The Expanded and Annotated My Life and Work

THE HENRY AND CLARA FORD HOSPITAL
The following material has profound implications for twenty-first century 
healthcare and its skyrocketing costs. Godfrey (2000) estimates that the 
cost of poor quality in healthcare wastes 30 to 50 cents of every healthcare 
dollar, while Panchak (2003) cites an estimate of up to 60% waste.
Ford set up a hospital along industrial lines, including a design that 
eliminated as much as possible the need for nurses to walk: a nonvalue-
adding activity for which they could not be paid. Doctors and nurses 
worked on a salary basis, and each patient was evaluated for overall health 
by a multidisciplinary team as opposed to receiving treatment for a spe-
cific ailment. The result was that the hospital delivered very high quality of 
care, and at a very low cost. The daily charge was $4.50 (less than the daily 
wage at the Ford plants), and a major operation cost $125 in the money of 
the early 1920s.
It is also noteworthy that the hospital had private rooms, and only private 
rooms. This doubtlessly helped prevent the spread of the hospital-acquired 
infections that claim thousands of lives even today. The semiprivate room, 
although nominally cheaper, therefore, is a false economy.
Anand (2009) reports meanwhile how an Indian surgeon, Dr. Devi 
Shetty, has revived Ford’s healthcare model very successfully. His 
Narayana Hrudayalaya Hospital performs open heart surgery for $2,000, 
in comparison to $20,000 to $100,000 for similar procedures in American 
hospitals. The article reports a 30-day mortality rate of 1.4% for coronary 
artery bypass graft surgery versus the United States average of 1.9%. The 

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Why Charity?  •  195
hospital’s keys to success include economy of scale, extensive experience 
among the doctors, and a focus on continuous cost reduction.
Shetty, like Ford, speaks explicitly about the need to pay attention 
to every aspect of cost: “In healthcare, you can’t do one big thing and 
reduce the price. We have to do 1,000 small things.” The article adds 
that he plans to open a hospital in the Cayman Islands for medical 
tourism purposes, which suggests that American hospitals need to pay 
attention to his methods and copy them if they do not wish to be left 
behind. Ford and Crowther (1926, p. 193) also identified the role of 
diet, a role that the United States only now seems to be rediscovering, 
in overall health.
It is also particularly telling that Ford was more than 40 years ahead of 
the Surgeon General in declaring that tobacco was a major cause of pre-
ventable illnesses. Ford News (August 1, 1923, pp. 2–3) carried an article 
by Luther Burbank that said, among other things, that tobacco caused 
President Grant’s throat cancer. Burbank also depicted nicotine as toxic 
to the heart, and added that money squandered on tobacco could instead 
pay for a house or a farm. Only in 1964 did the Surgeon General’s office 
finally publish similar conclusions, and tobacco use remains a major prob-
lem almost 60 years later.
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The Ford Hospital is being worked out on somewhat similar lines, but because 
of the interruption of the war—when it was given to the Government and 
became General Hospital No. 36, housing some fifteen hundred patients—
the work has not yet advanced to the point of absolutely definite results. I did 
not deliberately set out to build this hospital. It began in 1914 as the Detroit 
General Hospital and was designed to be erected by popular subscription. 
With others, I made a subscription, and the building began. Long before the 
first buildings were done, the funds became exhausted and I was asked to