Health Care System Models

The contribution of the health care system on overall population health has been accepted as being modest since Archie Cochrane published his famous monograph "Effectiveness and Efficiency: Random Reflections on the Health Care System".  His diagram of the decline of tuberculosis in England and Wales (showing that the decline pre-dated the development of any efficacious medical intervention) has become a classic.  Since then, it has become fashionable to argue the health care tends to do too little, too late.  Nonetheless, we should recognize the immense contribution of public health interventions, including sanitation, clean water supply and immunizations and vaccinations. 

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