CHAPTER XDEATHBEDS AND DIVIDENDS
Stock market reports do not show a relationship between deathbeds and dividends. Such a relationship exists, however. In this country, many are made to die miserably in order that a few may live magnificently. Every year, more than half a million human beings are compelled to die in order that a few thousands may make, every year, perhaps half a billion dollars. More than three millions are kept sick in order that a handful may be kept rich.
This is not mere rhetoric. It is fact. Irving Fisher, Professor of Political Economy at Yale, and President of the Committee of One Hundred on National Health, is one of the authorities for the figures. In his report on national vitality, to the Conservation Commission, he declared that in this country, every year, 600,000 human beings die whose lives might be saved; that there are constantly 3,000,000 ill who might be well.
Dr. Woods Hutchinson, New York physician, endorses these estimates. Moreover, the estimates are confirmed by the actual experience of New Zealand. New Zealand’s death-rate is 9.5 to the thousand. Our death-rate is 16.5 to the thousand. If New Zealand’s population were as great as our own, the number of deaths each year, under her present rate, would be 630,000 fewer than the number of Americans who die each year. Yet the climate of New Zealand is no more healthful than is that of America. New Zealand simply does not sacrifice her people to private greed. America does.
Plenty of laymen know how typhoid could be made a dead disease. Germany has already made typhoid all but a dead disease in Germany. Yet, in this country, tuberculosis, typhoid and other diseases that could easily be prevented, are permitted to go on, killing their millions.
Why? Because capitalism stands in the way. Because deathbeds could not be decreased in number without decreasing dividends in size. Because we can reduce the death-rate only by acting through our governments—national, state and municipal—and big business, rather than ourselves, controls these governments. Big business, desiring to keep the special privileges it has and to get more, puts men into office whom it believes will do its bidding. Usually, these men know nothing and care nothing about promoting the public health. They are politicians. If they do know something about promoting the public health, and attempt to apply their knowledge at the expense of somebody’s dividends, there is a fight. If it is a disease-infected tenement that it is desired to tear down, the injunction is brought into play.
Such a situation seems appalling. It is appalling. It borders upon the monstrous that a people who have at last learned how to prevent the great diseases should not be permitted to apply their knowledge. That the people endure such a condition can be explained only on the theory that they realize neither the ease with which modern science could extend their lives, nor the identity of the few who put dividends above life.
In order that there shall be no doubt concerning the power of present knowledge, if applied, to destroy some of the great diseases and cripple others, I shall set down here a question that I asked of Professor Irving Fisher, Dr. Woods Hutchinson, and Dr. J. N. McCormack. Dr. McCormack is an eminent physician, who devotes hisentire time to lecturing throughout the United States, under the auspices of the American Medical Association and the Committee of One Hundred. His topic is the advisability of applying modern knowledge to the public health problem. Here is the question:
“If you had the power of a czar, could you destroy tuberculosis and typhoid fever, and also greatly reduce the number of deaths from pneumonia?”
Professor Fisher and Dr. McCormack replied promptly in the affirmative. Evidently, I might as well have asked Dr. Hutchinson if, having a glass of water, he could drink it. He was most matter of fact. Without a doubt, tuberculosis could be destroyed. So could typhoid fever, which is solely a filth disease that no one can get without eating or drinking matter that has passed through the stomach of a typhoid victim. Parenthetically, I may say that I heard Dr. Hutchinson tell a committee of the United States Senate that if a National Department of Health were established and properly administered, half of the crime would cease in twenty-five years. Dr. Hutchinson also said that it was entirely possible to save the babies that died from preventable diseases—dysentery, for instance. The lowest estimate of the number of babies who die every year from preventable diseases is 100,000.
Ask the same question of any physician in the country who is worth his salt and he will give the same answer. Thus well known are the methods by which the great diseases might be destroyed.
The way to wipe out tuberculosis quickly, for instance, would be to destroy every habitation that is known to be hopelessly infected—and there are many such—permit no habitation to be erected without provision for sufficient sunlight and air; permit no factory or other workplaceto be erected without sufficient provision for sunlight and fresh air—and destroy such workplaces as now exist without this provision; reduce the cost of living so that the millions who now cannot afford to live in sanitary homes and buy adequate food could do so; isolate the infected and educate the people with regard to the necessity of sleeping with their bedroom windows wide open.
