Int J Health Serv
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Since the popular revolution in 1959, alterations in the organization and delivery of health care in Cuba have paralleled the country's broader political, economic, and social changes. This paper discusses the evolution of the Cuban health care system during the past seventeen years within the wider context of societal development. ⋯ For though it is true that a larger portion of Cuban national resources has been directed to the health and social services than in other developing countries, nonetheless, it was largely through the reorganization and equalization of the prerevolutionary health care system that improvement in the health status of the population was achieved. It appears that Cuba could well serve as an example for those who are skeptical about the possibility of combining technical development with improvement in the humane quality of care.
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This paper reflects on selected aspects of the work of Eliot Freidson and is based mainly on his three latest books--Profession of Medicine, Professional Dominance, and Doctoring Together--in which he draws together his various contributions and elaborates a substantial argument concerning the dominant position of physicians within the institution of medicine in particular and, more generally, their unique position within the broader society. Freidson's work is considered from the perspective of political economy. The paper discusses, on a broad level, some of the assumptions underlying his analysis, the adequacy of his theoretical orientation and level of analysis for understanding the House of Medicine in the United States, and some implications that follow.
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The general death rate rises during business booms and falls during depressions. The causes of death involved in this variation range from infectious diseases through accidents to heart disease, cancer, and cirrhosis of the liver, and include the great majority of all causes of death. ⋯ In twentieth-century cycles, the role of social stress is probably predominant. Overwork and fragmentation of community through migration are two important sources of stress which rise with the boom, and they are demonstrably related to the causes of death which show this variation.