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November 27, 1996

Paul Revere and Health Care for the Indigent-Reply

Author Affiliations

University of Kansas Medical Center Kansas City

JAMA. 1996;276(20):1636. doi:10.1001/jama.1996.03540200022018

In Reply.  —Dispensaries, the subject of Dr Carr's interesting letter, became common in the second half of the 18th century in Britain and then in some American colonies. Dispensaries were established to help those of modest means obtain good medical care on an outpatient basis. Supporters believed that timely care and medicines would prevent more serious illness and thus disability and financial hardship for the ill and their families.1-3 From the mid 17th century forward, learned physicians as a group had been criticized in England for their inadequate care of the working poor.1 Also, expanding groups of successful businessmen as well as the gentry believed they had a responsibility to aid the ill working poor in their communities. Some dispensaries were freestanding, and others were attached to voluntary and public hospitals. Both dispensaries and voluntary hospitals were supported by annual subscriptions, most of which were purchased by prosperous businessmen and,