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Register of the Philip Randolph Lee Papers, 1947-1984
MSS 91-1
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Title: Philip Randolph Lee Papers,
Date (inclusive): 1947-1984
Collection number: MSS 91-1
Creator: Lee, Philip Randolph
Extent: Number of containers: 20 cartons, 2 folders
Linear feet: approx. 25.00
Linear feet: approx. 25.00
Repository:
University of California, San Francisco. Library. Archives and Special Collections.
San Francisco, California 94143-0840
Shelf location: For current information on the location of these
materials, please consult the Library's online catalog.
Language:
English.
Collection is open for research.
[Identification of item], Philip Randolph Lee Papers, MSS 91-1, Archives & Special
Collections, UCSF Library & CKM
Philip Randolph Lee was Chancellor of the University of California San Francisco from
1969-71, and then became Director of the Health Policy Program (later expanded and
renamed the Institute for Health Policy Studies) at UCSF (1972-1993). He left IHPS in
1993 to join the Clinton Administration as Assistant Secretary for Health in the
Department of Health and Human Services (DHHS) (1993-1997) before returning to UCSF and
the IHPS as Senior Advisor and Professor Emeritus (1997-). Lee had previously served as
Assistant Secretary for Health and Scientific Affairs in the Department of Health
Education and Welfare (DHEW) (1965-1969) under President Lyndon Baines Johnson, and as
Director of Health Services at the Agency for International Development (USAID)
(1963-1965). Lee has been an active lecturer, writer and teacher, as well as serving on
numerous advisory boards and planning groups. He was licensed to practice medicine in
California in 1948, New York in 1955 and Board Certified in Internal Medicine in 1956.
Lee was born in San Francisco on April 17, 1924. His father was Russel Van Arsdale Lee,
the founder of the Palo Alto Clinic in Palo Alto, California, and he was one of five
children, all of whom went on to medical careers. He married Catherine Lockwood, an
attorney in 1953 and had 5 children. On February 9, 1980 Lee married Carroll Estes,
Professor of Sociology and Chair of the Department of Social and Behavioral Sciences in
the School of Nursing at UCSF, and Director of the Aging Health Policy Research Center
(later the Institute for Health and Aging) at UCSF's School of Nursing from 1979 to the
present. Estes and Lee collaborated on a number of books and projects, including
The Nation's Health (1984, 1997-5th ed.), chapters in
Caring for
the Elderly
(1989),
Eldercare: A Practical Guide to Gerontology
(1981), and
The Aging Enterprise (1979), and several working papers issued
by the Institute for Health and Aging.
Lee received his bachelors degree and his M.D. from Stanford university in 1945 and 1948
respectively. He served his internship at Massachusetts Memorial hospital in Boston
(1947-48) before returning to Stanford for his residency (1948-49). He served in the US
Navel Reserve (1943-45, and 1949-51) and received a Navy Unit Citation for his service in
the Korean Theater (1950-51). After completing his military service he became a Fellow at
the Bellevue Medical Center, New York (1951-53) and the Mayo Clinic, Rochester, Minnesota
(1953-55). While serving as a Mayo Fellow he earned his Masters of Science degree from
the University of Minnesota in 1955. From 1955-56, he was an Instructor and Assistant
Clinical Professor at New York University School of Medicine. Lee returned to Palo Alto
in 1956 and served as a Staff Member at the Palo Alto Medical Clinic and Assistant
Clinical Professor, Stanford University.
In 1963 he took a leave of absence from both of these positions and headed to Washington
for a position as Director of Health Services in the Office of Technical Cooperation and
Research at the Agency for International Development (USAID) (1963-1965). In 1965 he
resigned from the Palo Alto Clinic to take a position in the Johnson Administration.
