Fighting for business: the limits of professional cooperation among American doctors during the First World War.

The American medical profession participated extensively in preparedness and mobilization for the First World War, with more than one in five doctors voluntarily enlisting in various branches of the Army and Navy Medical Corps. Medical officers were widely valorized for suspending their civilian careers and for sacrificing their professional income while in service. Because of the meager commissions that medical officers received by comparison with fees many doctors earned in established private medical practices, scores of county medical societies implemented organizational solutions to this business problem, with the hopes of removing a significant disincentive to enlistment. In these "practice protection plans," a civilian doctor promised to take care of the patients of a military doctor, to forward a portion of the fees collected thereby to the family of the military doctor, and to refer these patients to the military doctor upon his return. Despite initial enthusiasm and promotion, these plans ultimately failed to achieve their objectives, leading some medical officers to accuse civilian doctors of being opportunistic, unpatriotic "slackers." This episode reveals the limits of professional cooperation in American medicine at the time and the need to explain organizational failures in the grand narrative of professionalization during the "Golden Age" of American medicine.

Reflections on the development of health economics in low- and middle-income countries.

Health economics is a relatively new discipline, though its antecedents can be traced back to William Petty FRS (1623-1687). In high-income countries, the academic discipline and scientific literature have grown rapidly since the 1960s. In low- and middle-income countries, the growth of health economics has been strongly influenced by trends in health policy, especially among the international and bilateral agencies involved in supporting health sector development. Valuable and influential research has been done in areas such as cost-benefit and cost-effectiveness analysis, financing of healthcare, healthcare provision, and health systems analysis, but there has been insufficient questioning of the relevance of theories and policy recommendations in the rich world literature to the circumstances of poorer countries. Characteristics such as a country's economic structure, strength of political and social institutions, management capacity, and dependence on external agencies, mean that theories and models cannot necessarily be transferred between settings. Recent innovations in the health economics literature on low- and middle-income countries indicate how health economics can be shaped to provide more relevant advice for policy. For this to be taken further, it is critical that such countries develop stronger capacity for health economics within their universities and research institutes, with greater local commitment of funding.

The political economy of death and the history of its criteria.

This paper argues for a constitutive link between ecologies of social interests and the social receptivity, if not also the formation, of some recent criteria of death. It maintains that these criteria have been embraced by ecologies that have been dominated by certain economic interests in pronouncing some patients dead. Moreover, the very same ecologies have also embraced philosophical representations of those criteria, but only such that were able to conceal these interests and thereby legitimize and reaffirm their hegemony. Based on this observation, the paper concludes that the current criteria of death and their philosophical representations are ideological constructs in the strict Marxian sense. They may or may not be 'really' true, but they are 'necessarily false' in one respect: they owe their social status to the fact that their self-professed role-pronouncing dead those who are dead-is not in accord with their objective, i.e., social, role-pronouncing dead those who should be dead.

Characterological psychology and German political economy in the Weimar period (1919-1933).

In the mid-1920s, applied (and theoretical) psychologists in many countries turned from studying elementary abilities to studying character or personality. This article examines this shift within the offices of the German labor administration, which aimed to place all German youths in appropriate jobs. Contrary to recent works on the history of psychology, which have emphasized the importance of cultural context, this article explains the turn to characterology in terms of German industry's evolving production strategies. As German companies developed a niche in flexible production, they came to value the highly skilled worker, who needed such character qualities as reliability, diligence, and conscientiousness. The article thus argues that historical analyses of applied, and perhaps even theoretical, psychology should also consider political economy as a potentially important context.

On the official medical doctrine in Bulgaria after establishment of Christianity as a state religion.

The author has been studying the problem of Bulgarian national diet tradition in the ninth and tenth centuries for thirty years. In the course of the research, it was necessary to elucidate what medical knowledge the Bulgarians at that time possessed. The analysis revealed an orderly medical doctrine functioning immediately after the conversion of Bulgaria to Christianity and meeting the requirements of the new faith. As early as the tenth century, converting other peoples to Christianity (the Slavonic tribes primarily), Bulgarians imposed their medical doctrine as part of the Christian propaganda among the newly converted communities. This is one of the contributions of the Bulgarian medieval civilization to the world of that time, a contribution that is not well known and therefore not assessed on its merits.

Globalization and the trade in human body parts.

Since the early 1980s, the number and variety of organ transplantations has increased enormously worldwide. Accompanying this increase has been the emergence of a market for human body parts. This paper argues that, while the trade in human body parts is conditioned by technological advances, it must be understood in the broader context of globalization, specifically the extension and intensification of a capitalist mode of exchange. In this regard, it is argued that the trade in human body parts mirrors the "normal" system of unequal exchanges that mark other forms of trade between the developed and undeveloped regions of the world.

Gender and the economy of health on the Santa Fe Trail.

Correspondence surrounding the death from consumption of a New England woman on the Santa Fe Trail in 1857 demonstrates how gender roles and economic network influenced health travel and the search for healthy places in the nineteenth century United States. Women did travel seeking healing or relief from sickness - sometimes, as here, in arduous, overland trips - but in ways subtly different from male health seekers: family attachments, as well as their own health concerns, impelled and justified women in their decisions to take journeys. Yet for women as for men, decisions about health travel were also bound up with the economic considerations that shaped their families' lives.

