Review Essay : The Evolution of Health Care Systems in England, France and Germany in the Light of 1848 European Revolutions

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Abstract
A public health movement and a movement to reform medical science were linked to the larger social reform movement of the 1840's in Europe. It included demands for sanitary reforms, public health legislation, large scale social reforms, a reformed organization of medicine as well as a new basis for medical science. It emphasized prevention, epidemiology and social medicine rather than clinical medicine. The victory of the political reaction after 1848 led to a senous setback for these developments, set the stage for the evolution of modern health care systems, and determined some major features of health care systems still present This idea is discussed, based on a re-reading of Rosen, Stevens, Boenheim as well as on a recent study by Pelling and some other material. In modern medical sociology texts it seems largely overlooked.

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