The Commonwealth Fund is a health care policy-focused private foundation. It funds research on and advocacy for health care systems, frequently taking a left-of-center perspective on state intervention in the medical system 1 and the power of public health authorities. 2
The foundation was created in 1918 by Anna Harkness, the widow of Stephen Harkness, a director and shareholder in John D. Rockefeller’s Standard Oil Company. Her son, Edward Harkness, would be the Fund’s first president. 3
In the Fund’s 2009 president’s message, then-Commonwealth Fund president Karen Davis claimed credit for the Fund having “marshaled its resources this year to produce timely and rigorous work that helped lay the groundwork for the historic Affordable Care Act, signed by President Obama in March 2010.” 4 In addition to producing research supporting greater government control of the hospital and health insurance systems, the Commonwealth Fund convened the Commonwealth Fund Commission on a National Public Health System to promote increased federal control of public health after the COVID-19 pandemic. 5
History
Commonwealth Fund was created by Anna Harkness, the widow of Standard Oil Company investor Stephen Harkness, in 1918. The Fund’s first president would be Edward Harkness, Anna’s son, and the Harkness family would provide more than $53 million to endow Commonwealth Fund through 1959. 6
Since the 1920s, Commonwealth Fund’s work has focused on public health and health care systems. According to the Fund, its early work “led to the development of the field of child guidance and contributed to the emergence of progressive public health departments in communities around the country.” Later work saw the Fund support hospital construction and medical education; since 1995, the Fund has focused on left-progressive approaches to health care system design and payment approaches. 7
Though the fund’s early grants supported a diverse range of educational, cultural, and medical organizations, the fund eventually gravitated toward heavy investment in organizations oriented around healthcare, especially child welfare.89 Institutions supported by the fund early on in its development include the American Board of Pediatrics, American Red Cross, American Museum of Natural History, Boy Scouts of America, Columbia University, the pro-abortion Guttmacher Institute, International Women’s Health Coalition, the Julliard School, the Urban Institute, and Vanderbilt University’s School of Medicine.10
Role in Obamacare
Commonwealth Fund claims credit for supporting the policy development for and enactment of the Patient Protection and Affordable Care Act, commonly known as Obamacare, in 2010. 11
International Health System Comparison Surveys
The Fund’s periodic surveys of international health system performance routinely show the United States performing exceptionally poorly. In her 2009 annual message entitled “Building a Foundation for Health Reform,” then-Commonwealth Fund president Karen Davis claimed the Fund deserved credit for providing “information on how the U.S. health system compares internationally—further evidence to build a compelling case for reform.” 12
Free-market critics of the Commonwealth Fund, which has continued to publish international health systems comparisons after Obamacare’s passage, have questioned the methodology the Fund uses to rate health systems, focusing on the Fund’s reliance on subjective analyses. 13 14 Philip Klein, then of the Washington Examiner, wrote in 2014 that the Fund’s study was “rigged to produce a result that favors socialized health care systems.” 15
Other critics of the Fund’s methodology have objected to its apparently circular assertion about cost impacts, with one writing, “It may be fine to blast the U.S. system for being expensive, but to say that we are paying too much for a bad system, while assessing badness based on the system being expensive, is circular logic that should have no place in serious scientific conversation.” 16
Training for Journalists
In 2013, after the launch of the Obamacare “exchange” websites resulted in severe technical problems, a Commonwealth Fund official spoke to the Society of American Business Editors and Writers on covering the problematic launch. At the “training,” the Fund’s Sara Collins argued that the technical problems did not signify “deeper problems” with the legislation, asserting, “I think it is a website issue.” 17
David Blumenthal, who took over as Commonwealth Fund president in 2013, worked as National Coordinator for Health Information Technology in the Obama administration from 2009 through 2011. 18 Critics of Obamacare suggested that because of Blumenthal’s connection to the administration, Commonwealth Fund’s training for journalists on rollout coverage “would violate SABEW’s code of ethics.” 19
Medicaid Expansion
Commonwealth Fund has reported making grants to left-of-center groups including Families USA Foundation, to support the expansion of Medicaid under Obamacare. A $195,000 grant to Families USA Foundation in 2020, focused on Mississippi, Missouri, Oklahoma, and Wyoming, covered “rapid response technical assistance,” “in-depth legal and policy analysis,” and “dissemination of facts around the value of Medicaid expansion, including via storytelling.” 20
Public Health Advocacy
COVID-19 Regulations
