Your ShelfYour Projects

Caring for the Sick Poor

4%

Review and Herald Publishing Association · Takoma Park Station, Washington, D. C. · Sep 30, 1915

FromReview and Herald, Vol. 92, No. 48.

Read the full edition

Caring for the Sick Poor

By L. A. Hansen

PERHAPS no question gives greater perplexity to our sanitarium workers than that of answering the many calls that come from the sick poor. The matter received attention at our last medical conventions. Some of the discussions may be considered with interest.
Dr. H. W. Miller introduced the matter as follows: “One of the purposes in the establishment of our sanitarium work was to provide facilities for our sick poor. As it is at present, there does not seem to be any well-developed general plan for carrying out this purpose, though the need is great.
“As our sanitariums are now conducted for carrying on their work as a whole, it is a difficult matter to receive very many patients on a charity basis. Our finances do not permit us to carry a great deal of such work, though considerable of it is being done.
“I have been interested to watch the growth of our Washington Sanitarium Dispensary and Mission Hospital. With inexpensive equipment and facilities and with help furnished by nurses on a missionary basis, we have been enabled to make a rate low enough to meet the needs of most people who cannot afford the regular sanitarium rates. Good care is given, and patients get well, and the work seems in every way successful.
“Possibly other sanitariums conducting training schools, and located near cities, could engage in dispensary work to advantage. It does not prove a drain on an institution, but rather a help.”
Dr. D. H. Kress: “Our physicians are often placed in a hard place over this matter of caring for the worthy sick poor. We come in contact with so many cases of urgent need, but know the inability of the sanitarium to care for all of them. I have thought that it would be well if we could have a sick poor fund from which our churches could meet the expense of caring for their sick poor, for the responsibility should rest with the churches.”
L. A. Hansen: “This burden of caring for the needy sick should not all rest on the sanitariums. Already considerable is being done in this direction. The rate sheet of an institution is its dependence for its income with which to carry on its work. It must be carefully guarded. To do much in quoting special rates, means to demoralize the rates and jeopardize the financial welfare of the institution. As it is, most of the sanitariums have made liberal provision for cases of special need.
“The rates made to our poor are considerably lower than what it actually costs per week to care for patients. The outlay for the care of such a patient is an actual expense to the institution. It is important that such bills be promptly met. Our sanitariums have on their books unpaid accounts of this kind representing thousands of dollars.
“It must be evident that it is easier for each individual to make arrangements for securing the money to meet the cost of his own care than it is for the institution to do it for the many who apply to it.”
F. M. Wilcox: “We cannot receive charity cases in the main institution and quote rates without letting down our rate standard. If we do it for some, others feel we must for them. As far as possible, we should provide another place where people can obtain necessary treatment at a minimum expense.
“We cannot place such work on a commercial basis. We must not seek a profit in it, but place the rates on a basis of actual cost, figured on ordinary running expenses. God would respond if we had more of the spirit of reaching out and helping our poor. Our people would respond and give our institutions their support. It would bring our sanitarium work into closer touch with our people.”
L. H. Christian: “We ought to care for our poor people; but we should not ask our sanitariums to do it. We should educate our churches to do this. They should not send their poor members to our sanitariums at the cost of the institution. They should pay the bill. It is easier for them to raise the money than for the sanitarium to do it. We should also educate our churches to try to get as many of the rich people as possible to come to our sanitariums.”
I. H. Evans: “Our sanitariums have a pretty heavy load, and I wonder why, as conferences, we should not have a fund that could be used for taking care of the needy poor. There are those who are helpless; it is wrong not to give such help when we can. Why should not the conference provide a fund, so that when such a case occurs it can be referred to the conference president, and arrangements be made to pay the sanitarium at least the cost of the food and the actual expense?
“It would be well for us to pass a recommendation to encourage our conferences to provide a fund for this. Then let the sanitarium make the lowest possible rate to these people, and when they must receive treatment let the conference provide for them. This would be money well spent.
“We used to carry two or three beds, and it was not difficult to keep them full. I have felt that our conferences could now each provide one or more beds in a sanitarium, taking advantage of the low rates offered, and help do something for the poor people needing the benefits of our health institutions. It certainly ought not to be left for the sanitariums to do it all.”
Dr. W. T. Lindsay: “In one of our conferences we used to take up a collection once a year. This was placed in the care of the conference president, and it was understood that correspondence regarding the care of the sick poor should be directed to him. He determined who should receive the benefits of this fund. The sanitarium made the lowest rate possible, not based on adding “overhead” expenses, but on actual cost. The sanitarium looked to the conference president for settlement of the bill, and he saw that it was paid.
“It is hard for the business manager or the medical superintendent to reply to some of the urgent appeals that come. They would like to respond to them, but cannot always do so. Then, too, there are instances in which it is not clear that the applicant is entitled to the special rate. It is best that conference officers have the matter in charge. The responsibility of caring for the poor really belongs there.”
Chas. E. Rice called attention to the fact that sanitariums are doing a liberal share in caring for the sick poor, even when the board and room expense is met, as the average weekly cost of caring for a patient, aside from the board and room, is considerable.
C. F. Marvin had seen the need of some such provision as pointed out, and believed that the plan proposed would offer the much-needed help. He thought the churches should do their part.
Dr. E. D. Haysmer spoke of his experience in connection with the dispensary work in Washington, and what he thought of it as a practical way of helping the poor and at the same time giving nurses a wider experience in certain lines of medical work than is offered in the sanitarium, as well as giving them a practical missionary experience.
Dr. H. A. Green saw advantages in city dispensary and hospital work in meeting the needs of a large class of people, and thought it practical for a sanitarium located near the city to engage in such work.
Burton Castle spoke of some of the difficulties in meeting charity demands, citing instances where efforts to meet such needs had resulted in embarrassment to the institution.
E. J. Baker also spoke of unfavorable experiences in the effort to meet requests for special consideration, and stated that sometimes great harm to the work of the institution comes from unfair criticism that arises in connection with such effort.
Other speakers agreed with the foregoing. The following resolution was then adopted:—
“Resolved, That our sanitariums co-operate with the conferences in the care of the sick poor among us to the extent that we furnish board, room, and treatment at seven dollars a week, with nursing and other necessary special service at cost, it being understood that the persons receiving the benefits of this provision shall be recommended by conference officers, and that the conference or local church will be responsible for the payment of bills thus incurred; and that on the health and temperance Sabbath of each year a special collection shall be taken for the care of the sick poor, the same to be sent to the local conference office, to be used by the local conference in the care of such cases as it may be responsible for.”
L. A. HANSEN.