Agricultural variation and human fertility in antebellum Pennsylvania.

PIP: Focus in this discussion is on research designed to examine human fertility variation in 59 Pennsylvania counties in 1850 and 1860. The research goes beyond previous historical studies in examining the relationship between land quality and fertility and in separating the possible impacts of settlement from the availability of land for agricultural purposes. The measure of human fertility used in the analysis was the child-woman ratio, defined as the number of children aged 0-4/1000 white women aged 15-49. In 1850 the child-woman ratio ranged from 488-889. The child-woman ratio fell slightly between 1850 and 1860, and county level variation was reduced. Yet, Pennsylvania counties varied substantially in fertility levels during this period. The range between the highest and lowest fertility countries was over 400 children in 1850 and almost 350 in 1860. The set of agricultural variables displayed expected differences at the 2 time periods. The excess demand for farmsites increased between 1850 and 1860, while the variation in demand decreased by over one-half, reflecting additional settlement within all acres of the state. The settlement ratio increased over the decade; the sex ratio declined, most likely in response to outmigration westward. The agricultural variables were all negatively related to the child-woman ratio and were statistically significant, except for the labor/acre variable. The strongest correlation in 1850 was between the excess demand for farmsites and fertility. This coefficient indicated that the greater the excess demand for farmsites, the lower the child-woman ratio. This relationship was attentuated somewhat for 1860, yet it continued to be negative and statistically significant. The socioeconomic and demographic variables were all related to fertility in the expected direction, but only 5 of the 7 correlations were statistically significant in 1850 and 6 in 1860. The settlement ratio, sex ratio, percent urban, distance to urban place, and the measure of female age composition were all significantly related to fertility in 1850 and 1860. The study results support the growing body of research which has identified agricultural opportunity as a significant factor in fertility in rural areas of 19th century America. The findings also suggest that the importance of agricultural opportunity extended beyond the frontier period.^ieng

George Spence: surgeon and servant of the Hudson's Bay Company, 1738-41.

At the beginning of his medical career, George Spence signed a contract with the Hudson's Bay Company (HBC) as surgeon for the Fort Albany fur trading post located on James Bay in British North America. During his first three years (1738-41), Spence encountered formidable personal and professional challenges which can be partially reconstructed through examination of surgeon's journal for 1740-41. By unique good fortune, two other corroborating journals exist for Albany from the same year: the journal of another HBC servant and the regular post journal. Spence's is the only surgeon's journal in the HBC archives prior to 1846 and one of very few such journals from any period of the company's history. This paper examines everyday medical practice in one fur trading context from the perspective of HBC employees and the recipients of medical care. George Spence's significance lies partially in the ordinary nature of his practice in contrast to heroic historical accounts, and partially in his contribution toward knowledge of an earlier context in medical history than has been previously analyzed. I have drawn on concepts from labour and professionalization history to analyze the seemingly contradictory position of the surgeon as both an autonomous professional and a servant in relation to the HBC. While Spence successfully fulfilled his role as surgeon, he struggled to meet expectations as a servant of the company. His struggle was partially based on emerging professional ideologies, and partially based on changing labour relationships within a pre-industrial society.

Inclusiveness in the health economic evaluation space.

This paper presents an overview of Gavin Mooney's contributions to broadening the evaluative space in health economics. It outlines how Mooney's ideas have encouraged many, including ourselves, to expand the conventional QALYs/health gain approach and look more broadly at what it is that is of value from health services. We reflect on Mooney's contributions to debates around cost-effectiveness analysis, Quality Adjusted Life Years (QALYs) and cost-utility analysis as well as his contribution to the development and application of contingent valuation and discrete choice experiments in health economics. We conclude by suggesting important avenues for future research to take forward Mooney's work.

Celebrating the work of Gavin Mooney: inclusiveness and involvement in global and public health issues.

This paper considers Gavin Mooney's contributions to the research literature on inclusiveness in global and public health issues. Much of his contribution in this area stems from engaging with Indigenous people, which cemented his conviction that it is important to recognise the heterogeneity of groups in society, especially in relation to cultural differences. He believed that in order to develop appropriate equitable and efficient health and related policies, the preferences of citizens should be elicited. While this could feed into very specific policy decisions, such as how to allocate available resources within a particular community, more generally, community preferences should determine the core values that underpin a health system. He proposed that these values be documented in a 'constitution' and serve as the basis on which policy-makers and health managers make decisions. Preference elicitation has value in itself, as procedural justice allows for self-determination and contributes to empowerment. Further, engagement by citizens in deliberative processes can overcome polarisation. Health systems themselves, if developed as social institutions, can influence the nature of society and contribute to greater unity. Mooney raised similar concerns about policies arising from mono-cultural global perspectives and argued that, whether at the national or global level, values for health systems should be based on community preferences. He particularly highlighted the unequal distribution of benefits of neoliberal globalisation as the cause of growing health and wealth inequalities globally. There is resonance between Mooney's views on these issues and some of the contributions to the post-2015 development agenda debates. While it is unlikely that we have reached a point where the stranglehold of neo-liberal governments on key global institutions will be broken, the current debates nevertheless present an important window of opportunity to struggle for shifts in the global political economy. Current debates about universal coverage also provide a critical opportunity to move towards health systems that are built on values determined by citizens and are social institutions that build solidarity, redress inequalities and unite fractured societies.