The relief of poverty is at the best an inefficient and expensive remedy. It is seldom adequate, and it has few preventive elements. The prevention of poverty by prevention of the illness causing it, and by early and satisfactory treatment of such illness as fails to be prevented is the only efficient, as well as in the long run the only economical plan of campaign. Money insurance against sickness has its place as a means of alleviating the results of poverty. But it is not an aid to its prevention; under any existing system of insurance the money payment is insufficient and definitely limited in duration. Although such relief is useful, it is totally unsatisfactory when not linked up with a complete system of hygienic measures, and when not associated with adequate medical treatment and nursing. For the linking of treatment provided largely out of public funds with insurance there is no justification, and it is contrary to the public interest; and it is unfortunate that monetary insurance has been provided in England for a section of the population under these unsatisfactory conditions, thus diverting expenditure from the public health services in which it was urgently needed, and in which its use would at once have been fruitful in increased health and happiness. FOOTNOTES: [16] An address to the Political Economy Club, Johns Hopkins University, Jan. 19, 1920. CHAPTER IX THE CAUSATION OF TUBERCULOSIS AND THE MEASURES FOR ITS CONTROL IN ENGLAND[17] My task is to attempt to give a bird’s-eye view of “The Methods of Controlling Tuberculosis in England,” and to revaluate, as far as is practicable, in the light of many years’ study of the disease, the relative value of the measures which historically have been followed by the greatly reduced mortality from tuberculosis. The subject teems with difficulties, and as you are aware there is no unanimity of opinion when tuberculosis is thus considered. This is the more surprising in view of our present accurate knowledge of the pathology of disease caused by bovine and human tubercle bacilli, and in view of the fairly general unanimity of opinion as to the methods of control which are needed to secure still more rapid reduction of the devastations of tuberculosis. This general opinion may, I think, be summarised in the statement which I have made elsewhere, that the removal or diminution of infection from each single case of tuberculosis reduces correspondingly the prospect of further cases, but that tuberculosis will not be completely controlled until every tuberculous patient receives such care throughout the whole course of his life, as will ensure his welfare and will obviate the likelihood of his infecting others.