By James G. Kahn, M.D., M.P.H.
Emeritus Professor of Health Policy, University of California, San Francisco
Last week saw the passing of two amazing leaders in the pursuit of health care justice in the United States – one who operated at the highest political, policy, and academic levels, and one who worked tirelessly at the grassroots with the most vulnerable. Phil Lee and Don Bechler led and inspired us for decades in the ongoing struggle for a health system that benefits everyone. I had the distinct honor of knowing and working with both of them.
Philip R. Lee was 96, with a storied career spanning more than 50 years in government and academia. I met Phil in 1987 when he invited me to do an AIDS cost research project at the Institute for Health Policy Studies (now named for him) at UCSF. I extended my association with him in 1989 as a health policy fellow at IHPS. He was the ultimate networker, with a massive double Rolodex, when those were physical items. He knew everyone in health policy and often had hired and/or mentored them. He was the person in DC who, as Assistant Secretary for Health under LBJ, told U.S. hospitals: if you want Medicare money, no more racially segregated wards. After serving as UCSF Chancellor, he started IHPS as the first ever academic health policy unit in the U.S. He served another stint as Assistant Secretary for Health under Bill Clinton. He was and is a guiding light for many of us: with Phil, it was always about public service and improving health. He consistently projected his vision, his determination to achieve that vision, and his encyclopedic knowledge of people and ideas. He guided me in my fellowship days. One small memory comes to mind. I jotted on a piece of paper something like “Health services research is the study of how outcomes (mortality, cost, etc) in operating health systems vary according to location, type of provider, patient characteristics, etc.” Phil saw it, and said, that’s a great definition, where did you get it? “I made it up.” To this day, this approval from Phil is one of my proudest moments. I’m sure thousands will mourn his loss and recall his greatness. Millions benefited – and continue to benefit – from his leadership.
Don Bechler (73) followed a different and also awe-inspiring path. Don trained and worked as an airplane mechanic. He worked intensively in 1994 on the California Prop 186 single payer ballot initiative. In the late 1990s he was laid off from his airline job, and started full-time organizing around single payer, supported for living expenses by single payer colleagues. He had an unswerving devotion to work at the grassroots level with community members and groups, in mirror image to Phil’s hobnobbing with presidents and prominent academics. I wonder if they knew each other; I hope so. Don was a wonderful colleague in the single payer movement, appreciating the role of research like mine. I was always honored when Don called to request a talk about one economic issue or another. But for Don the core focus was people, the vulnerable and downtrodden, those who would be helped by truly universal health insurance. I remember when I saw him at a Bernie speech at Zellerbach Hall at UC Berkeley in 2016. We were chatting in line and I asked him, “So, realistically, is single payer happening?” – this question to a guy who lived each day as if it must. He became thoughtful, “There’s too much money vested in what we currently have.” Oddly, I wasn’t put off or disconcerted by that. I redoubled my efforts. Don was an inspiration: every day he worked for what was right and just, despite the odds. Don signed off of every email with “You are great! Don.” I try to pass that sentiment forward with my colleagues in the fight for health justice.
A Biden win in the election tomorrow saves democracy. It doesn’t solve health systems problems, but offers a platform for moving forward. Phil and Don will inspire us as we fight for that crucial next step.
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