The year 1962 was pre-medicare. The public was concerned about access and individual affordability of care. Funding involved public or private responsibility and the role of government. Physicians, the most influential providers, were concerned that government funding would result in the loss of their independence and their becoming state employees.

The retrospective analysis "Looking Back 50 Years in Hospital Administration" by Graham and Sibbald is arresting as it underlines just how much progress we have made in what could be termed "hardware" in support of healthcare policy and hospital administration. From this perspective, the progress has been eye opening, given the advent of universal healthcare, the advancement in our physical facilities, the development of high-quality diagnostic equipment, the explosion of new research centres and new and complex clinical procedures. The development of this hardware has given our providers better weapons and contributed to a remarkable improvement in life expectancy.

But progress in health administration and policy management involves more than hardware. If the hardware constitutes the tools, then the "software" of the healthcare system involves the human resources and the culture change that must be positioned to make maximum use of the hardware. In 2062, looking back at the 2012 experience, the legacy test may be whether we dealt with health human resources and culture change at a rate that matched our progress in hardware.

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