This volume brings together the views of authors involved in many aspects of biomedicine-from research on basic biology to clinical invest igation of the causes and treatment of human disease to hospital adminis tration ·to health care planning on the state and Federal levels to Con gressionallegislation covering biomedical research, medical education, the development of medical technology, and the delivery of health care. The purpose is not to present a "party line" representing a consensus of these often divergent viewpoints, and we do not suggest that we have found solutions to the many problems encountered in the interaction of scientists, administrators, legislators, and the recipients of health care. These articles are intended primarily to communicate to both biomedical scientists and intelligent laymen the processes, social and political as well as scientific, whereby biomedical science advances, and the need for biomedical scientists to take an interest and initiative not only in scientific research but also in research on health care delivery and in related public issues before the legislative and administrative branches of government.

The world is on the threshold of a great new industrial revolution, a 1 scientific-industrial revolution. Recombinant DNA technology and hybridoma technology ("monoclonal antibodies") have already pro vided unique investment opportunities for venture capitalists. Hence published reports of biomedical research are no longer restricted to scientific journals, but now appear regularly not only in weekly news 2 magazines like Time and U. S. News & World Report,3 but also in the financial sections of The New York Times,4 The Wall Street Journal,S 6 8 Business Week, Fortune,7 and The Economist, as well as in such stock 9 market advisory publications as New Issues and Inc. (The Magazine for Growing Companies). 10 These publications now appear to be as impor tant to biomedical scientists in keeping abreast of new scientific devel opments in biotechnology as is Current Contents. (The costs of health cost provision and of fundamental biomedical research are now also being followed by such media. ) Conversely, Wall Street financial bro kers increasingly no longer confine their reading to economic journals but are also perusing Nature,ll Science,12 and Science N 13 for infor ews mation on both fiscal and scientific advances in these areas. It is obvious that the information explosion in biotechnology is crossing traditional boundaries (e. g. , ref. 14). This volume is the second of several that are intended to inform both the biomedical community and interested intelligent laymen of the political and economic implications of biomedical research.

This volume brings together the views of authors involved in many aspects of biomedicine-from research on basic biology to clinical invest igation of the causes and treatment of human disease to hospital adminis tration ·to health care planning on the state and Federal levels to Con gressionallegislation covering biomedical research, medical education, the development of medical technology, and the delivery of health care. The purpose is not to present a "party line" representing a consensus of these often divergent viewpoints, and we do not suggest that we have found solutions to the many problems encountered in the interaction of scientists, administrators, legislators, and the recipients of health care. These articles are intended primarily to communicate to both biomedical scientists and intelligent laymen the processes, social and political as well as scientific, whereby biomedical science advances, and the need for biomedical scientists to take an interest and initiative not only in scientific research but also in research on health care delivery and in related public issues before the legislative and administrative branches of government.

Biomedicine in the Twentieth Century: Practices, Policies, and Politics is a testimony to the growing interest of scholars in the development of the biomedical sciences in the twentieth century and to the number of historians, social scientists and health policy analysts now working on the subject. The book is comprised of essays by noted historians and social scientists that offer insights on a range of subjects that should be a significant stimulus for further historical investigation. It details the NIH’s practices, policies and politics on a variety of fronts, including the development of the intramural program, the National Institute of Mental Health and mental health policy, the politics and funding of heart transplantation and the initial focus of the National Cancer Institute. Comparisons can be made with the development of other American and British institutions involved in medical research, such as the Rockefeller Institute and the Medical Research Council. Discussions of the larger scientific and social context of United States’ federal support for research, the role of lay institutions in federal funding of virus research, the consequences of technology transfer and patenting, the effects of vaccine and drug development and the environment of research discoveries all offer new insights and suggest questions for further exploration.

Biomedical scientists' concern about the future of funding of health science research prompted this volume's exploration of the financing of the entire health research enterprise and the complex reasons underlying these increasing concerns. The committee presents clear-cut recommendations for improving allocation policies to ensure a balanced distribution of resources that will allow the biomedical research community to build on exciting recent discoveries in many areas. Funding Health Sciences Research also provides the first-ever comprehensive reports on the 1980s policies that have affected the research landscape, including stabilization, downward negotiation, and extended grant duration.