Lee, Philip R. (Philip Randolph), 1924-

Biographical Statement

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.

Family

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.

Education and Career Path

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.

Speeches

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.

Publications

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.

Honors and Awards

Professional Organizations

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 - 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 - 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

From the guide to the Philip Randolph Lee Papers, 1947-1984, (University of California, San Francisco. Library. Archives and Special Collections.)