Foreword

The Fund normally discourages authors from expressing opinions in its reports. But Jo Ivey Boufford and Philip R. Lee are specially qualified to analyze and judge the effectiveness of the federal government in carrying out its responsibilities for health during the past generation. Their report is based on personal experience as policymakers, interviews, careful reading of both official documents and scholarly publications, and consideration of the views of numerous reviewers and members of an advisory group convened by the Fund.

The authors began this report in order to inform policymakers in a new administration who would decide whether and how to reorganize federal agencies that have responsibility for health. Their most important recommendation is that changes in organization and management should implement a significant change in the purposes of health policy.

Boufford and Lee believe that policy should accord higher priority to improving the health of the population and the subpopulations that comprise it. Higher priority for population health requires research, services, and changes in law and regulation to address the environmental and socioeconomic causes of health and illness. At the same time, the federal government should expand current programs to prevent, diagnose, and treat disease.

Persons who assisted in the preparation of this report are listed in the Acknowledgments.

Daniel M. Fox
President
Milbank Memorial Fund

Lawrence J. Korb
Vice President/Maurice R. Greenberg Chair, Director of Studies
Council on Foreign Relations