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From the Editor-in-Chief
Oct 11, 2021
Oct 5, 2021
Back to The Milbank Quarterly
As one who is privileged to edit a journal as distinguished as The Milbank Quarterly, I am keenly aware that the position sits squarely on the shoulder of giants. One of those giants, David Willis—who edited the Quarterly from 1970 to 1990—died this past January. He was 86.
I never met Mr. Willis in person, but because I began reading the Quarterly in the 1980s, I was well aware of his legendary editorial skills and of the superb issues he reliably produced.
Born in Queens, New York, in 1930, David Willis was a Phi Beta Kappa graduate of Haverford College. He also held a master’s in public health from the University of Pittsburgh and attended the graduate program in demography at the University of Pennsylvania. As a student he spent considerable time in Great Britain studying the newly created National Health Service, where he came under the influence of the legendary health policymakers William Beveridge and Aneurin Bevan.
Willis began his career with administrative positions at the Massachusetts General Hospital, Temple University Health Sciences Center, and the Allegheny County Hospital Planning Association.
But it was in his capacity as vice president of the Milbank Memorial Fund and editor of what was then titled The Milbank Memorial Fund Quarterly/Health and Society where he shined the brightest. In this role, he influenced a generation of health policy and population health scholars. No methodological approach was too esoteric for Mr. Willis, provided that the papers he edited and accepted for publication elucidated new knowledge and valuable ideas about health services research, demography, economics, sociology, ethics, law, and history, to name but a few of the scholarly lines of attack he helped advance. For those readers curious enough to substantiate this statement, I invite you to review a few of his issues, which are available in their entirety on The Milbank Quarterly website. Prepare to be astounded by the prescience and value of the hundreds of fine papers he shepherded onto the Quarterly’s pages.
Upon retiring from the Fund in 1990, Willis was appointed as a senior fellow at the National Institute on Aging, of the National Institutes of Health, and the Agency for Health Care Policy and Research, where he was awarded the US Secretary of Health and Human Services’ Citation for his contributions in survey research on AIDS services.
Despite knowing Mr. Willis only by reputation, I am fortunate to know many of the scholars who contributed to the Quarterly during his editorship, worked closely with him, and were profoundly influenced by his kindness, intelligence, and sensitivity.1
For example, Samuel L. Milbank, chairman of the board of the Milbank Memorial Fund, recalled Willis as “a first-class professional who set the tone of excellence for the Quarterly.” Similarly, Daniel M. Fox, president emeritus of the Fund, who worked with Willis for more than a decade, recalled that he was “steadfast in his devotion to maintaining and increasing the reputation of The Milbank Quarterly, for the scholarly excellence and relevance of its articles, and for the importance of the themes of its special issues.”
More personally, David Rosner, the Ronald H. Lauterstein Professor and codirector of the Center for the History and Ethics of Public Health at the Columbia University Mailman School of Public Health, reminisced:
I will never forget meeting David for the first time. I had recently arrived in New York and David asked that I come to his Milbank Memorial Fund office in [the Harkness] Mansion on Fifth Avenue. He wanted to go over the editorial changes he had suggested for an article I had submitted. It was 1982 and he could not await the usual “snail mail” response. I was a new father, babysitting my newborn child Zach, and asked, could it wait until my wife returned? “Well, what better way to get to know the family,” he said. “Bring Zach over, I’d love to meet him!” I pushed the stroller across Central Park and David and I bonded over a red pencil, wild jokes, and a drooling baby. David never failed to ask about Zach every time we met over a friendship that lasted 35 years. As anyone who met him knows, David was the warmest, smartest, and most thoughtful human being you could ever hope to know. He was, of course, the best editor you could ever hope to know, as well.
Paul Cleary, the dean of the Yale School of Public Health and a former editor of the Quarterly (1992-2000), recollected:
I knew David by reputation from my early days in graduate school because of his role in making The Milbank Quarterly one of the most prominent and influential journals in health policy. My first direct interactions with him, however, were as an author of an article that subsequently was published in the Quarterly. That was relatively early in my career and I have published numerous articles since then, but I can confidently say that although I have worked with many very talented editors, I have never worked with someone who was as conscientious, precise, exacting, and at the same time, as supportive and nurturing as David. David solicited a large number of reviews of my article and he worked assiduously with me to ensure that every comment and suggestion had been addressed as completely as possible and at the same time provided his own insights and suggestions, all of which improved the original submission immeasurably. That experience was like a master class in both writing and mentoring. I will be forever grateful to David for what I learned from him both as a writer and as a person. He set a standard for scientific writing and mentoring that I often aspired to, although almost certainly never achieved. Subsequently, as a colleague of David’s and eventually as an editor of the Quarterly myself, I have been privileged to work with some of the best authors and editors in multiple fields and I have learned that my experiences working with David were not the exception but the rule; he approached every potential Quarterly article with care, precision, and attention to detail that was almost without parallel. I will be forever grateful for his help and inspiration and miss him dearly.
Perhaps most endearing are the observations of Ronald Bayer, professor of sociomedical sciences at the Columbia University Mailman School of Public Health and former editor of the Quarterly (1991-1992):
I met David Willis about 35 years ago at the start of my work as a scholar. I had submitted a paper to the Quarterly and he asked me to come by his office to talk about it. There he was in his cramped office, pages and pages of notes on yellow pads [on his desk], a burning cigarette in his ashtray. No one had ever engaged a piece of my writing with such intensity and such demanding encouragement. He was an editor like no other. He was not merely a traffic manager; he was more like a literary midwife. I watched him over the next several years as he attended academic meetings, identified promising young scholars, and zoomed in and nourished them. David left an enduring imprint on so many authors’ lives. His last years were very difficult. He was severely burdened by disease and homebound. But on the occasions that I visited, he met me with a sparkle that rekindled memories of better times. I saw him two days before his death. I’m not certain he knew who I was. I held his hand, kissed his forehead, and said goodbye. How lucky I was to have known such a man.
