The development of the Hill-Burton legislation: interests, issues and compromises

The Hill-Burton Hospital Survey and Construction Act has its roots in the social health and welfare programs of the New Deal. This paper traces its development and the positions of three groups-the hospital industry, the U.S. Public Health Service, and the Senate Subcommittee on Wartime Health and Education-on four issues: the nature of federal funding to states, the use of public funds by private hospitals, the oversight powers of a Federal Hospital Council, and health services for the poor. The analysis involves two lines of thought: the political strategy of incrementalism and the roles of the three interest groups in reaching compromises to quickly pass an "unsponsored" bill. Relevance to the current effort to pass a single payer national health insurance is explored.