How Basic Healthcare Became Big Business in America after World War I
By Alexander Zaitchik
via the Literary Hub web site
The Great War was a short one for the United States. But in sixteen months of fighting alongside the Entente powers, 116,000 American soldiers were killed. Contemporaries grasped that a break had occurred, forming two distinct periods in the political and cultural life of the country. The defining novel of the prewar decade was Upton Sinclair’s The Jungle, a work of social protest and journalism that captured the tone and preoccupations of the Progressive Era. Sinclair’s depiction of the Chicago meatpacking industry will forever be paired with the Pure Food and Drug Act of 1906, signed by Teddy Roosevelt six months after the novel’s publication.
In the postwar decade, the shrunken public imagination and concerns of the Harding Era were indelibly recorded by the other Sinclair of American literature. Sinclair Lewis’s 1922 novel Babbitt depicted America’s stultifying embrace of the idea, expressed with pith by Calvin Coolidge in 1925, that the country’s natural concern is not civic duty or social improvement, but “the business of business.”
The celebration of commerce and its values colored the drug patent debate when it resumed shortly after the war. But the main theater of this debate shifted from the drug companies to the American university, where a collision of science and commerce spurred development of institutions and mores to manage and rationalize the new business of “ethical” academic patenting. Together, the worlds of academic science, organized medicine, and drug companies initiated the process of revising and shaking off the honor codes that had long buffered them from the crass commercialism of other industries and their own worst natures.
The context for this shift was the maturation of scientific medicine. New research fields were extending the vistas of medical science in every direction, but conducting this research cost money and required expertise. This reality drew academic researchers, medical gatekeepers, and drug companies closer together by necessity. The only guidebooks on hand for ordering these new relationships, however, amounted to a long list of restrictions and negative commandments dating to Hippocrates. The process of formulating and establishing new rules and codes would occur in fits and starts during the interwar decades, eventually supplanting the “ethical” system that had provided medicine and drug making with identity and purpose since Benjamin Rush collected leeches in the swamps outside Philadelphia.
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