REMEMBERING JACK GEIGER, MD - Medical Activist Extraordinaire

From Oliver Fein, PNHP - NY Metro Board Chair

On December 28, 2020, I wrote to our Board the sad news that Dr. Jack Geiger had died that morning. Martha Livingston, Chapter Vice Chair, recalled that we had honored Jack at our 2016 Gala Celebrating Single Payer Champions, and that we had asked Ted Brown, healthcare historian from the University of Rochester, to present our award to Jack. Below are Ted’s wonderful comments at that occasion. In 2012 and 2018, I had the privilege to work together with Jack on expanding his chapter on Medical Care, in Social Injustice and Public Health, edited by Barry Levy and Victor Sidel. Ted quotes from that chapter which advocates for a universal, equitable, single-payer, “Medicare for All” health system. The New York Metro PNHP chapter had a special relationship with Jack Geiger, which I wanted to share with you.

Remarks by Theodore Brown, PhD, at the NY-Metro PNHP Celebration of Single Payer Champions - June 1, 2016

     I am deeply gratified to have been asked by Metro New York PNHP to help honor Dr. Jack Geiger this evening. But I must admit that it is a daunting challenge to find a new way to recognize his achievements. Just a week and a half ago, Jack received his latest honor that I know of, an honoris causa Doctorate of Public Service from Tufts University. This was on top of a truly remarkable number of other awards over the years. He has received the Sedgwick Medal for “distinguished service in public health” from the American Public Health Association, the Lienhardt Award from the Institute of Medicine for “outstanding contributions to minority health,” and the Albert Schweitzer Prize for “Humanitarianism.” These are just a very small sampling of a much longer list of awards and recognitions.

     Jack has received these awards for his inspiring achievements in and advocacy for social justice in health over the span of his long career, achievements and advocacy which derived from his deep understanding of the roots of health inequalities in the social order. His understanding has been as profound as that of Friedrich Engels and Rudolf Virchow in the 1840s, and, indeed, one of the reasons I so admire Jack is because he has been our best current role model and most direct link to the “Spirit of 1848” and to the principles of social justice that are the proper foundation for public health and health reform. He understood these principles as a teenager before he settled on medicine as a career, he acted on them as a premedical and medical student, and he transformed them into concrete accomplishments as a young health professional when he helped found the Medical Committee for Human Rights in the Sixties, went to Mississippi during Freedom Summer, and brought a radically innovative model of health reform and political action from Pholela, South Africa to Mound Bayou, Mississippi.

     Jack saw the big picture. He wrote the following in 1969: “Right now we health professionals are standing in the middle of an endlessly revolving door … doing some good on a short-term basis…. [But] we cannot go on providing health services without regard to the system in which the roots of poverty, sickness, and many other social ills are embedded. We have to be willing to identify the real problems and confront them … we have to create new social institutions appropriate to the problem; and, finally, we need a sense of passionate commitment to bring about the changes that are so urgently needed.” Jack saw the Mound Bayou center as one of those “new social institutions,” a health center which had “as its primary thesis that the determinants of health are in the social order, not health care. … We think there’s a better way to … [improve a community’s health] by using health services as a route of entry for these other kinds of social change.”

     That, of course, was a radical vision, and Jack never lost sight of it. But he also never lost sight of how important properly organized and accessible health services are (hence his life-long commitment to the primary care movement), nor did he lose sight of the central importance of equity in access to quality health services. He articulated the critical connections between equity in access and social justice in a brilliant essay on “Medical Care” published in Barry Levy and Vic Sidel’s wonderful book, Social Injustice and Public Health. Jack wrote as follows: “Medical care … makes a difference to both personal and public health – one that is most clearly revealed when care is absent or denied. For example, failures to provide immunization have repeatedly led to outbreaks. … Lack of prenatal care is associated with higher rates of infant and maternal mortality … Studies of poor adults removed from programs that fund access to care … have documented the occurrence of uncontrolled illness – and some preventable deaths. …” And most generally, “because poor health care and poor health so profoundly limit opportunities … for the full realization of one’s potential … justice in health care is good for the public’s health, and the public’s good health, in turn, broadens opportunities and facilitates a more just society.”

     In that same essay, Jack identifies the basic source of injustice in access to health care in our country: ideological and political biases that “treat medical care as a market commodity … rather than as a social good to be distributed in response to medical need, a responsibility of government, and a fundamental right embodied in a social contract.” The alternative to our present system is clear, and Jack has known it for a very long time: a universal, equitable, single-payer, “Medicare for All” health system in the United States. And thus, among the many other admirable things Jack has done he has also been a passionate supporter of the single-payer cause. He did this in the context of the American Public Health Association and other professional and advocacy organizations in the 1970s and 1980s; as a founder of Physicians for a National Health Program in the late eighties; as a stalwart member and advocate for PNHP in the 1990s, including one memorable appearance in 1998 as a speaker at a rally on the steps of the Canadian embassy after a march from the APHA meeting through the streets of Washington led by Quentin Young in search for “health care asylum”; and as a strong, clear voice for “Everybody In, Nobody Out” at the local, state and national level in recent years.

   For these reasons, the New York Metro Chapter of Physicians for a National Health Program is tonight presenting Jack with another, richly deserved award, its “Health Justice Award.” Congratulations, Jack.

Ted Brown

June 1, 2016