Health care and health-related services are New York City’s major employment sector, represented by major activist unions.  Our five largest hospitals are ranked in the top twelve enterprises in the City in employment and revenue.  The six major mega-merged systems, including Mt. Sinai-NYU and the Catholic Network, are the largest institutional complexes in the metropolitan area.  Their scientific research, development, and educational capacities are arguably the City’s major international economic comparative advantage.  Now, with the new national challenge for a bio-terrorism/wartime public health infrastructure, there is a core industry leadership opportunity as part of Lower Manhattan rebuilding today.  
 
The Kennedy-Frist  billion dollar Public Health Infrastructure Bill should now make ground zero NYC its epicenter (not, as it is now, CDC-Atlanta nor FBI-DC); likely led by the Center for Public Health Preparedness at Columbia and its rapidly growing partnerships with CDC, specialized scientific industry, and state and city health departments across the U.S.   
 
As the Times Metro section has reported, hospitals have been hard hit by lost patient visits, on the one hand, and by a growing number of uninsured needy and at-risk patients services costs.  Betances and Chinatown Community Health Centers were major support centers near ground zero and experienced damage and shutdown, alongside the costly dislocations of NYU Downtown and University Hospitals, HHC Bellevue and Gouverneur, St. Vincent’s, and Beth Israel Hospitals.  A survey of the 30 federally qualified Community Health Centers in the metro region came up with $2 million in immediate costs/lost revenues impacts and a projected 5-10% increase in the uninsured patients being served.  These CHC’s are the frontline of a community-based public health infrastructure comprehensively protecting all communities for the diseases of economic insecurity and environmental-occupational stresses as well as bio-terrorism.   Betances (Lower East Side) and Chinatown Health Centers can play a major catalytic role in Community District micro-plans, as integral to the Lower Manhattan rebuilding plans.  
 
The centerpiece of healthy rebuilding for all is to demonstrate, on a targeted communities and metro-regional basis, a truly protectively rebuilt public health infrastructure - a “National
Defense Universal Health Care Act” (as in the 1950’s Cold War/Sputnik challenge of the National Defense Education Act].   A supportive-housing-inclusive Habitat collective housing industry development demonstration and basic communications and transportation infrastructure developments are essential to health care access and health-protecting environment. 
 
Pier 94’s “9/11 Families” support process, along with those of the Central Labor Council and interfaith and inter-professional support responses, are a true model of what working economic and health security family support can be, as compared to the old Giuliani Workfare, characterized by punitive make-work, which displaces City employees and college students.
 
This should all be part of a “Healthy Rebuilding for All” process, which publicly begins immediately, but is given new leadership after the November 6th elections.  And, on January 1st,  the new City Administration and City Council inaugurate an officially working community/labor-participatory planning process with a vision of a “new New Deal” for New York City’s communities, like real public housing, world-class municipal hospitals, truly public primary, secondary, and higher education, and real mass transit of the post-World War II period, as Josh Freeman’s book, Working Class New York,  evokes.  
 
Academics, non-profits, (inter)faith-based organizations, and all community-based public health advocacy organizations should provide the anticipatory support now for the Central Labor Council, New York State Federation, and health sector leaders 1199/SEIU and DC37 to provide a visionary campaign and front-line policy muscle for a “Healthy Rebuilding” movement now.
 
Robb Burlage is director of healh programs for the National Council of Churches.

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