By Rosemary Stevens
American hospitals are distinctive: a mixture of private and non-private associations which are right away charities and companies, social welfare associations and icons of U.S. technology, wealth, and technical success. In affliction and in Wealth is helping us comprehend this large and infrequently contradictory "industry" and exhibits that all through this century the voluntary not-for-profit hospitals were profit-maximizing companies, although they've got considered themselves as charities serving the neighborhood. even if our hospitals have supplied the main complicated remedy for acutely unwell and curable sufferers, they've been less winning in assembly the wishes of the chronically unwell and the socially deprived. That, Stevens concludes, is the following pressing activity of social policy.
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Additional resources for In sickness and in wealth : American hospitals in the twentieth century
This is an important point to remember in today's debates about hospitals as "charities": the essence of the act was giving per se rather than giving to a particular population. An organization that provided useful services, for a fee, to self-reliant individuals could still be recognized as a public charity. 17 America, proclaimed British hospital expert Henry C. "18 Patients who could afford to pay more were often charged at rates above cost to help subsidize the poor, while additional funds were sought through private donations and government subsidy.
62 There was little serious pressure for abandoning the voluntary ideal, so central to the production of social institutions in the flowering of industrial capitalism, in favor of a governmental system. The utilitarian function of voluntary association for charitable purposes, including hospitals, was evident both to proponents and to critics. Progressive criticism focused on tidiness, that is, on clear roles, responsibilities, and efficiencies, rather than on rejection of private benevolence itself.
In the first two decades of the century, local groups of doctors pressed hospitals throughout the country to open their staffs to all practitioners. Second, doctors had no wish to be more restricted in their clinical work, professional behavior, and ability to charge fees in charitable, religious, or governmental hospitals than they would be in hospitals under their own direct control. They wanted, in short, professional autonomy. Two lasting themes of American hospital history were thus laid down well before World War I: the strong stance taken by organized medicine in favor of "open-staff" hospitals, and professional control of the hospital's clinical work.
In sickness and in wealth : American hospitals in the twentieth century by Rosemary Stevens