This paper seeks to explore urban hospital policy, its history, and, in particular, the contradictions, challenges, and opportunities that it poses for community development in U.S. cities. Are urban hospitals a largely overlooked resource for urban economic development that can provide a ladder of long-term upward mobility for impoverished inner-city communities? Or are urban hospitals an anchor that has been dropped into sand, and that may be swept away by the winds of the healthcare crisis that has begun to storm across the United States?