First appointed as Deputy Assistant Secretary for Health and Scientific Affairs in the
Department of Health Education and Welfare, he was promoted to Assistant Secretary a few
months later. He retained this position until the end of Johnson administration when he
accepted the position of Chancellor at UCSF. His nomination as chancellor was not without
controversy with the San Francisco Medical Society and the California Medical Association
proposing an alternate candidate. Ronald Reagan and a number of regents also opposed his
appointment. Lee, however, was the choice of the campus administration and was strongly
supported by former California Lieutenant Governor Robert Finch (the secretary of DHEW
under Nixon) who used his conservative credentials to help ensure the appointment, though
he also asked for the appointment to be postponed briefly so that Lee could finish
working on the DHEW reorganization project. He served as Chancellor until the end of 1972
when he resigned to establish the Health Policy Program (later expanded and renamed the
Institute for Health Policy Studies) at UCSF. In making this change Lee stated his desire
to devote more time to his main interests: patient care, teaching and health policy
research. Lee was recalled to public service by the Clinton administration as Assistant
Secretary for Health in the Department of Health and Human Services from 1993-1997. Lee
continues his work in public policy as Institute for Health Policy Studies Senior Advisor
to the School of Medicine and Professor Emeritus.
Research and Professional Contributions
Lee's earliest research and writing was in rehabilitation, arthritis and cardiovascular
disease. He was also very concerned with the public service aspects of medicine and wider
social issues. In the early 1960s, Lee became a dissenting voice in the medical
establishment when he broke with American Medical Association (AMA) official policy and
actively campaigned for the passage of Medicare. He was also a founding member of the
Chowder and Marching Society, an oddly named organization of progressive members of the
medical community from across California. Later in Washington, D.C. he worked with the
AMA to clarify Medicare regulations and policies and simplify reporting requirements.
During 1968 and 1969 he oversaw a massive restructuring of the Department of Health
Education and Welfare and federal health services.
In 1961 Lee went on a Medical Ecology Mission to the Soviet Union. He wrote an article
about this trip, "The Organization of Health Services in the Soviet Union", published in
the May 1962,
Stanford Medical Bulletin. In 1963 he moved to Washington to
join the staff of the Agency for International Development (USAID), as Director of Health
Services in the Office of Technical Cooperation and Research. His work at the USAID
helped hone his international health policy interests. While at the USAID Lee gave a
series of speeches on the AID and international development , wrote an article on
Nephrology, and worked with the Rockefeller Foundation Advisory Board to arrange a
meeting in Dakar.
When Lee accepted the position in the Department of Health Education and Welfare, his
focus returned to domestic health policy, but he never lost his interest in international
health, especially as related to domestic issues. It was during this period that his
interests in family planning, health manpower issues, allied health provider issues,
civil rights, and health access blossomed. From 1965-1967, Lee's first two years as
assistant secretary, Congress passed an unprecedented amount of health legislation. As a
result of the reorganization project, the Public Health Service and the Surgeon General
came under the control of Lee's office.
During his tenure as chancellor, Lee oversaw the creation of affirmative action policies
and advocated for an increase in minority students at UCSF. To rectify the health
manpower shortage of the late 1960s, he was deeply interested in issues concerning the
training of physicians and allied health professionals. Lee traced the minority
admissions deficit to both passive and active discouragement of minority students from
going into the health professions. Recruitment, including working to improve pre-medical
classes at community college and undergraduate levels, increasing the summer programs at
UCSF, and other community outreach projects, became a major focus of his term as
Chancellor.
Lee was a major force in UCSF's increasing commitment to research and public service.
Research, he said in his Inaugural Address, needed to be done into how "social,
psychological and environmental forces" relate to health and disease. Medical and health
issues could not be separated from poverty and the changing urban structures of American
life. This led to his interest in less traditional treatment modalities and his
friendship with Werner Earhardt, the founder of EST (Earhardt Seminar Training). He also
encouraged the study of ways to create "new models" for the delivery of health care.
Besides his early and continued championing of Medicare, he also showed interest in the
idea of national and pre-paid health insurance. These concerns are also evident in his
ongoing research interests in family planning, drug and alcohol abuse, and the dangers of
tobacco.
Lee championed the San Francisco campus during UC-wide financial difficulties and
challenged the governor's finance department's auditors report. The period between 1969
and 1972, during which Lee was Chancellor, was also a volatile time politically for
colleges and universities across the country. UCSF was no exception, though it was more
subdued than the University of California at Berkeley. Lee dealt with controversial
issues including responses to the Vietnam War and Governor Reagan's three day closure of
all UC campuses, as well as a LSD symposium, and student use of the computer center to
print political pamphlets. Lee also served as an evaluator of the University of Ohio's
medical program and was involved in reviewing proposals concerning the nation's Public
Health Service Hospitals. However, as he wrote to a friend, the chancellor position was
even more work than his DHEW job had been. Lee wanted time to adequately pursue his
primary interests in health policy development, research, and teaching so he tendered his
resignation as Chancellor in February 1972.