Commonwealth Fund advocated for continuation of strict COVID-19 regulations. The organization published an international health systems comparison to promote the adoption of COVID-19 vaccination mandates, praising New York and Los Angeles for adopting wide-ranging mandates in an accompanying statement. 21
In 2022, Commonwealth Fund published a blog post criticizing a ruling by a federal judge Kathryn Kimball Mizelle that held that the Centers for Disease Control (CDC) had exceeded its authority by requiring all public transportation and airline passengers to wear masks. The author concluded, “Do we really want the federal government’s power to address the next epidemic to be constrained by a judge’s preferred reading of an 80-year-old dictionary?” 22 Commonwealth Fund president David Blumenthal wrote, “It is hard to see the ruling as anything other than a direct attack on the very right of government to set rules that balance individual freedom and collective responsibility when it comes to pandemic illness.” 23
Commission on a National Public Health System
In 2022, Commonwealth Fund announced a commission to “lay out a vision for reform of the U.S. public health infrastructure at the federal, state, and local levels” that would be chaired by Margaret Hamburg, a public health official who most notably served as Commissioner of the Food and Drug Administration in the Obama administration. 24 Other members of the commission include Mandy Cohen, former North Carolina state Secretary of Health and Human Services in the administration of Gov. Roy Cooper (D); Karen DeSalvo, the chief health officer of Google and a former Health and Human Services official in the Obama administration; 25 Joneigh Khaldun, chief health equity officer for CVS Health and a former official in the administrations of Michigan Gov. Gretchen Whitmer (D) and Detroit Mayor Mike Duggan (D); 26 Herminia Palacio, president and CEO of the abortion-advocacy group Guttmacher Institute and a former official in the administration of New York City Mayor Bill de Blasio (D); 27 Nirav Shah, a former Commissioner of Health for the State of New York in the administration of Gov. Andrew Cuomo (D); 28 David Lakey, former Texas Health Commissioner under Gov. Rick Perry (R), Julie Gerberding, Director of the Centers for Disease Control and Prevention in the George W. Bush administration, and Ellen MacKenzie, the dean of the Johns Hopkins Bloomberg School of Public Health. 29 30
In June 2022, the Commission issued a report calling for extensive increases in federal authority over state and local public health responses, with the federal government given what a New York Times report characterized as “the power to set minimum health standards for the states.” 31
Grantmaking
Much of Commonwealth Fund’s advocacy takes the form of grants made to other advocacy groups, which are frequently aligned with left-of-center causes. The organization’s 2020 tax returns report grants to AARP Foundation, the Brookings Institution, Families USA Foundation, the Guttmacher Institute, Hopewell Fund, National Academy of Social Insurance, Small Business Majority, the Century Foundation, and the Urban Institute. 32
Fellowships
In addition to its grantmaking activity, the Commonwealth fund offers fellowships generally aligned with its aims, such as the Harkness Fellowship in Health Care Policy and Practice, which supports individuals conducting internationally comparative research in health care policy in the United States; the Association of Health Care Journalists International Health Study Fellowship, which supports longtime U.S.-based health care journalists in their work on an approved story or project comparing a facet of the U.S. healthcare system to that of another country; the Association of Health Care Journalists Reporting Fellowship on Health Care Performance, which supports mid-career healthcare journalists on projects related to examining healthcare systems; and the Commonwealth Fund Fellowship in Minority Health Policy, which supports students pursuing a master of public health degree at the Harvard School of Public Health or a master of public administration degree at the Harvard Kennedy School of Government.33343536
David Blumenthal
David Blumenthal is president of the Commonwealth Fund. Formerly, Blumenthal was the Samuel O. Thier professor of medicine at Harvard Medical School, chief health information and innovation officer at Partners Healthcare System in Boston (now Mass General Brigham), director of the Institute for Health Policy, professor of medicine and health policy at Massachusetts General Hospital, staff member for the U.S. Senate Subcommittee on Health and Scientific Research, founding chairman of AcademyHealth (a national organization of health services researchers), and senior vice president at Boston’s Brigham and Women’s Hospital. 37
Additionally, Blumenthal is a member of the National Academy of Medicine and sits the on boards of organizations including the Josiah Macy Jr. Foundation, the Carol Emmott Foundation, and the New England Journal of Medicine. Previously, he sat on the boards of the University of Chicago Health System and the University of Pennsylvania Health System.38
References
- Gratzer, David, and Merrill Matthews. “Last in Credibility.” Washington Examiner. Washington Examiner, August 9, 2010. https://www.washingtonexaminer.com/weekly-standard/last-in-credibility.
