In 1971 (1), Lewis Thomas outlined 3 levels of health care technology. The first he called “nontechnology”: care that attends to ill patients but does little to alter the course of disease. Second were “halfway technologies”: those that do not eliminate diseases but at least postpone their effects. In this large group he put everything from solid organ transplantation to cardiac care units—what today we might call chronic disease management. Third was technology so transformative we often take it for granted, such as childhood vaccines to prevent diphtheria and antimicrobials to treat syphilis. He urged further investment in the basic sciences that support this third level of technology, arguing that the first 2 contributed greatly to the $60 billion spent at the time on U.S. health care and the third was “the only way to get the full mileage that biology owes to the science of medicine, even though it seems … like asking for the moon.”

1971年（1），刘易斯·托马斯（Lewis Thomas）概述了3种医疗保健技术水平。他首先将其称为“非技术”：照顾病人，但对改变病程几乎没有作用。其次是“中途技术”：这些技术无法消除疾病，但至少会延迟其影响。在这个庞大的小组中，他把从实体器官移植到心脏保健单位的所有东西都放了起来，今天我们称之为慢性疾病管理。第三是技术如此具有革命性，我们常常认为这是理所当然的，例如预防白喉的儿童疫苗和治疗梅毒的抗菌剂。他敦促在支持该第三技术水平的基础科学领域进行进一步投资，认为前两个技术对当时在美国花费的600亿美元做出了巨大贡献。