Welcome to the Health Policy Advisory Center (Health/PAC) Digital Archive! This web site is a complete collection of the influential Health/PAC Bulletin, which was published for nearly three decades until Health/PAC closed in 1994. Full-text searchable, it amounts to a documentary history of mid- to late- 20th Century American health policy and politics. (Quick note: The Bulletins, alas, were not always given consistent numbers. Please let us know if you think there is something missing – and if you have it – and be aware that there are some chronological gaps, especially in later years.)

Health/PAC originated in 1967 when the Institute of Policy Studies (IPS), a Washington-based think tank, asked Robb Burlage, a co-founder of Students for Democratic Society (SDS), to study the implications of the New York City hospital affiliation agreements that gave administrative and financial control of the New York City public hospitals to the voluntary hospitals and academic medical centers. In the study, nicknamed the “Burlage Report,” he uncovered a host of abuses on the part of the latter. Along with journalist and activist Maxine Kenny, he developed a systematic critique of the city health system, focusing particularly on parasitic relations between medical schools and their environs (a map of them, which first appeared in a Bulletin, is this site’s background); hierarchical and undemocratic health planning; and emerging neighborhood health movements to alter it.

Located in New York City and briefly with a West Coast office in San Francisco, Health/PAC staffers and authors wrote and spoke to health activists across the country on every issue from free clinics to women’s health struggles to health worker organizing to environmental justice.  Health/PAC both reported on what was going on (before there was an Internet) and reflected back on a wide variety of strategies and tactics to build a more just health system – a conversation that continues today. It coined the terms “medical empire” and “medical industrial complex” to capture the ways the profit motive distorted priorities in the American health care system. It critiqued Big Pharma and rising medical costs before these became staples of domestic policy debate, explored the differing forms of health activism, and made it clear that a seemingly disorganized health care system was in fact quite organized to serve ends other than the people’s health. Its first book, The American Health Empire (1970), published by Random House, brought its analysis to national attention. Other edited collections of the Bulletins followed: Prognosis Negative (1976) and Beyond Crisis(1994).

Particularly in the late 1960s and early 1970s, health activists from across the country found their way to the Health/PAC office at 17 Murray Street in New York to ask questions, get support for their questioning, and think through their strategies. In turn, Health/PAC staffers were sent out to speak and strategize with groups of activists in medical and nursing schools, free clinics, and women’s storefront classrooms across the country. Lower East Side community health organizer Terry Mizrahi, now a Professor of Social Work at Hunter College, remarked that Health/PAC’s relationship to activists “was one of reciprocity and exchange… each of us learning from and educating the other.” A more detailed examination of Health/PAC during this period appeared in a recent issue of the American Journal of Public Health here.

Health/PAC Mission Statement from 1968 Bulletin

Even as broader political foment in the country died down by the mid-1970s, Health/PAC remained and published important pieces on women’s health, occupational/environmental health risks, incarceration, Medicare/Medicaid crises, and HIV/AIDS, among many other topics. Its masthead contains dozens of figures who would make influential marks in many sectors, including municipal health services delivery, occupational health, social work, legal aid, city politics, and academia. Over the next few months, we will be adding a number of features to the site. These include photographs, non-Bulletin Health/PAC publications; short essays on municipal health care provision; advanced indexing that will allow viewers to browse issues by topic; a historical web-based interactive map that will allow visitors to explore geographically the landscape of health care activism in New York City, and data analyses of how Bulletin content changed over time.

As we continue adding these features, we welcome your feedback and suggestions.  Use the Contact Form to send us a note.

Keep visiting the site, and pass the word along!