Lecture Vol. 11 Tab C (Pst SG yrs.) March 11, 1990 cover Speech BY C. Everett Koop, MD, ScD American Pharmaceutical Association Washington DC March 11.1990 Many of my talks at this particular time of my life were on the doctor/patient relationship and the plea to return to a humanitarian basis in the practice of medicine. I often lamented the fact that whereas when I was younger the physicians were always number one in polls about the profession the public most admired. Medicine has slipped (it is now 170, but at this time pharmacists had for the first time risen to the rank of Number 1 - a position they have maintained practically every year since 1990. The value of this presentation for the user of this archive or the historian of health care delivery is that time when we had very high expectations for medicine and health, we do not seem to be delivering and even though many of the causes that demand a change that might be condensed under the term of “health care reform”. It is amazing to me thirteen years after giving.this talk how much we knew, how many signs were evident, how much could have been done, and yet, how little has been accomplished. Subsequent talks in this archive - which naturally have to be somewhat repetitive from time to time - will outline for the user the way the problems mounted like a brick wall, “small brick upon small brick, until at the present time as this introduction is being written, we have over 40 per cent of our population uninsured, we spend more money than any other industrialized nation on health care delivery, and yet, we have not the health population such expenditure, should guarantee.