To pursue these interests, Lee founded the Health Policy Program (HPP) in 1972. In 1977
HPP, now called the Institute for Health Policy Studies (IHPS), was awarded a five-year
grant as the national Health Services Policy Analysis Center by the National Center for
Health Services Research, Department of Health, Education and Welfare. In 1981 the
Institute was officially designated as an organized research unit within the University
of California. The Institute has a tripartite mission: to conduct policy-oriented
research into health issues; apply research findings to health policy issues; and to
provide education and training opportunities in health policy research.
During his time as director of the IHPS, Lee produced the majority of his written work
co-authoring 10 books and numerous book chapters, monographs, and articles. Lee's major
research projects during this period included an international drug study that led to his
1982 book,
Prescriptions for Death: The Drugging of the Third World, and
work with the Human Sexuality Program's Cleveland Project --a study of the development of
sexual knowledge and attitudes. Lee also became interested in issues of aging and worked
with Carroll Estes on a number of research projects and monographs. He taught classes in
bioethics and served on numerous boards of directors and advisory committees, at both
local and federal levels. In 1985 he became the first president of the San Francisco
Health Commission and became involved in AIDS issues. Lee remained director of the IHPS
until 1993, when at the urging of the Clinton administration he again took up the mantle
of Assistant Secretary in the renamed Department of Health and Human Services. He
returned to UC in 1997 as Senior Advisor to the School of Medicine and Professor Emeritus
based at the IHPS. He retains his national and international research and consultation
activities.
Throughout his career Lee has been an inveterate speech maker and these documents reveal
the broad range of his interests. Many of these speeches were also published as articles
in a variety of popular and medical/scientific journals. Topics covered include: "The
Rehabilitation of the Rheumatic Child" (1957), "Health Aspects of the USAID Program"
(1963), "Population, Public Health and International Development" (1965), "Creative
Federalism and Public Health --New Patterns (1966), "Population Growth--Problems,
Progress, Prognosis (1967), "Has the World Grown Too Small," "Health and the City," and
"Toward a Dream of World Health" (1968), "Equal Opportunity--A Reality for Minority
Students in the Health Professions? and "Health Services and an Optimum Level of
Population--Are We Part of the Solution or Part of the Problem? (1969), "The University
Medical Center and Urban Crisis" and "Child Health -Who Cares" (1970), "National Health
Insurance --Problems, Proposals and Policies" (1971), "Is There a Future for Family
Medicine? (1973).
Lee gave speeches at universities, medical conferences, professional organizations,
political groups, community groups and more. Besides speeches to groups and organizations
Lee also appeared on several of Oakland television station, KTVU, Channel 2's "Doctor's
News Conferences." This series of shows concerned current medical issues and featured Lee
and other local medical experts.
Lee has authored more than 150 articles, as well as co-authoring numerous books, book
chapters, and monographs. He co-authored two books and a monograph on rehabilitation:
Cardiovascular Rehabilitation (1957),
Rehabilitation of the
Cardiovascular Patient
(1958), and
An Evaluation of Rehabilitation of
Patients with Hemiparesis or Hemiplegia Due to Cerebral Vascular Disease
(1958).
