A Matter of Principle: Community Health Centers and Health Care as a Right

The Community Health Center of the latter 20th century was born of the War on Poverty, an offspring of the Civil Rights movement. The first centers and the law that governed them represented an enormous departure for the federal government. CHCs leapfrogged states and – then as now – authorized grants directly from the federal government to community organizations to operate centers. This was a purposeful political reaction to the failures of states (particularly Southern ones) in providing services to their citizens and a purposeful national effort to make care available to people who could not buy into the predominant private system of the time. The advent of CHCs made health care a right in practice – if not in name – for many Americans.

Those first few CHCs (then called Neighborhood Health Centers) have grown to a national web of more than 1000 centers serving 18 million people. The CHC story has been one of steady growth but constant struggle. Creating pressure to grow the movement, battling the vicissitudes of the economy, working in an environment of public ambivalence about health care as a right have made the success of the health center movement to date hard to predict and an extraordinary accomplishment.

This presentation will explore the future. Will health care reform cement the accomplishments of CHCs as a cornerstone of health care as a right in America or will a business model of care delivery fracture the 50 year old movement?