Vol. 3 # 8 "Perspectives on the Future of Health Care" Delivered as a Keynote Address to the Fifth Annual Medical Conference of the Medical Association of the British Virgin Islands Tortola, BVI February 5,1983 The people connected with the Medical Association of the British Virgin Islands are all physicians and sailors. The Annual Conference was started under the aegis of Butterworth Hospital in Grand Rapids, Michigan largely through the efforts of their Chief of Plastic Surgery, Dr. Ralph Blocksma. He, working with the Queen's physician to the British Virgin Islands, Dr. Tattersall, held a series of annual conferences in Tortola to which physicians from the West Indies were invited to join other invitees from places, such as the University of London, the University of Michigan, the Mayo Clinic, the University of West Indies, etcetera, to participate in what I had always thought was one of the most interesting of medical conferences. The mornings were spent on rather informal presentations by unquestioned experts and the afternoons were spent seeing patients brought to the island of Tortola by West Indian practitioners to get expert advice on patient management. A few of these patients were fortunate enough to be taken under the wing of American and British practitioners with great generosity of spirit to have their maladies treated and their defects corrected in some of the outstanding medical centers of the world. This was the second full year of my first term as Surgeon General and it was the first of many such conferences at which he delivered the keynote address. This one was my concept of the perspectives of the future of healthcare through the eyes of the Surgeon General of the United States. It was a wonderful coincidence that my first presentation to the Caribbean Medical Society coincided with President Ronald Reagan's "Caribbean Basin Initiative" under the auspices of the Organization of American States. President Reagan has said, "What happens anywhere in the Americas affects us in this country. We share a common destiny . . . in the commitment to freedom and independence; the people of this hemisphere are one. In this profound sense, we are all Americans." It will be interesting to compare what I said about the baby-boom generation prospectively and what I said at later times as I prophesied that it would be the baby-boom generation that turned the healthcare system around in this country. "Baby Boom" Generation Blood pressure control Cancer Caribbean Basin Initiative Demography of care Fatality rate Four "D's" - discomfort, disease, disability, & death "Graying of America" Heart disease Hybridoma technologies Infant mortality Immunization Life expectancy Nutrition Preventive medicine Reduction of motor vehicle deaths Smoking Stroke Ralph Blocksma Albert Einstein "Healthy People" Jose Marti Minister O'Neal National Institutes of Health Jean Jacques Rousseau