McClure's Magazine, Vol. XXXI, No. 3, July 1908.

Excerpt

John Chinaman is the logician of hygiene. To his family doctor he says: "I pay you to keep me well. Earn your money." Let him or his fall sick, and the physician's recompense stops until health returns to that household. Being fair-minded as well as logical, the Oriental obeys his physical guardian's directions. Now, it may be possible to criticize certain Chinese medical methods, such as burning parallel holes in a man's back to cure him of appendicitis, or banging for six hours a day on a brass tom-tom to eliminate the devil of headache; but the underlying principle of "No health, no pay" is worthy of consideration.

This principle it is which, theoretically, we have adopted in the matter of the public health. To our city, State, or national doctors we pay a certain stipend (when we pay them at all) on the tacit understanding that they are to keep us free from illness. With the cure of disease they have no concern. The minute you fall ill, Mr. Taxpayer, you pass into the hands of your private physician. No longer are you an item of interest to your health officer, except as you may communicate your disease to your fellow citizens. If he looks after you at all, it is not that you may become well, but that others may not become ill through you. Being less logical in our conduct than the Chinese, we, as a people, pay little or no heed to the instructions of the public doctors whom we employ. We grind down their appropriations; we flout the wise and by no means over-rigorous regulations which they succeed in getting established, usually against the stupid opposition of unprogressive legislatures; we permit—nay, we influence our private physicians to disobey the laws in our interest, preferring to imperil our neighbors rather than submit to the inconvenience necessary to prevent the spread of disease; and we doggedly, despite counsel and warning, continue to poison ourselves perseveringly with bad air, bad water, and bad food, the three B's that account for 90 per cent. of our unnecessary deaths. Then, if we are beset by some well-deserved epidemic, we resentfully demand to know why such things are allowed to occur. For it usually happens that the virtuous public which fell asleep with a germ in its mouth, wakes up with a stone in its hand to throw at the health officer. Considering what we, as a people, do and fail to do, we get, on the whole, better public health service than we deserve, and worse than we can afford.

Our Health Boards and Their Powers

As a nation, we have no comprehensive health organization. The crying need for one I shall point out in a future article. Our only Federal guardianship is vested in the United States Public Health and Marine Hospital Service, which, by some mystery of governmental construction, got itself placed in the Treasury Department, where it certainly does not belong. It is, with the exception of a few ancient political appointees now relegated to unimportant posts, a highly trained and efficient body of hygienists and medical men, the best of whom have also qualified as diplomats in trying crises....