With the creation of the Medicare and Medicaid programs in 1965, the United States began its first large-scale experiment with a formal national health system. Almost overnight, it began subsidizing medical care for the elderly and poor. But for Alonzo Yerby, who served as a consultant to the Johnson Administration during the drafting of the legislation, the nation hadn’t gone far enough.
“Health care for the disadvantaged… tends to be piecemeal, poorly supervised, and uncoordinated,” he wrote in an address to the White House Conference on Health in January 1966, six months after the legislation was passed. “We can no longer tolerate a two-class system of health care.”
Yerby, who later became head of Harvard School of Public Health’s Department of Health Policy and Management, remained troubled by the social injustice he saw within medicine. Creating a successful national health system, he felt, had to begin with addressing the day-to-day issues of people living in poverty.
An effective health service must “strike not at the symptoms, but at the causes of the health crises of our metropolitan areas,” he wrote in 1965, setting the tone for his tenure at HSPH. “The social environment of the individual… influences his health and potential for recovery from disease.”
Providing quality preventative care was essential in Yerby’s eyes. So too was access to doctors, since long waiting times and frequent travel between specialists placed a heavy burden on the poor.
Today, Yerby’s passion for equity and social justice in public health is perhaps his greatest legacy. During his 16 years on Harvard’s faculty, he inspired legions of students, and left a lasting impression on his peers—and on his son Mark, who followed in his father’s footsteps by earning an MD and MPH, and now holds a private neurology practice in Portland, Oregon, where he still adheres to the key principle of his father’s work. “He believed that public health was not just the purview of health professionals, but belonged to every physician,” Mark Yerby told Harvard Public Health Review in 1997, three years after his father’s death.
David Levin is a freelance science writer based in Boston. He can be reached through his website at www.therealdavidlevin.com.
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