If this program were put through, tuberculosis would cease as soon as those who are now infected should either have recovered or died. It is because such a program has not been put through that, according to Professor Fisher, there are always 500,000 Americans suffering from tuberculosis, and the annual death-roll from the disease is 150,000. Any municipal government, if it were disposed to do so and the courts were willing to let it do so, could put through the housing part of the program in a single summer. The dangerous habitations could be condemned. The government, if necessary, could build and rent at cost, sanitary houses in the suburbs, as the government of New Zealand does for its people. Congress, the President and the courts, if they were disposed to do so, could reduce the cost of living. If the government can teach farmers by mail how to prevent hog-cholera, there would seem to be no reason why it should not teach human beings by mail to breathe fresh air both night and day.
What stands in the way of immediately putting through such a program? Nothing in the world except the men whose property would be destroyed, or whose stealings in food-prices would be stopped. The property loss would be enormous. (Think of calling the destruction of a lot of death-traps a “loss.”) The “value” of the property destroyed might be a billion dollars. Maybe itwould be two billions. What difference need it make if it should take five billion dollars’ worth of labor, lumber, bricks, steel and other materials to replace death-traps with life-traps? One hundred and fifty thousand lives would be saved every year from tuberculosis alone, and the rebuilding operations would create greater prosperity for labor than was ever created by any act of Congress.
A hundred years ago, no one knew how to stamp out tuberculosis. What good does it do us to know how? We are not permitted to apply our knowledge. We can peck away if we want to, at the edge of the problem, but we mustn’t strike at the middle. If we should, we might cut somebody’s dividends. We might interfere with the “vested interests” of the owners of the cellars in which 25,000 New York families live, or with the owners of the 101,000 windowless rooms in which New Yorkers live, or with the owners of the unsanitary houses and factories in other cities. Our public officials know better than to try to do anything really radical in the health line. They have condemned just enough pestholes to know how dangerous it is to political prospects to grapple with property, and enforced just enough of the factory laws to know how dangerous it is to try to enforce factory laws at all.
In New York City, according to Tenement House Commissioner Murphy, 45 persons are burned alive every year in death-trap tenements. A new tenement house law prohibits the erection of death-traps, and in the new tenements there are no cremations. But the old death-traps are permitted to stand. In ten years, 450 more persons will have been burned alive. In 10 years, 1,500,000 more Americans will have died from tuberculosis.
“Of the people living in the United States to-day,” said J. Pease Norton, Assistant Professor of Political Economy at Yale, “more than 8,000,000 will die oftuberculosis.” Between the ages of 20 and 30, every third death is from consumption, and, at all ages, the mortality from the same disease is one in nine.
We now censure ancient kings for having slaughtered men in war for private profit. But what ancient king ever made such a record in war as our dividend-takers make in peace? What ancient king, in his whole lifetime, ever slew 8,000,000 men? What modern war marked the end of so many men as tuberculosis kills in a year? During the four years of the Civil War, only a little more than 200,000 men were killed in battle. Tuberculosis kills 300,000 Americans every two years. Other diseases that could be prevented if dividends were out of the way bring up the total of avoidable deaths in this country to 1,200,000 every two years.
What if our Government did nothing to end a war that was killing 600,000 Americans each year? What if a few contractors who were making millions out of the war controlled elections, administrations and the courts and would not let the government end the war?
What difference does it make whether foreign foes and army contractors kill these millions, or whether domestic dividend-takers and their governments kill them? Dead men not only “tell no tales,” but they have no preferences. It is as bad to be dead from one cause as from another.
“During the next ten years,” said Professor Norton, “more than 6,000,000 infants less than two years old will end their little spans of life, while mothers sit by and watch in utter helplessness. And yet this number could probably be decreased by as much as half. But nothing is done.”
Dr. Cressey L. Wilbur, Chief Statistician for Vital Statistics for the Federal Census Bureau, says that atleast 100,000 and perhaps 200,000 children less than five years old die in this country every year from preventable causes.
Our national government freights the mails with circulars telling how to cure hog-cholera and kill the insects that prey on fruit trees; but in all the years since the Revolutionary War, it has never sent a circular to a mother telling her how to keep her baby alive. The state and the municipal governments have done something, but they have usually stopped when they reached the big money bags. Not a state or a city has made it impossible for a baby to be given bad milk. Not a state or a city has rid itself of unsanitary habitations. Not a state or a city has condemned all the workshops in which men and women work at the peril of their lives. Not a state or a city has even enforced its own factory-inspection laws.
