. Roman numerals (i. II. Ap
represent major cycles of biomedical progress (see Fig. 2). Ton SESS aa

oot Eade
(prahatoe Cond Tus wi GT becannn be

-
Part rly my argument, cascenid bey fe tapos iS € ilomized ina

chart familiar to many of you: the improvement of life expectancy since 1900

(Fig. 1).It also shows the percentage of the Gross National Product which has

been devoted to health expenditure since 1930, when the collection of those

statistics began. The striking thing you can see from this chart is that there

seemed to be no correlation between the very sharp increase in expenditures

for health that this country has experienced since the middle fifties and the —

near flattening of our mortality rate until the last decade.
Let me stress that throughout this period expenditures for health research

have fluctuated between a little over one percent and perhaps as much as four

percent of the total health expenditure at various periods. ‘In fact, there i is No

 

 

 

 

 

 

 

 

 

 

 
Wed Jul 23 15:37:35 EDT 1986

reading -tu-r--n- 1 ysl 1085 Jul 23 15:37 TAT/graham.
7/86
thoughts on agenda for graham. No surprises

Rationalization of world economy.
US competitive advantages
hi tech
information infrastructure
°°
agriculture
other resources
Educational systems
international trade: export controls
US competitive disadv.

National Security
US-USSR
weapons
arms control
intelligence: interface to policy
scientific and technical relations: vs human rights
(export control isssues?

terrorism: safe travel
CEW

US as fount of technology for world development
| essentiality for avoidance of major conflict
| world health
world population
world agriculture
US economic and technical interactions with all of
abovei and with division of labor

Environmental tradeoffs

asbestos

toxic waste disposal
protect water supply; standards?
oceansi incineration?
radioactive
CW

energy
coe
nuclear souwer

Health
aging population
AIDS; vaccines
rationalize health expend. / outcomes
not only mortality: 8.9. psychiatric
drug abuse

ostp

sed x