1946

Passage of Hill-Burton Act under President Truman, “the most important piece of health legislation in the postwar decade (Stevens, 269; Burrow, 338). It subsidized the building of hospitals in rural areas through grants to state agencies (275-276). Hill-Burton had a major impact on hospital costs, since hospitals had to raise $2 for every federal dollar received, so that “debt service on the local matching funds became a significant new expenditure” (Cunningham, 92). While the act contained a nondiscrimination clause re provision of service, it provided a loophole allowing segregated states to maintain racial separation, whereby states that already had separate hospitals for black and whites could ignore the nondiscrimination clause as long as hospital facilities “of like quality” were provided for black citizens. “In the wake of Hill-Burton construction, black physicians were still excluded from the staffs of most public and nonprofit hospitals in the South.” Black physicians still benefitted from Hill-Burton, as its mandate for equal facilities for the races led some cities and counties to build new all-black hospitals with federal money, most open to black physicians. More commonly, Hill-Burton allowed southern cities and counties to turn over existing public hospitals to black community and build new, federally funded hospitals for whites (Ward, 176-177). In Memphis, “Cautious general practitioners regarded new hospitals and more specialists as unwelcome competition; they looked upon national health initiatives with hostility, and they braced themselves for the trouble such federal activism might stir up” (Wailoo III, 93).