Of all the areas of public policy commonly lumped under the rubric of 'the welfare state' none has been as hotly contested as health policy. The extent, and very legitimacy, of state intervention in the provision and subsidization of medical and other health services has fuelled clashes involving most of the major interest groups and political parties, and the institutions of the state themselves, as each level of government has vied for control of the direction of the system. Along the way, Australia has been the only liberal democracy to legislate to establish a popular national health insurance system, only to see it promptly dismantled.

The bitterness of this political history calls for some perspective to be placed upon contemporary events. In tracing the course of these battles my aim has been to explain some of the structural causes which have made a lasting settlement so intractable. This understanding can only be achieved by moving away from a view of conflict as a simple clash between medical professional independence on one side and state intervention on the other. The hostility of organized medicine towards state intervention was neither automatic nor consistent. Similarly, this history was by no means unique to Australia. Some of the ingredients of Australian medical politics have been common to the medical profession - or to the sociology of the professions - in general.