National Health Agencies Their Service is Needed

This is the second of a series of articles, the first of which appeared on April 14. The final article will appear in the weekend edition of April 21. Dr. Karpf is the director of the Graduate School for Jewish Social Service Work in New York.

As is well known, there has been some question in some circles about the national health agencies. One occasionally hears the question: Is there really a need for their work.

There is a view regarding the treatment of tuberculosis—held I think by a great many if not most of the tuberculosis experts in the country—that the effect of climatic conditions upon tuberculosis is not nearly as important as was once believed. It is natural, therefore, that people should ask whether the national health agencies in Denver and elsewhere have a real reason for existence.

Another question frequently heard relates to the administration of those agencies. It is charged that there is no control of their work and development. One hears, similarly, that their collection costs are excessive. It is charged, with what truth I do not know, that in some instances collection costs are as high as thirty to forty per cent.

Let us examine these questions more closely. Are the national health agencies needed? There is an old Jewish saying that in the case of illness one should not ask the doctor but the patient. Ask the tuberculosis patients on the East Side of New York City and what corresponds to the East Side of any other large city in the United States, where they want to go for treatment. They will tell you, I think with few exceptions, that they want to go to Denver or Los Angeles. Never mind their reasons. The important thing at the moment is the attitude of the patient.

I recall a very interesting experience of my own in Chicago when I came there in 1919. I faced the problem of the national health agencies sending tubercular patients to Denver and I wanted to do something about it. I organized a committee of three physicians; one representing the Denver Hospitals and in general adhering to the view in favor of Denver and Los Angeles as the places to send tuberculosis patients; one representing a local hospital for the tuberculous and unalterably opposed to climatic treatment of tuberculosis; and one a neutral physician, a man of very high standing and reputation in Chicago.

This committee of three was to rule upon every application to the Jewish Social Service Bureau of Chicago for Denver. These applications were considered at conferences where all the factors were handled on their merits. We had considered and the situations were some very interesting times at those conferences but I must admit that comparatively few patients were sent to Denver or Los Angeles by this committee.

After this had gone on for about a year or more, my neutral friend, the physician, came and told me that he was obliged to give up his work on the committee because he was going out to Denver. I was surprised and asked him what he was going to do there. His reply was, “My brother contracted tuberculosis and he wants to go to Denver. I don’t believe in Denver much myself but it is his point of view that counts,” and so he went to Denver with his brother.

I thought then and I think now that he was right. The attitude and point of view of the patient are most important, for the confidence of the patient is half the battle and more. So long as patients have confidence in and want to go to these hospitals there is a need for them regardless what anyone else may think and say.

Last year I had the privilege of visiting the hospitals in Denver and Los Angeles. They made an excellent impression on me from every standpoint. They have built up a remarkably fine reputation in their own field of service. They have ample justification for pride in their achievements. They cannot accept the verdict that they must die. No agency, no organization, no person, no community, can accept such a verdict.

But how shall they secure the funds with which to continue to live and function? Rightly or wrongly, whether the criticisms of them are justified or not, they will and must go on for the present. Will federations and welfare funds supply the means? Hardly. At best they supply only a small fraction of the needs of these agencies. At worst they not only give them nothing but oppose their independent campaigns.

Now if we are honest with ourselves we must admit that the Federation’s unwillingness to give funds to the national hospitals and for that matter to any national agencies is not due solely to scepticism and criticism of the work of these agencies.

In this connection the story told by a well-known campaigner for funds is in point. According to him, he and a friend invited a gentleman to lunch in an endeavor to get funds from him for the local drive. They let him eat his lunch in peace. For dessert he ordered apple pie and cheese and while he was munching these they asked him for a contribution to the drive. The man thrust aside the pie and cheese from him and said “I wont give.” “Why won’t you give?” asked his host. “Because I don’t like the cheese,” was the reply. “What has the cheese to do with your contribution?” asked the campaigner in surprise. “Well, if you don’t want to give, a piece of cheese is as good an excuse as any other,” was the answer.

Even so is it between the federations and the national agencies The mood is the thing; and federations, by and large, are not in the giving mood where the national agencies are concerned.

To be concluded in the weekend edition.