Investment in human capital of a powerful interest group : the case of the medical profession in Britain, France, Sweden and the United States from 1890 to 1970

This paper presents a new agenda for analyzing the consequences from investments in human capital by suggesting that sociological research should focus on particular sectors of society, that performances other than economic growth and productivity should be considered, and that the role of the state influences the impact which investments in human capital have on system performance. The research assesses the impact which investments in doctors and medical specialists have on social effectiveness (measured as reductions in mortality) and social efficiency (the level of health achieved relative to the cost per capita) in Britain, France, Sweden and the United States during the period between 1890 and 1970. In addition to evaluating the impact of investments in human capital on social efficiency and social effectiveness, the paper contributes to the literature on the state by developing measures for assessing the contribution of state structure on system performance. As hypothesized, investments in human capital are socially effective but not socially efficient. When the state intervenes in the delivery of medical care, it has a multiplier effect on the impact of human capital on social effectiveness.