Medical care does add to life expectancy

EDITOR,—In their editorial on the future of medicine Ian Morrison and Richard Smith comment on politicians' “reluctance to invest heavily in health services when they have only a small effect on health.”1 Smith's editorial two weeks later, on medicine's core values, includes a similar statement (“If health care has only a limited impact on the health of the population … “).2 The belief that medical care contributes little to health harks back to the conclusions drawn by McKeown from his epidemiological studies of public health data from the years before 1971.3 Modest challenges have been made to McKeown's …