In Sickness and in Wealth

For me, personally, the book constituted an invitation to rethink the relationship-warts and all-among the benevolent, charitable, and business missions of the hospital, while at the same time disabusing me of my inclination to cite history to support or defend a view I might otherwise have preferred to hold. -- Merlin K. DuVal, M.D., Senior Vice President, Samaritan Health Service, Phoenix, Arizona

That, Stevens concludes, is the next urgent task of social policy.American hospitals are unique: a combination of public and private institutions that are at once charities and businesses, social welfare institutions and icons of U.S. science, wealth, and technical achievement. In Sickness and in Wealth helps us understand this huge and often contradictory "industry" and shows that throughout this century the voluntary not-for-profit hospitals have been profit-maximizing enterprises, even though they have viewed themselves as charities serving the community. Although our hospitals have provided the most advanced medical care for acutely sick and curable patients, they have been much less successful in meeting the needs of the chronically ill and the socially disadvantaged. That, Stevens concludes, is the next urgent task of social policy.