- Blumenthal, David. “What Do We Owe Each Other? Balancing Personal Freedom and Collective Responsibility in the Age of Covid.” Commonwealth Fund, April 27, 2022. https://www.commonwealthfund.org/blog/2022/what-do-we-owe-each-other-balancing-personal-freedom-and-collective-responsibility-age.
- “Foundation History.” Commonwealth Fund. Accessed June 29, 2022. https://www.commonwealthfund.org/about-us/foundation-history#:~:text=In%201918%2C%20Anna%20Harkness%20founded,gift%20of%20nearly%20%2410%20million.
- Davis, Karen. “2009 Annual Report President’s Message: Building a Foundation for Health Reform.” Commonwealth Fund, June 16, 2010. https://www.commonwealthfund.org/publications/other-publication/2010/jun/2009-annual-report-presidents-message-building-foundation.
- “Commonwealth Fund Commission on a National Public Health System.” Commonwealth Fund. Accessed June 29, 2022. https://www.commonwealthfund.org/about-us/public-health-commission.
- “Foundation History.” Commonwealth Fund. Accessed August 11, 2022. https://www.commonwealthfund.org/about-us/foundation-history#:~:text=In%201918%2C%20Anna%20Harkness%20founded,gift%20of%20nearly%20%2410%20million.
- “Foundation History.” Commonwealth Fund. Accessed August 11, 2022. https://www.commonwealthfund.org/about-us/foundation-history#:~:text=In%201918%2C%20Anna%20Harkness%20founded,gift%20of%20nearly%20%2410%20million.
- “Foundation History.” Commonwealth Fund. Accessed May 9, 2022. https://www.commonwealthfund.org/about-us/foundation-history
- Fleishman, J.L. The Foundation: A Great American Secret: How Private Wealth Is Changing the World. PublicAffairs. 2007. Accessed May 9, 2022. https://archive.org/details/foundationgreata00flei
- “Commonwealth Fund records, Subgroup 2.” Rockefeller Archive Center. 1918-2012. Accessed May 9, 2022 https://dimes.rockarch.org/collections/NoXxVaTaDZuqNxFmA9NKfz
- “Foundation History.” Commonwealth Fund. Accessed August 11, 2022. https://www.commonwealthfund.org/about-us/foundation-history#:~:text=In%201918%2C%20Anna%20Harkness%20founded,gift%20of%20nearly%20%2410%20million.
- Davis, Karen. “2009 Annual Report President’s Message: Building a Foundation for Health Reform.” Commonwealth Fund, June 16, 2010. https://www.commonwealthfund.org/publications/other-publication/2010/jun/2009-annual-report-presidents-message-building-foundation.
- Gratzer, David, and Merrill Matthews. “Last in Credibility.” Washington Examiner. Washington Examiner, August 9, 2010. https://www.washingtonexaminer.com/weekly-standard/last-in-credibility.
- Roy, Avik. “The Commonwealth Fund Rags on U.S. Health Care.” National Review. National Review, June 27, 2010. https://www.nationalreview.com/the-agenda/commonwealth-fund-rags-us-health-care-avik-roy/.
- Klein, Philip. “Flawed Study Ranks United States as the Worst Health Care System.” Washington Examiner. Washington Examiner, June 16, 2014. https://www.washingtonexaminer.com/flawed-study-ranks-united-states-as-the-worst-health-care-system
- [1] Gur-Arie, Margalit. “Digging Deeper into the Commonwealth Fund Health Rankings.” KevinMD.com, June 24, 2014. https://www.kevinmd.com/2014/07/digging-deeper-commonwealth-fund-health-rankings.html.
- Gehrke, Joel. “Pro-Obamacare Team Trains Reporters on Covering Obamacare Website Problems.” Washington Examiner. Washington Examiner, November 6, 2013. https://www.washingtonexaminer.com/pro-obamacare-team-trains-reporters-on-covering-obamacare-website-problems?_amp=true.
- “David Blumenthal to Step down as Commonwealth Fund President at End of Year.” Commonwealth Fund, May 11, 2022. https://www.commonwealthfund.org/press-release/2022/david-blumenthal-step-down-commonwealth-fund-president-end-year.
