Evening star. [volume] (Washington, D.C.) 1854-1972, 1892-10-03

10 the INSTITUTIONS themselves. Those interested
IN given institution, seeing no specific reason
why such large amounts should be given to
other institutions (whose work and methods
they possibly failed TO correctly apprehend) and
SO little TO themselves, resorted to special plead
ing that in nowise contributed to informing
the committees as TO the merits of the given
case.
The recommendations of the superintendent
OF charities. while adopted in the main. could
not be followed with exactness, because his
knowledge OF the subject was complete enough,
so that he had no special confidence in the fair
ness of his own recommendations Representa-
tives of almost every one Of the institutions in
/ terested expressed to him their dissatisfaction
\ with such a method of asking for public sup
port As one of the gentlemen remarked, 1T
| puts me in the attitude OF beggar, and do
not have to beg" In order to determine what
amount should be given to each institution
from the public treasury it is obvious that some
method must be used OF obtaining an accurate
estimate of the purely public service which that
/ institution renders 1t is proper for the public
| specific work, but it is not proper to
! hand around appropriations on the general
/ theory that the institutions receiving them are
7 doing something that in some way Is useful.
When the latter method is tried all sorts of ex-
traneOus considerations are brought into the dis
cussiOn. such the recognizing of a given
nationality or a given denomination or some
! other influential class in the community.
II was. therefore, with good deal OF salts
I faction that witnessed the passage Of the act
4 tO create a board of childrens guardians for
the District ard ito establish q municipal lodg-
ing house for the care of the homeless poor. In
these two departments I think that the new
machinery provided for will enable us to in
troduCe the principle OF specific payment for
specific work and therefore to put the sub
sizzling Of private institutions on a business
basis.
DISTRICT CHARITIES FOR THE FISCAL YEAR.
A table IL given which summarizes the finan-
cial operations of the institutions whose work
is reviewed by the superintendent OF charities.
According TO this table these institutions taken
together receive from endowments $7.970.57,
from earnings S2l.60J.08 and from all Other
private sources. including subscriptions. dona-
tons, dues, dc. but no. including loans,
S32.5l97I Few OF them have 10 pay rent as
only 81 800 40 was expended for this purpose.
The expenditures for salaries amounted to
S43. 63O.64 For all other items of maiate-
nance, Including ordinary repairs. fi04 ,243.17.
For permanent improvements. including Pur-
chasing of real estate, So, 203.52. For interest
on debts "a .05I IS. For the payment of the
principal OF debts. IS. 1877.
The per cent Of income less balances. earnings
and loans contributed from the public revenues
was 72.7. a reduction of S.3 per cent from the
year before.
MEDICAL CHARITIES.
Referring TO medical charities the report
gives the expenditures of ten American cities
fo- the purpose of supporting medical charities.
The per capita expenditure of Warrington is
shown by these figures 20 be twice the average
OF the zen cities. and some 20 cents per 1T adj
higher than that of Gny other CITY investigated.
Il consider the amount expended for medi-
cal chaTities, Mr.. Warner SAYS. las probably
larger than is necessary for this city. but there
ne way OF reaching definite conclusions in
this matter. since no official has any right
TO inquire into the operations OF all the ms .itu
tiol.s concerned or 10 make any recommend
tiCns cOmp-ehending the whole system of mcdi-
cal charities of the District. Medical charities
serve two very distinct purposes. One is the
relief of the poor and the other il the advance
Tccnt OF thc professional interests, by educa-
tlOnal and other means. of the MEM
bers Of the medical profession 1t has been
found that in nearly all cases where the condi-
tion OF tn applicants for medical relief was
Thoroughly investigated many applied for
such relief who we're able to paw for it and
should have been compelled to do SO. In two
hospitals in the city of New York serving sub
stantially the same class. one was very largely
supported by The pay of those benefited, while
the other hung as a dead weigh. upon the
benevolent public. Those acquainted with the
experience OF medical charities are distinctly of
the opinion that good results come 10 the
patients when the latter required to pay for
what they get. i'll so far as their means permit -
The explanation OF laxness of medical chari-
ties IN the matter OF investigating the appl-
cants that go TO them results. the report SAYS
from. first, the difficulty of making such inves-
legations. and. secondly. from the competitive
element a. between different institutions. There
is a tendency to measure the value of an insti-
tuition by the gross amount of work and to
gauge the importance of the men connected
with II by similar measure.
The English experience in these matters is
very instructive. The Medical Times has said
that the amount of gratuitous work done BY the
profession IN no way raises II In public estima-
ton. IL is well known til 1t il il not performed
/ from motives of charity, but from the position
/ that Is gained by being attached to a hospital
staff and the hope of a good practice accruing
therefrOm. The British Medical Journal
SAYS: Hospitals compete with each other to
the number Of patients without regard to The
fitness of the cases or the position
krens Hospital in London, where the
rule adopted of referring all applicants to
the Charity Organization Society and where
no patients were excluded when the parents
were making 80 shillings a week, there was
found an abuse rate of 81 per cent. In the
London Hospital when an inspector was ap-
pointed for the outdoor patients there was -
reduction in twelve months of 1911 patients,
which brought about saving OF some 81 900
In one year to the charity. At this hospital the
ABUSE rate was about % per cent. One or the
British writers on the subject complained that
physicians practicing among the wealthy classes
recommended these people to always send their
servants TO dispensaries for treatment. When
spoke Of this to Washington physician his
only comment was THAT is my course invaria-
bly," Further conversation with him devel-
oped the fac: that he thought it unadvisable to
have any other physician enter the houses Of
his patients TO treat the servants and did not
care TO treat the latter himself but to find dis
pensaries in the city. An attempt was made at
two different dispensaries in Washington to
prescribe for the superintendent Of charities
when he called on business although he made
no attempt to appear especially unwell or impe-
cunious.
MIGHT BE LARGELY REDUCED.
There are doubtless many reasons which
make it necessary that Washington should have
large public expenditures for medical charities
larger, perhaps. in proportion to the popula-
ton than some other cities. We are without
the great endcwments, which, in PHILADELPHIA,
have freed the city from the necessity of pro-
/ ducing any other hospital than that connected
with the aims house. But after all allowances
are made i cannot but think that il business
like principles were adopted in providing for
the INDECENT sick Of Washington the expendi-
lures in their behalf might be very largely re-
duced. In Buffalo, where the population is
about the same size Washington, the per
capita expenditure for medical charities is only
20 cents. little more than one-third our own.
In that city admissions to the hospitals OBJ
timed only from the poor law officers or the
hen dam ri. he of sha LATE