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The battle over universal healthcare in the USA
  1. John W Puntis
  1. Correspondence to Dr John W Puntis, retired paediatrician, Leeds, UK; john.puntis{at}

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In 1948 America, arguments about universal healthcare were causing political divisions. Illuminating the debate over the nature of US medicine was an item of photo journalism portraying the life of general practitioner Dr Ernest Ceriani (‘Country Doctor’, Life Magazine, September 1948).1 Commissioned by the American Medical Association (AMA) and ostensibly focusing on the problems of rural healthcare, the essay can also be read as celebrating the lone doctor as selfless hero standing in opposition to a state organised health service. This theme was about to be employed to devastating effect just 2 months later in an unprecedented campaign by the AMA to turn public opinion against a national health service.

‘Country Doctor’

Dr Ceriani worked single-handedly to provide comprehensive healthcare for a scattered population around Kremmling, a small town in the foothills of the Rocky Mountains. The Life Magazine article was solicited from W Eugene Smith, a photographer who is key in the development of the editorial photo essay.2 Dr Ceriani had begun training in surgery but switched to general practice in Kremmling, seeing patients in his office and often travelling many miles by horseback for home visits.3 The text accompanying the images notes that ‘he was a physician, surgeon, obstetrician, paediatrician, psychiatrist, dentist, oculist, and laboratory technician’, with children evidently representing a large proportion of his work. One picture that seizes the viewer’s attention shows Ceriani tending to a small girl (figure 1). In others, he is seen delivering a baby, examining …

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  • Provenance and peer review Not commissioned; externally peer reviewed.