If objection is taken to such wide sweeping proposals, let me remind you that free communal services of sanitation and education are already provided; and that the care of personal health is of equal importance with these. All will agree that a large proportion of the population cannot afford to pay individually for medical attendance and nursing under present conditions, still less for the consultant and hospital services which advances in medical service have rendered indispensable. There is always present in our midst a large mass of illness which might have been avoided or curtailed, had there been an organized system of state medicine. Lest there should be alarm as to the possible consequences of the coöperative provision on such a scale of this primary need of humanity, let me also remind you that coöperative medical aid differs from financial aid in an essential particular. It does not create a demand for further aid, but is always engaged in diminishing this demand. Dependency on financial assistance is liable to continue indefinitely; much wants more. This result of medical aid is almost inconceivable. The Reverend Doctor Chalmers, of Glasgow, said early in the last century: “Ostensible provision for the relief of poverty creates more poverty. An ostensible provision for the relief of disease does not create more disease.” Doctor Chalmers was opposed to the giving of any domiciliary assistance from rates or taxes, and he organized his parish so that every needy person was adequately helped out of charitable funds. But he advocated extended hospital and other medical assistance for the poor; and until this is done, apart altogether from any system of insurance, and as a complete measure on the lines of our educational system, we cannot say that all that is practicable has been done to secure the physical well being of our fellow citizens. FOOTNOTES: [5] An Address at the Forty-seventh Annual Meeting of the American Public Health Association, New Orleans, October 27, 1919. [6] The importance of this is seen in the fact that there are in England and Wales 14,614 parishes, and only 646 unions for the relief of the poor. [7] Rumsey: Essays in State Medicine, 1856, pp. 190, 277, 282. [8] Goodnow: Municipal Problems, p. 226. CHAPTER III THE INCREASING SOCIALIZATION OF MEDICINE[9] Medicine has always been the most altruistic of learned professions; and can proudly claim that its practitioners have ever been ready to give gratuitous assistance to all in need of it. Even more than when Burton wrote his Anatomy of Melancholy—for then medicine was an art with but limited foundation in science—physicians can be defined as “God’s intermediate ministers”; and can rightly assume the proud position which Burton gives them: