versão impressa ISSN 0042-9686
Bull World Health Organ vol.79 no.5 Genebra Jan. 2001
Milton I. Roemer, 19162001
Milton I. Roemer, MD, MPH, Professor Emeritus of the UCLA School of Public Health, Department of Health Services, died on 3 January 2001 aged 84 years, of cardiac failure after a brief illness. He had served at all levels of health administration county, state, national and international and was one of a handful of people in the 20th century whose work on a worldwide scale for more than 60 years benefited the lives of millions of people.
As a medical officer of the New Jersey State Health Department, he supervised 92 venereal disease clinics, as they were called in 1943. During the Second World War, as a member of the commissioned corps of the US Public Health Service, he served as Assistant to the Chief Medical Officer of the War Food Administration and Associate in Medical Care Administration to the Chief of the States Relations Division. His postwar book, written with F.D. Mott (1), was the first to analyse systematically rural health needs and services in the United States. Among his prolific writings on the social aspects of health services were many influential studies of the orientation of health services in the United States (24).
Roemers international work, which involved 71 countries, began in 1950 when the World Health Organization (WHO) asked him to design health demonstration areas in El Salvador and Ceylon (now Sri Lanka). On the staff of the fledgling WHO in 1951, he was responsible for a wide range of services including occupational health, hospital administration, medical aspects of social security, medical rehabilitation, organization of medical care, hygiene of seafarers, control of noncommunicable diseases, prevention of traffic accidents, and health aspects of sports, but he was forced to stand down as an international civil servant in 1953 when the US government withdrew approval of his appointment under pressure of McCarthyism.
After implementing the first social insurance programme for hospital care in North America (in the Canadian Province of Saskatchewan) and teaching at Yale and Cornell Universities, Roemer came to the School of Public Health at the University of California, Los Angeles (UCLA) in 1962; he taught courses in public health, medical care, hospital administration, and comparative national health systems for 38 years and served as Chairman of the Department of Health Services for eight years. During this time he undertook extensive work in many parts of the world, notably in Latin America (5) and Asia, particularly in China, Cuba, Malaysia, Nicaragua, and Thailand; his international activities covered comparative health manpower policies (6); and his work with WHO included global analysis of human resources for health, health systems, and health policy. In his wide-ranging research and prolific writings on public health and health services (7), Roemers vision strengthened health systems to improve the organization, financing, and delivery of health care. The pinnacle of his international health work and his many publications is his two-volume, monumental comparative analysis of national health systems of countries of the world set in a logical and coherent framework (8).
Among Milton Roemers many notable achievements were his studies showing that under a system of health insurance the ultimate determinant of the volume of hospital days is the supply of beds available. He showed that, in an insured population, a hospital bed built is a bed filled a finding that contributed to the enactment of certificate of need legislation and comprehensive health planning in the United States. This finding was so robust that it bears his name: Roemers Law.
Roemers prescience of important health issues enabled him to foresee trends and possibilities that led to his great contributions to health policy. He was a strong supporter of the role of government in health services and an advocate for the public sector in health care. His research encouraged the development of health maintenance organizations, promoted the use of ambulatory care, and documented the need for a system of national health insurance covering the total population. He advocated the development of doctoral training to prepare leaders for public health practice and had great respect for the contributions of public health workers at the local level, establishing endowments to support these two categories.
Milton Roemer received many honours in recognition of his work, among them: membership in the prestigious Institute of Medicine of the US National Academy of Sciences; the International Award for Excellence in Promoting and Protecting the Health of People, from the American Public Health Association (APHA) in 1977, and APHAs highest honour, the Sedgwick Memorial Medal for Distinguished Service in Public Health, in 1983; the Joseph W. Mountin Award from the Centers for Disease Control in 1992; and in 1997 the Lifetime Achievement Award of the APHA International Health Section and the Distinguished Career Award of the Association for Health Services Research.
Milton I. Roemer is survived by his wife of 61 years, Ruth, his son, John E. Roemer of Yale University, his daughter, Beth Roemer Lewis of the Kaiser Permanente Medical Care Program, and six grandchildren. He was beloved by generations of students and admired by colleagues as a luminary of unequalled stature and strength. A staunch political liberal and lifelong fighter for human rights, Roemers international health work has strengthened health systems throughout the world.
Adjunct Professor Emerita
University of California, Los Angeles
School of Public Health
Department of Health Services
10833 Le Conte Avenue
Los Angeles, CA 90095-1772, USA
1. Mott FD, Roemer MI. Rural health and medical care. New York, McGraw-Hill, 1948.
2. Roemer MI, Friedman JW. Doctors in hospitals: medical staff organization and hospital performance. Baltimore, John Hopkins Press, 1971.
3. Roemer MI. Ambulatory health services in America Past, present and future. Rockville MD, Aspen Systems Corp, 1981.
4. RoemerMI. An introduction to the US health care system. New York, Springer Publishing Co., 1982.
5. Roemer MI. Medical care in Latin America. Washington DC, Pan American Union, 1963.
6. Roemer MI, Roemer R. Health care systems and comparative manpower policies. New York, Marcel Dekker, 1981.
7. Roemer MI. National strategies for health care organization: a world overview. Ann Arbor MI, Health Administration Press, 1985.
8. Roemer MI. National health systems of the world. Vol. I The countries; Vol. II Issues. New York and London, Oxford University Press, 1991; 1993.