A Century of Advancing Health Care for All

By David Blumenthal, M.D., President, The Commonwealth Fund
Twitter: @CommonwealthFnd

In 1918, Anna Harkness founded the Commonwealth Fund with a gift of $10 million ($151 million today) and the mandate that it should “do something for the welfare of mankind.” One of the first women to launch a major foundation, Anna was the widow of Stephen Harkness, who had made his fortune as a partner to John D. Rockefeller in Standard Oil.

From the beginning, and for the past 100 years, the Commonwealth Fund has worked to improve health care and make it affordable and accessible for all Americans, especially the most vulnerable. Edward Stephen Harkness, Anna’s son and the Fund’s first president, shared her commitment to responsive philanthropy in service of the social good. He also believed that a staff of talented and experienced people, dedicated to making a difference and open to experimenting with fresh ideas, could have a real impact on the health and welfare of Americans. That belief is a hallmark of the foundation a century later.

As the Fund’s current staff spent time in the past year researching the foundation’s history — with the assistance of the Rockefeller Archive Center, which holds its historical records — we were struck by how many of the Commonwealth Fund’s original values and, indeed, its philanthropic methods, have remained constant to this day.

A commitment to health care access is one example. In its earliest days, the Commonwealth Fund provided public health services to rural communities. Later, it supported minority students entering the medical profession to ensure that all communities had enough health care providers. Still later, it addressed gaps in medical care among the poor elderly and pinpointed the special health care issues that affect girls and women. The goal was always the same: improving access to high-quality, affordable health care for all Americans.

My own affiliation with the Commonwealth Fund dates back several decades; long before I became president I was a Fund grantee and served on several commissions, including as chair of the Commission on a High Performance Health System. Both during those years, and when I was being considered for my current position, I was drawn to the Commonwealth Fund for a number of reasons.

First, its mission of creating a high-performing health system was consistent with my own goals and values. My prior experiences in the health care system were diverse: I was a primary care physician, a hospital administrator, a health system manager, a policymaker. I was comfortable with, and focused on, issues related to how the U.S. health system delivered care — and that was where the Commonwealth Fund had placed itself in the health care debate.

Beyond that I was, and am, passionate, about the Fund’s values — its commitment to equity, to expanding coverage for all Americans, to making a difference.

As an endowed foundation, we have a unique privilege — independence. That independence allows us to step back and decide how best to accomplish the goal for which we were created. In doing that, we rely on a Board of Directors that is chosen for their expertise and their personal values and their commitments, and we rely on a staff that’s highly professional and highly trained. But we have to be accountable to higher purposes, and that is a great opportunity and a great responsibility.

In turbulent times — and there have been many since 1918 — the preservation of our nation’s values and critical institutions falls heavily to the nongovernmental organizations that constitute our civil society. These include our churches, synagogues, and mosques; our universities; and our many charitable and philanthropic organizations. The Commonwealth Fund is one of these institutions. As an endowed philanthropy, the Fund has for a century enjoyed the extraordinary privilege of economic independence. Part of our obligation in return is to hold a mirror up to the rest of our society: to show where we are meeting the needs of our people, and where we still have work to do.

The Commonwealth Fund’s efforts and achievements in holding up that mirror over the past 100 years demonstrate that by working at the intersection of philanthropy, research, and policy, we can in fact drive change to improve the human condition.

To mark the Commonwealth Fund’s centennial year, we have launched a new website that seeks both to describe the unique history of the Commonwealth Fund and, we hope, to draw some lessons from its work over a hundred years. Visitors who are familiar only with the Fund of recent years may be surprised to learn of some earlier efforts: supporting the research that led to the widespread adoption of the Pap smear; building the rural hospitals that led to the enactment of the Hill-Burton Act; helping to bring hospice care to the United States. Others may be unaware of the foundation’s activities around helping to develop the evidence base and framework for the Affordable Care Act.

We invite you to explore the site, not only to reflect on the work of the Commonwealth Fund over a momentous century, but to see how that work has been informed by a constancy of mission and an attuned responsiveness to the ever-changing American health system.

Our hope is that you will come away with a better understanding of the Commonwealth Fund’s rich and diverse history, its current work, and its vision for the future.

Please visit centennial.commonwealthfund.org.

This article was originally published on the Commonwealth Fund Blog and republished here with permission.