His next book, the 1972
Politics of Health, co-edited with Douglass
Carter, was created during his years as chancellor, but the rest of his books and
monographs come from his years at the IHPS. Lee was author or co-author of:
Notes
on a Visit to China
(1973),
Pills, Profits, and Politics (1974),
Deliberations and Compromise: The Health Professions Educational Assistance Act of
1976
(1977),
Primary Care in a Specialized World (1976),
Abortion Politics: Private Morality and Public Policy (1981),
Exercise and Health: The Evidence and the Implications (1981),
Pills and the Public Purse (1981),
Prescriptions for Death: The
Drugging of the Third World
(1982),
Drugs and the Elderly: Clinical,
Social, and Policy Perspectives
(1988), and
The Nation's Health
(1st ed. 1981, 5th edition 1997),
Bad Medicine (1992)
Besides these books Lee also served as author or co-author of a numerous Policy Papers
and Working Papers issued by the IHPS or the Aging Health Policy Center. Titles from this
series, on which he is listed as co-author, include:
Nutrition Policy and the
Elderly
(1983),
Drugs and the Elderly: A Background Paper (1983),
Policy Developments in the Medicare, Medicaid, and Social Services
Programs
(1983),
Lifetime Fitness and Exercise for Older People
(1983),
Public Policy, the Private Non Profit Sector and the Delivery of Community
Based Longterm Care Services for the Elderly
(1986), and
Federal Cap on
Medicaid Expenditures Impact on Long Term Care for the Elderly
(1981). He is also
listed as co-principal investigator, though not author, on
Organizational and
Community Responses to Medicare Policy: Consequences for Health and Social Services For
the Elderly : Final Report.
He contributed chapters to books ranging from
The Aging Enterprise to
The American Hospital System and AIDS:
Public Policy Dimensions,
and articles to medical, legal, and public policy
journals as well as more popular media.
As educator, research, writer, and policy maker, Philip Randolph Lee contributed to a
wide range of health issues and worked to create new responses to the major health policy
and manpower issues of the period.
- Young Man of the Year, Palo Alto Junior Chamber of Commerce --1962
- Superior Honor Award, Agency for International Development --1965
- Honorary Degree (Sc.D.), MacMurray College, Jacksonville, Illinois --1967
- Hilleboe prize in Public Health --1968.
- Secretary's Special Citation, Department of Health Education an Welfare --1969
- Certificate of Honor, San Francisco Board of Supervisors --1972
- Hugo Schaefer Medal, American Pharmacy Association --1976
- Kaiser Senior Fellow, Center for Advanced Study in Behavioral Sciences --1980-81
- Honorary Degree (Ph.D.), Ben Gurion University of the Negev, Israel --??
- American Medical Association
- American Public Health Association
- American College of Physicians
- American Federation of Clinical Research
- Association of American Medical Colleges
- Alpha Omega Alpha --[ gave speeches there too]
- American Association for the Advancement of Science
- American Geriatrics Society
- California Society of Internal Medicine
- Institute of Medicine --National Academy of Sciences
- Society for Research and Education in primary Care Internal Medicine.
Professional and Civic Service
| 1960-61 | Chairman, Senior Citizens Division, Executive Board, Community Council of Northern Santa Clara County, California |
| 1960-63 | Board of Directors, Palo Alto Medical Research Foundation |
| 1960-65 | Board of Directors, Channing House, Palo Alto, California |
| 1960-61 | Chairman, Senior Citizens Division, Executive Board, Community Council of Northern Santa Clara County, California. |
| 1961 | Advisory Committee on Aged and Handicapped Services, Santa Clara County Department of Welfare. |
| 1968-71 | Harvard Visiting Committee, School of Medicine and School of Dental Medicine |
| 1969-70 | Commission on Foundations and Private Philanthropies |
| 1969-70 | Technical Advisory Committee, Carnegie Commission on Higher Education |
| 1970-72 | Board of Directors, San Francisco Planing and Urban Renewal Association |
| 1971-? | Board of Directors, World Without War Council |
| 1971-72 | Board of Directors, National Medical Fellowships |
| 1971-75 | Board of Directors, Mayo Foundation |
| 1971-79 | Board of Directors, Carnegie Corporation |
| 1974-76 | Chairman, Board of Trustees, The Foundation for the Realization of Man |
| 1974-76 | Chairman, Health Services Development Grants Study Section, National Center for Health Services Research, Department of Health, Education and Welfare |
| 1977-78 | National Commission on Smoking and Public Policy |
| 1978-80 | National Council on Health Planning & Development |
| 1980-? | Co-Director, Institute on Health & Aging, School of Nursing, UCSF |
| 1984-93 | Board of Directors, World Institute on Disability |
| 1983-86 | Member, Population Committee, National Research Council, National Academy of Science |
| 1985-89 | President, Health Commission, City and County of San Francisco |
| 1986-93 | Chair, Physician Payment Review Commission, established by US Congress |
This collection documents Philip Randolph Lee's career as a health policy researcher and
administrator. It includes speeches and articles from the early years of his career,
including his 1955 master's thesis. The bulk of the collection concerns his years of
government and UC service until 1983. There are extensive Correspondence and Speech files
for his years as Assistant Secretary at the Department of Health Education and Welfare
and as Chancellor of UCSF. There is Correspondence, Speech and Subject/Publication files
for his first eleven years as director of the Institute for Health Policy Studies (IHPS)
and its predecessor (HPP). There are no materials from his second stint as Assistant
Secretary in the Department of Health and Human Services (1993-97) or as Professor
Emeritus and Senior Advisor at UCSF (post 1997).
