Showing papers by "Daniel M. Fox published in 2016"

The Significance of the Milbank Memorial Fund for Policy: An Assessment at Its

Abstract: In 1935, when medical societies across the United States were complaining that the Milbank Memorial Fund endorsed health insurance mandated and subsidized by government, Albert G. Milbank, president of its board, accorded priority to protecting the Fund's “reputation and its personality” (Kingsbury 1935a). This article, on the occasion of the Fund's centennial, describes how its personality, expressed in the values, priorities, and methods of its leaders, influenced its reputation among persons who made, implemented, and studied the results of health policy. Its theme is that the Fund has been most effective when it has been a broker of practical knowledge about policy for preventing and treating illness, organizing and financing health and related services, and protecting and enhancing the health of populations. The Fund has been consistent in its goals, and in how its board and staff implemented them, for most of its history. Elizabeth Milbank Anderson, who donated its endowment between 1905 and 1920, described four goals in 1913 when she announced an initiative by the Fund and New York City's then leading social welfare organization to improve policy and practice aimed at the health and social welfare of the poor. The first goal was “fostering preventive and constructive social measures for the welfare of the poor.” The next was to “prevent sickness and thus relieve poverty.” The third was “cooperat[ion] with public authorities” and other philanthropies. Fourth, she believed it “prudent to devote some time and money to investigation and research” in order to assure that “any proposed measure will accomplish the object sought to be obtained” (Anderson 1913). Two decades later, John A. Kingsbury, who had become the Fund's first full-time chief executive in 1921, reiterated in his own words the goals Anderson had announced. The Fund, Kingsbury wrote, sought “improvement in the general level of public welfare and public health through the translation into practical usefulness of knowledge.” Such knowledge included principles that were “confirmed by experience” as well as “sustained by scientific research” (Kingsbury 1930). Kingsbury's longest-serving successors acted on the goals set for them in 1913. Frank Boudreau, chief executive from 1937 to 1961, explained that “our attempt has always been to improve the public health, to test methods and procedures, and [to] try to have them adopted eventually by the public health authorities” (Boudreau 1950). In October 2004, proposing a program for my fifteenth year as president of the Fund, I told my colleagues on its board, “The Fund seeks to improve health by helping decision makers in the public, private, and nonprofit sectors use the best available evidence to inform policy for health care and population health” (Fox 2004). Because this article is about the significance of the Fund for policy, it describes its institutional history only when necessary for context. The Fund's centennial report provides a chronological history of its programs, leadership, and financial resources (Milbank Memorial Fund 2005a). The introduction to an anthology of articles from this journal describes its role in the history of the Fund (Milbank Quarterly 2005).