The Struggle to Save a Public Health Care Institution

“The Struggle to Save a Public Health Institution” explores the late twentieth-century attack on the American welfare state and those who fought against retrenchment through the microcosm of Cook County Hospital (CCH). Chicago’s only public hospital served as a vital safety net health care institution for poor, uninsured, and socially marginalized Chicagoans. Like other parts of the welfare state, CCH was chronically plagued by underfunding across much of the twentieth century. But in the 1970s, rising health care costs, diminishing local revenue, and state and federal budget cuts propelled CCH into crisis, threatening the hospital’s very existence. The county government, which oversaw the hospital, targeted CCH with budget cuts, layoffs and privatization. For the people who relied on CCH for their health care and their wages, the vast majority of whom were people of color, these actions had serious consequences. But retrenchment did not go uncontested. Medical professionals, support staff, patients, and community members mobilized against budget cuts and privatization imposed by government officials and corporate consultants. This paper investigates how the hospital community resisted actions that compromised CCH’s ability to redistribute resources and care to vulnerable populations. This paper asks, what does this activism reveal about attitudes toward privatization and the welfare state during this era?