Cutting Cost without Cutting the Quality of Care

THE invitation to give the Shattuck Lecture posed a problem for me. How could an economist from California relate to Dr. Benjamin Shattuck, colonial physician in Templeton, Massachusetts, and the distinguished line of Shattuck physicians that followed him? Then I discovered Lemuel Shattuck (1793–1859), not a physician, but a businessman, a founder of the American Statistical Association and principal author of the Report of a General Plan for the Promotion of Public and Personal Health, published in 1850.1 Lemuel's interest was not primarily in how the medical profession could lift itself above quackery, a problem very much on the mind . . .