Abstract
| - Controlled clinical trials are very necessary in medicine, in the reevaluation of a number of medical practices and therapeutic interventions, if its claim to be a branch of science is to gain general acknowledgment. One of the main problems of the measurement of ill health is in defining the term. III health is much more complex than simply that point on the distribution curve from where one treatment does more good than harm. The author considers the difficulties in finding a definition and in establishing measurement criteria, and suggests that the restrictions on the amount of resources available for health have very little to do with the measurement of ill health. The increasing cost of health services is due mainly to expenses on research into ‘untreatable’ diseases, on mostly unavailing palliative intervention in hopelessly advanced illness, and on a wide panel of expensive drugs and therapeutic intervention of doubtful effect. The duty of the medical profession is to exert criticism on the ‘health market’, to educate people towards a better recognition of the interaction between mode of life and development of disease, and to find more and more ‘risk factors’ of future ill health and elaborate ways for their elimination. Unfortunately there is practically no market yet for these goals and nobody wants to pay the bill.
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