Charles Dickens began his masterpiece, David Copperfield, with a wonderful line I often quote to my students and, on particularly tough days, to myself:
Whether I shall turn out to be the hero of my own life, or whether that station will be held by anybody else, these pages must show.
David Willis’s heroism sings out loud on every page he edited for The Milbank Quarterly and we are forever grateful for it. Requiescat in pace.
* * * *
We begin our March issue with a rousing symphony of inquiries on the potential impact of the current climate in Washington on health policy and population health. But first, I must offer a few words of explanation.
For its entire history, The Milbank Quarterly has maintained an allegiance to the Milbank Memorial Fund’s policy of engaging “in nonpartisan analysis, study, research and communication on significant issues in health policy.” And while we have no intention of abandoning the wisdom of our predecessors, our Op-Ed contributors are, in fact, world-renowned authorities on health policy and population health. It would be irresponsible not to give these experts the voice and space our pages afford to articulate their assessments of the current political environment’s impact on the public’s health. Disagreeing with a particular president, senator, or congressman, let alone warning about the consequences of poorly thought out policies, which have the power to endanger our nation’s health—especially to those who are the poorest among us—is neither partisan nor biased. It is, in fact, the Quarterly’s moral, intellectual, and patriotic responsibility to discuss these issues as long as they are buttressed with the power of sound evidence and hard-won experience. That is precisely what we will do in the months and years to come. As editor-in-chief of The Milbank Quarterly I am firmly committed to facilitating that process. You have my word on it.
We begin the Op-Ed section with Lawrence Gostin’s examination of the effects that an “America First” mentality may have on global health. We then proceed to Sandro Galea, dean of the Boston University School of Public Health, who will be joining The Milbank Quarterly’s roster of Op-Ed columnists. In this issue he considers how the Trump administration’s policies may harm our nation’s health. Guest columnist David Mechanic, a longtime Quarterly contributor and the Rene Dubos Professor Emeritus of Behavioral Sciences and founding director of the Institute for Health, Health Care Policy, and Aging Research at Rutgers University, poses critical questions about what might happen to the mentally ill in the United States if the Affordable Care Act is repealed. John McDonough delineates the opposing values of Republicans and Democrats as to whether or not Americans have a right to health care and how that has played out in recent years. Guest columnist David Jones, of Boston University, dissects the Democrats’ dilemma with respect to cooperating (or not cooperating) with the Republicans to any degree on health reform as the latter seek to repeal and replace the Affordable Care Act (ACA). Joshua Sharfstein writes about the critical role the Food and Drug Administration has played in approving safe and effective drugs and why that role is more important now than ever in the face of calls to speed up or shortcut its careful process of review. Gail Wilensky cogently reminds us that, with or without the ACA, there is an existential threat to Medicare, given the rising rates of enrollment by aging baby boomers and the rising costs of medical care associated with that trend. Sara Rosenbaum analyzes the Wollschlaeger v. Governor, State of Florida case, which was decided in February 2017 by the US Court of Appeals for the Eleventh Circuit and struck a blow for sanity by protecting the right of pediatricians to discuss the dangers of firearms with their patients and their patients’ parents. Finally, David Rosner reminds us of the risks of deregulating safety laws governing the use of dangerous and toxic substances such as asbestos.
Equally, if not more, important, we are delighted to introduce this issue’s original contributions,which illuminate a wide variety of pressing issues in population health and health policy:
As we close this issue only months after the inauguration of a new American president, within a maelstrom of confusion and anxiety over the potential erasure of hard-fought battles to protect the health of our citizenry, it seems apt to recall the closing lines of F. Scott Fitzgerald’s masterpiece, The Great Gatsby, which first appeared in print on April 10, 1925:
Gatsby believed in the green light, the orgastic future that year by year recedes before us. It eluded us then, but that’s no matter— tomorrow we will run faster, stretch out our arms farther. And one fine morning— So we beat on, boats against the current, borne back ceaselessly into the past.
Howard Markel is the editor-in-chief of The Milbank Quarterly. He is also the George E. Wantz Distinguished Professor of the History of Medicine and director of the Center for the History of Medicine at the University of Michigan. An acclaimed social and cultural historian of medicine, Dr. Markel has published widely on epidemic disease, quarantine and public health policy, addiction and substance abuse, and children’s health policy. From 2006 to 2016, he served as the principal historical consultant on pandemic preparedness for the U.S. Centers for Disease Control and Prevention. From late April 2009 to February 2011, he served as a member of the CDC director’s “Novel A/H1N1 Influenza Team B,” a real-time think tank of experts charged with evaluating the federal government’s influenza policies on a daily basis during the outbreak. The author or co-author of ten books and over 350 publications, he is editor-in-chief of The 1918–1919 American Influenza Pandemic: A Digital Encyclopedia and Archive. He received his AB (summa cum laude) and MD (cum laude) from the University of Michigan and a PhD from the Johns Hopkins University. He completed his internship, residency, and fellowship in general pediatrics at the Johns Hopkins Hospital. In 2008, he was elected a member of the Institute of Medicine of the National Academy of Sciences.
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