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APHA Scientific Session and Event Listing

Recorded presentation

Robb Burlage, PhD, Joint Graduate Degree Program in Public Health and Urban Planning, Columbia University, 200 West 90th Street, Suite #6E, New York, NY 10024, 917-441-1042, RBurlage@aol.com, Elena Padilla, PhD, Scholar-in-Residence, St. Barnabas Hospital of the South Bronx, Braker Building, Fourth Floor, 181 Third Avenue, Bronx, New York, NY 10487-2594, and Merlin Chowkwanyun, Phd Candidate, Department of History, University of Pennsylvania, 4701 Pine Street #M5, Philadelphia, PA 19143.

Public health care institutions generally have been "affiliated" with legally not-for-profit academic medical centers (AMCs) and public teaching hospitals. One senior author in the 1960's pioneered evaluating the "Affiliation Plan" for New York City's then 17 public hospitals. The other senior author was a major actor in the creation of a public benefit authority to change these relationships. The Affiliation report demonstrated anti-public health priorities, financial exploitation, and public/working community unaccountability. Labeling these "medical empires," the Health Policy Advisory Center (Health/PAC) was launched. The junior author has researched and written about the hidden history of this institutional and policy analysis and advocacy by Health/PAC and traces their influence in generating a new kind of national health care and public health movement with nationally linked local social policy analysis, advocacy, and organizing. Much of the mainstream health policy debate has shifted to the crisis of the growing number of uninsured and underinsured. This shift, however vital, has obscured analysis of institutional restructuring and priority problems at the regional level. We propose to present a comparative, contemporary baseline analysis of health care inter-institutional relations, emphasizing the cases of New York, Los Angeles, and 'trans-Katrina' New Orleans. Understanding this changing new local and national sector environment and policy framework of "medical-finance complexes", we contend, can contribute to a potential new social movement for health care sector accountability; as well as for the most effective, community/public health-oriented coverage for all.

Learning Objectives:

LEARNING OBJECTIVES
• Reformulate an updated analysis of how legally not-for-profit institutions, particularly academic medical center complexes and major teaching hospitals, contributed to the "poverty of public health," most notably documented in the 1960's and beyond in New York City.
• Analyze how the Health/PAC "medical empires" analysis contributed to a major national and local social movement challenge.
• Make the argument that helping community groups, patients, health care workforce and the general public understand the changing health care systems structure and inter-institutional relations today in the three cities of New York, Los Angeles, and New Orleans can contribute to a potential new national and local "public/working community accountability movement" that challenges new institutional bases of the "poverty of public health".

Keywords: Public Health Advocacy, Health Care Restructuring

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation