ABSTRACT
The main objectives of the strategy were to promote healthy lifestyles, to prevent preventable conditions, and to enable rehabilitation of those whose health has been impaired. The challenge to the legitimacy of this therapeutic optimism was already under way in the late 1960s from a variety of academic studies on psychiatry, public health and chronic disability which questioned both the efficacy of medically based care and also its monopoly of the knowledge field. The Lalonde Report was a powerful weapon for governments in their confrontation with medical establishments. All countries have some level of central exchequer funding of health care, but there are variations in where, when, to whom and for what the moneys are actually paid. The material so far has been concerned with structures and policies, but medicine is also a culturally based ideology and practice, and despite its claims for a 'scientific' knowledge status it involves values and beliefs.
