Edited by Brian P. Pace, MA, Assistant Editor.
Dr. Frederick Holme Wiggin of New York read a paper with this title
before the New York State Medical Association, Oct. 12, 1897. His object was
not so much to present individual views as to cull from recent literature,
both lay and medical, the opinions of many writers. He said that it was easy
to demonstrate conclusively that as at present administered medical charity
is demoralizing to both the recipients and the donor. Some idea of the alarming
growth and extent of this evil might be obtained from the carefully prepared
report of Dr. Stephen Smith to the State Board of Charity. Here it was shown
that during the year 1895, 837,971 persons applied for and received free medical
treatment at 105 dispensaries in that city; that 1,418,847 free visits were
made by these applicants to these dispensaries; and that 78,000 persons received
free board, lodging, nursing, drugs, surgical dressings and treatment; in
other words, that something more than 49 per cent. of all who live within
our borders had claimed in one year to be unable to care for themselves. This
should be contrasted with another statement by Dr. Smith to the effect that
during the period from 1791, when the first dispensary was established in
New York, to about 1870, the applicants for charity bore a ratio to the total
population of 1.5 per cent. Dr. Wiggin then went on to quote from an editorial
in the New York Herald to show that Greater New York
spent fifty millions of dollars every year on charities, and that according
to a conservative estimate fully 50 per cent. of the donors' money was diverted
from the purpose for which it was intended and was practically filched from
the poor to whom it rightfully belonged. Again, according to one author, Dr.
J. B. Huber, one might find in large numbers at dispensaries such people as
actors, opera singers, gamblers, bartenders, policemen, farmers from out of
town, prosperous business men and those owning houses, lawyers, and perhaps
even a street railway president. According to another author, Dr. George F.
Shrady, fully 50 per cent. of the applicants in the reception room of a well-known
institution, which he dubs "the diamond dispensary," were well dressed, 10
per cent. were finely dressed, more than half of the men bore no evidence
of poverty, and among the women there was an attractive display of fine millinery;
yet all obtained the free treatment supposed to be given only to poor persons.
. . . Surely, the author continues, these instances "certainly show the spirit
in which charity is asked for and accepted; it is largely a desire to save
money, without apparently thinking that self-respect is lost in the effort,
or that a wrong is done to the really poor and to the physician, who is certainly
as much entitled to his hire as the clergyman, or other members of the community,
as he too has social obligations to fulfill. . . . "
THE ABUSE OF MEDICAL CHARITY; A CRITICAL REVIEW OF RECENT LITERATURE.. JAMA. 1998;279(10):734N. doi:10.1001/jama.279.10.734