Major topics or issues addressed in the collection include: rehabilitation, family
planning, health manpower issues, maternal and child health, Medicare, reorganization of
DHEW, administration of UCSF, implementation of affirmative action policies at UCSF, HMOs
and other group practice and prepaid health insurance options, public health service
hospitals, and federal health policy.
Other Philip R. Lee materials may be found at the Johnson Presidential Library (see
letter from Lee to the Chester A. Newland, Director, Johnson Presidential Library,
January 27, 1970). More information on Lee and his career can be found in the Philip
Randolph Lee Oral History being conducted by the UCSF History of Health Science program.
A copy of this Oral History will be deposited in the UCSF Library and CKM Archives and
Special Collections upon completion.
The collection is divided into 5 chronological series corresponding to Lee's changing
institutional connections:
Title: I: Early Career, II: USAID, III: DHEW, IV:
Chancellor of UCSF
, and
Title: V: IHPS
. Each of these series
is divided into several subseries based on document type: Correspondence, Speeches,
Articles, Subject Files. These subseries are arranged chronologically with the exception
of the Subject files which are arranged intellectually as well as chronologically.
The
Title: Early Career Series
documents the period from his graduate
studies until his first federal government position. Besides his University of Minnesota
Master's Thesis this series includes information on the Chowder and Marching Society, a
group of physicians from all over California who were interested in group practice and
other innovative healthcare concepts in the early 1960s, and materials documenting his
interest and work in the field of rehabilitation. Also included is a diary from his 1961
Medical Ecology Mission to the Soviet Union. Most of the documents in this series relate
to his work at the Palo Alto Clinic and as Faculty at Stanford University. This series is
divided into three subseries: Speeches, Articles, and Miscellaneous.
The
Title: USAID Series
includes materials dealing with his two years of
work as Director of the Health Service in the Office of Human Resources and Social
Development. There is no official AID correspondence within this series but extensive
correspondence with colleagues in California, on a variety of topics of interest, and
with various professional organizations. The speeches and articles in this series, for
the most part, deal directly with his USAID work and concern international health and
health education.
The
Title: DHEW Series
is one of the largest series in the collection
due, in part, to its large correspondence subseries. Lee had wide-ranging duties as
Assistant Secretary for Health and Science in the Department of Health, Education, and
Welfare. The majority of this series consists of Lee's chronological correspondence and
shows the sheer daily volume of federal governmental correspondence and a cross-section
of the duties of the office. Some routine and repetitive correspondence concerning the
issuing of licensing of blood products has been weeded from the collection. There is also
correspondence with his friends in California and elsewhere. Major topics included in
this series are Family Planning, Medicare, Health Manpower, and the reorganization of the
Department of Health Education and Welfare. The series also documents more than 140
speeches made by Lee during his four years at DHEW. Lee also retained many subject files
that included numerous government documents and compilations relating to his work at
DHEW. These include summaries of legislation, DHEW policy goals and senate briefing
booklets. Also included are materials concerning family planning and maternal and child
health care issues.
The
Title: Chancellor Series
includes extensive chronological official
correspondence, some personal correspondence and correspondence with professional groups
and organizations. The majority of this correspondence consists of carbon copies of
outgoing correspondence. There are also speech and article files, though not as extensive
as in the DHEW series. The subject subseries documents Lee's extra-chancellery interests,
including evaluation of medical programs for the Ohio Board of Regents and Harvard
University and work on a Public Health Service Hospital Conversion Project.
