For more than a century, New York City's public hospitals have played a major role in ensuring that people of every class have had a place to turn for care. This comparison of the history of Bellevue Hospital with that of the private New York Hospital illuminates the unique contribution that public hospitals have made to the city and confirms their continued value today. Portraying the hospital as an urban institution that reflects the social, political, economic, demographic, and physical changes of the surrounding city, this book links the role of public hospitals to the ongoing debate about the place of public institutions in American society.

I can think of no one more fitting to provide the broad perspective on the City's health system, as well as a specific analysis of the current state of affairs. --James R. Tallone, Jr., President, United Hospital FundFor the three decades since passage of Medicare and Medicaid, health care service to the American people has expanded. Relatively few studies have assessed the extent to which access to health care have actually improved for specific groups, such as the poor and the middle class. This book is an in-depth assessment of the extent to which Medicare and Medicaid have met expectations of citizens. New York City is the focus because of its long-standing commitment to provide essential health care to all citizens irrespective of ability to pay, its hospital system composed of voluntary and public sectors, and its vast governmental and private funding.

Traces the development of the sanitary and health problems of New York City from earliest Dutch times to the culmination of a nineteenth-century reform movement that produced the Metropolitan Health Act of 1866, the forerunner of the present New York City Department of Health. Professor Duffy shows the city's transition from a clean and healthy colonial settlement to an epidemic-ridden community in the eighteenth century, as the city outgrew its health and sanitation facilities. He describes the slow growth of a demand for adequate health laws in the mid-nineteenth century, leading to the establishment of the first permanent health agency in 1866.