Arteriosclerosis. Policy, polity, and parity.

Duff and his contributions to the pathology of arteriosclerosis have been honored by men who have continued to advance the frontiers of science in these same areas. Still, a man who would so influence others that a society of peers would be set up (the Society of Arteriosclerosis, later to merge with the American Heart Association) would fully understand that from time to time it is necessary for someone to accept the responsibility for the allocation of public resources for the solution of public health problems. Within present polity, that is, within the present form of government, the current method of doing federal business, this responsibility falls in part upon me, as Director of the National Heart and Lung Institute. In exercising this responsibility it often appears that I speak for you, the scientists and physicians interested and involved in any way in diseases of the heart, particularly in arteriosclerosis. I speak, or I appear to speak, as your representative and at times as your advocate. I am aware and sensitive to the fact that this is not representation by participatory selection. Hence, it is not only appropriate-it is vital that we talk about policy, that you understand polity and recognize what is involved in parity. I am sure, although his setting was different, that Dr. need for discussion, for interchange, for decisions. Within our present polity and for as long as we are a republic, some bureaucrat will be the spokesman for the scientists, the physicians involved in eradicating or treating arterioscle-rosis, and for the patients who may have, or are at risk of acquiring, arteriosclerosis in one or more of its clinical manifestations. All groups need to know what our present policy encompasses, and what is involved in attempting to obtain a share of the public purse commensurate with the magnitude of the problem and its promise of solution, and proportional to expenditures in other cardiac and noncardiac disease areas. Many investigators feel that many of our decisions are unwise. Some investigators and even some laymen feel that I am ill-informed, and perhaps biased by certain lobbyists, politicians, and vested interests, including the particular interests of a select group of distinguished scientists. If you were to ask whether or not we have a national policy on arteriosclerosis, the answers that you would receive would be quite guarded and varied, for national policy is a spacious mantle. To ask …