The U.S. Public Health Service · Episode 9 of 34 · 36 min
The Diminishment, Part I: Starved and Shuttered (1965–1981)
Founded in 1798 to care for merchant seamen, the Public Health Service ran hospitals for 183 years. Medicare and Medicaid eroded the rationale for federal hospitals, the War on Cancer pulled money toward the NIH, and administrations proposed closures while Congress kept saving them, until a 1981 budget law closed the last eight hospitals and the Carville leprosarium. The money did not vanish but migrated to research.
Who's who
- Richard SchweikerSecretary of Health and Human Services when the closures were carried out
Where it happens
- Baltimore, Maryland+5 more episodesOne of the last eight PHS hospitals
- Boston, Massachusetts+11 more episodesOne of the last eight PHS hospitals
- Galveston, TexasOne of the last eight PHS hospitals
- New Orleans, Louisiana+3 more episodesOne of the last eight PHS hospitals
- Norfolk, Virginia+2 more episodesOne of the last eight PHS hospitals
- San Francisco, California+12 more episodesOne of the last eight PHS hospitals
Timeline
- 1965Medicare and Medicaid enacted
- 1970Emergency Health Personnel Act creates the National Health Service Corps; Congress holds hearings on closure plans
- 1971National Cancer Act launches the War on Cancer
- August 13, 1981Omnibus Budget Reconciliation Act mandates closure of PHS hospitals
- October 31, 1981Statutory deadline; the last eight hospitals and Carville close
Still debated
Historians treat Medicare and Medicaid as a slow solvent rather than a trigger, and the idea that money migrated to the NIH is the series' interpretation rather than a line-item fact. Counts of clinics closed vary, and the starving was bipartisan.
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