In 1961 New York City (NYC) brokered more than ten “affiliation” agreements between private academic medical centers (AMCs) and 18 of the City's 21 public hospitals, to fix crises in both sectors. For nearly 50 years NYC poured millions of dollars into the AMCs to run the public hospitals, giving private institutions enormous power and advantage in deciding how to spend the money; thus placing the delivery of healthcare to the public primarily in the hands of the private sector. This article examines the Columbia University/Harlem Hospital affiliation in the 1960s. It brings the discussion to 2010 when the Health and Hospitals Corporation dissolved the relationship after years of mismanagement, carelessness and tragedy; and entered a corporate phase of privatization.
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