Correspondence includes information on the organization of the Sun Valley Symposia, as
well as his continuing interest in health policy issues along with his chancellery
duties. Major internal (UCSF) issues addressed include budget, long-range planning,
staffing, and curriculum issues. Of special interest are Lee's attention to the question
of minority admissions and the creation of affirmative action policies on campus. Lee was
also chancellor during a time of national turmoil. Issues connected to the Vietnam war,
war protests, Kent State are treated in letters and speeches. There are also reports Lee
received connected to the Public Health Service Hospital Conversion Project.
The final series covers the first 11 years of the
Title: Institute of Health Policy
Studies (IHPS)
including its founding as the Health Policy Program in 1972
through its designation as the national Health Services Policy Analysis Center and its
official designation as an organized research unit within the University of California.
The correspondence in this series, again, consists primarily of carbons of outgoing
correspondence. Topics covered include discussion of Lee's and the Institute's teaching
programs, Lee's involvement with the Sun Valley Forum (also documented in the Chancellor
series), the Human Sexuality Program, drug dumping and the Third World Drug Study, and
other social and medical issues. There is some material on Lee's 1973 Medical Mission to
China. Also included are research files and draft copies of several of Lee's major books:
Pills and the Public Purse,
Drugs and Elderly, and
Deliberations and Compromise.
The Early Career and the IHPS Series break somewhat from the main organizational pattern.
In the Early Career Series, there is no correspondence subseries instead some
correspondence can be found in the Miscellany subseries at the end of the series. The
IHPS subseries does not include an Articles subseries, but draft manuscripts for several
monographs can be found in the Subject/Publication subseries.
Across the collection, the four Correspondence subseries are approximately half of the
collection and covers the years from 1963-83. The majority of the correspondence consists
of carbons of outgoing letters including official DHEW and Chancellor's Office
correspondence. Some incoming correspondence is found in each of the correspondence
subseries. Incoming correspondence is also found in the subject and speeches subseries.
The second largest subseries are the Speeches subseries. This subseries consists of
information pertaining to the myriad of speeches delivered by Lee at various points in
his career. Several of the Speeches subseries are made up of two overlapping filing runs.
One consists of speech files that list an individual speaking event and contains some
combination of speech draft, correspondence, reprints, and background material used to
prepare the speech or about the organization being addressed. The other consists of a
numbered chronological list of the speeches and then manuscripts of the speeches in
numerical order. These speech books are not complete.
Several items have been removed from the collection, primarily published government
documents removed from the DHEW and IHPS subject files, these items can be found in any
Federal Depository Library and several are also found in the UCSF library catalog. Items
removed from the collection:
- The Budget of the United States Government for the Fiscal Year Ending June 30 1966: Appendix. Washington, DC : US Government Printing Office, 1965.
- The Budget of the United States Government Fiscal Year 1969: Appendix. Washington, DC : US Government Printing Office, 1968.
- Report of the National Advisory Commission on Health Manpower. Volume 1 & 2 November 1967. Washington, DC : US Government Printing Office, 1967 (2 copies)
- Drug Regulation Reform Act of 1978 : Hearings Before the Subcommittee on Health and Scientific Research of the Committee on Human Resources, United States Senate, Ninety-fifth Congress, Second Session on S. 2755. Part 1 & 2. Washington : US Government Printing Office, 1978
- Drug Regulation Act of 1979: Report of the Committee on Labor and Human Resources, United States Senate, to Accompany S. 1075 together with Additional Views. 96th Congress, 1st Session, Report No. 96-321, Calendar No. 334. Washington: US Government Printing Office, 1o79
- Drug Regulation Reform Act of 1978 : The Administration Proposal : Section-By-Section Analysis, H.R. 11611 and S. 2755, 95th Congress, Second Session. [Washington : Dept. of Health, Education, and Welfare], 1978
- Administered Prices. Hearings Before The Subcommittee on Antitrust and Monopoly of The Committee on the Judiciary, United States Senate, Eighty-Fifth Congress, First Session. Part 14, 17, 18, 20, 23 (Volume 1 & 2), 24 (Volume 1 & 2) Washington, US Government Printing Office, 1957-