- Gehrke, Joel. “Pro-Obamacare Team Trains Reporters on Covering Obamacare Website Problems.” Washington Examiner. Washington Examiner, November 6, 2013. https://www.washingtonexaminer.com/pro-obamacare-team-trains-reporters-on-covering-obamacare-website-problems?_amp=true.
- “Supporting Medicaid Expansion in Mississippi, Missouri, Oklahoma, and Wyoming.” Commonwealth Fund, March 4, 2021. https://www.commonwealthfund.org/grants/supporting-medicaid-expansion-mississippi-missouri-oklahoma-and-wyoming.
- Heath, Sara. “Commonwealth Fund: Will Mandates Improve US Vaccine Access?” PatientEngagementHIT, December 20, 2021. https://patientengagementhit.com/news/commonwealth-fund-will-mandates-improve-us-vaccine-access.
- Jost, Timothy S. “Federal Judge Eliminates the CDC’s Public Transportation Mask Mandate.” Commonwealth Fund, April 27, 2022. https://www.commonwealthfund.org/blog/2022/federal-judge-eliminates-cdcs-public-transportation-mask-mandate.
- Blumenthal, David. “What Do We Owe Each Other? Balancing Personal Freedom and Collective Responsibility in the Age of COVID.” Commonwealth Fund, April 27, 2022. https://www.commonwealthfund.org/blog/2022/what-do-we-owe-each-other-balancing-personal-freedom-and-collective-responsibility-age.
- “The Commonwealth Fund Launches Commission to Envision a National Public Health System in the U.S.” Commonwealth Fund, March 3, 2022. https://www.commonwealthfund.org/press-release/2022/public-health-commission.
- “Our Team of Experts.” Google Health. Accessed August 12, 2022. https://health.google/about-us/.
- “CVS Health Names Dr. Joneigh S. Khaldun as Vice President and Chief Health Equity Officer.” CVS Health, October 18, 2021. https://www.cvshealth.com/news-and-insights/press-releases/cvs-health-names-dr-joneigh-s-khaldun-as-vice-president-and-chief.
- “Herminia Palacio.” Guttmacher Institute, July 9, 2020. https://www.guttmacher.org/about/staff/herminia-palacio.
- “Nirav R. Shah, MD, MPH.” Nirav R. Shah, MD, MPH’s Profile | Stanford Profiles. Accessed August 12, 2022. https://profiles.stanford.edu/nirav-shah.
- “The Commonwealth Fund Launches Commission to Envision a National Public Health System in the U.S.” Commonwealth Fund, March 3, 2022. https://www.commonwealthfund.org/press-release/2022/public-health-commission.
- The Commonwealth Fund Commission on a National Public Health System. “Meeting America’s Public Health Challenge.” Commonwealth Fund, June 2022. https://www.commonwealthfund.org/sites/default/files/2022-07/TCF-002%20National%20Public%20Heath%20System%20Report-r6-final.pdf.
- Stolberg, Sheryl Gay. “Citing a Disastrous Pandemic Response, an Expert Panel Calls for an Overhaul of the U.S. Public Health System.” The New York Times. The New York Times, June 21, 2022. https://www.nytimes.com/2022/06/21/us/politics/public-health-commonwealth-fund.html.
- Commonwealth Fund, Return of a Private Foundation (Form 990-PF), 2019, Part XV Line 3 https://projects.propublica.org/nonprofits/display_990/131635260/05_2021_prefixes_13-13%2F131635260_202006_990PF_2021050518064306
- “Harkness Fellowships in Health Care Policy and Practice.” The Commonwealth Fund. Accessed May 9, 2022. https://www.commonwealthfund.org/fellowships/harkness-fellowships-health-care-policy-and-practice
- “Association of Health Care Journalists International Health Study Fellowship.” The Commonwealth Fund. Accessed May 9, 2022. https://www.commonwealthfund.org/fellowships/association-health-care-journalists-international-health-study-fellowship
- “Association of Health Care Journalists Reporting Fellowships on Health Care Performance.” The Commonwealth Fund. Accessed May 9, 2022. https://www.commonwealthfund.org/fellowships/association-health-care-journalists-reporting-fellowships-health-care-performance
- “Commonwealth Fund Fellowships in Minority Health.” The Commonwealth Fund. Accessed May 9, 2022. https://www.commonwealthfund.org/fellowships/commonwealth-fund-fellowships-minority-health
- “David Blumenthal.” The Commonwealth Fund. Accessed May 9, 2022.
- “David Blumenthal.” The Commonwealth Fund. Accessed May 9, 2022.