If the men whom big business has put in office were even intelligently interested in public health, probably 50,000 babies could be saved each year without tearing down a rookery or providing a single better house. A little intelligent effort and a few thousand dollars would suffice.
Dr. Hutchinson tells what a little intelligent effort and a few dollars did for the babies of the small English city of Huddersfield. A few years ago a physician was elected mayor. One of his first acts was to announce that he would give a prize of ten shillings to the mother of every child born during the mayor’s administration, provided the babies were brought to his office in perfect health, on the first anniversary of their birth. The only other stipulation was that no mother should be eligible to a prize who did not immediately report to the mayor the birth of her infant.
Though the prize was small, there was no lack of mothers who were willing to be takers. The doctor-mayor established what amounted to a correspondence school for mothers, and, at the birth of each child, began to send circulars telling how to take care of the baby; what to feed it and what not to feed it; what to do if the baby appeared so-and-so—and so on. Moreover, he kept a city physician on the circuit to look in at each home as often as possible, to see how the babies appeared and give the mothers further advice.
That’s all there is to this story—except that he brought down the death-rate for babies from 130 to 55; saved 75 babies each year to each thousand born. More than that he helped the babies who would have lived anyway. Good care, says the doctor, will increase the strength of strong babies from 15 to 25 per cent.
Any American government could do as much. By condemning unsanitary homes any American government could do more. All that is necessary is the desire—and the permission of those who control the governments. The people that cast the ballots are willing to give the permission, but the ballots they cast perpetuate the conditions against which they complain. Otherwise, there would be no death-trap houses; nor impure food; nor extortionate food-prices; nor unsanitary workplaces. And somebody would go to jail if an ice trust, desiring to cripple competitors who might cut prices, should send ships up a river to destroy the ice. It was brought out in court that the New York Ice Trust did that. The ice trust was convicted under the State anti-trust law. But nobody is in jail. And ice is still selling at a price that kills the children of the poor.
The only way to get big business on the side of public health is to get public health and private profit on thesame side. Health makes efficiency, efficiency makes profit, and whenever public health can be bought at a price that seems likely to yield a profit in efficiency, big business will buy. That is the way Professor Fisher figures it out and here is a case that he cites in point:
The girls in one of the Chicago telephone exchanges that is located in a particularly smoky and dusty part of the city complained to the manager of the smoke and dust. He cheerfully advised them to forget the smoke and dust and go on with their work, which, having more hunger than money, they did.
A few months later a growing volume of complaints against bad service caused the manager to investigate. He found that the smoke and dust were interfering with the operation of the switchboards. The little brass tags were so gummed that frequently they did not fall when subscribers called. Nor did the grime on the “plugs” with which connections are made constitute a good medium for the flow of electricity.
When the manager learned what the smoke and dust were doing to his human machines he did nothing. But when he learned what smoke and dust were doing to his metallic machines he wasted no time. He laid the matter before his superiors, with the result that a plan was installed for the filtration, through water, of every particle of air that entered the exchange.
It is not to the interest of big business as a whole that the people should have pure food. The markets are flooded with unwholesome food that an honest law, honestly administered, would have barred. Professor Fisher relates an incident that shows how afraid the big meat dealers are of the pure food law.
The professor was sitting in the lobby of a hotel not distant from New York. The proprietor of the hotelcalled up a New York meat dealer on the long-distance ‘phone to complain that some bad beef had been sent to the hotel. He said he had never yet fed his patrons on rotten beef and he didn’t intend to begin. The beef must be taken away and the charge deducted from his bill. The man at the other end of the wire evidently offered no opposition, and the receiver was hung up.
Soon the telephone rang again. New York was on the wire. The conversation was brief. All that Professor Fisher could hear was the hotel man’s single remark: “I’ll see what I can do and let you know.”
The hotel man rang off and immediately called up a local restaurant. Then Professor Fisher heard this cheerful statement go over the wire:
“I’ve got some beef here that ain’t just right, and the New York people who sent it to me wanted me to see if I couldn’t sell it for them up here ... Oh, it’ll hang together yet, but ’tain’t what I want for my people; you might use it, though ... I don’t know what the price will be. You’ll have to make your bargain with them, but it won’t be much.... All right, send over and get it.”
And this—and a thousand times more than this—under the Pure Food Law! Such crimes could not occur if the government, when it tried to enact a decent law, had not been thrown flat on its back. The pity of it is that when big business and a government come into collision over public health matters, the government is usually thrown on its back.
“I doubt,” said Dr. Hutchinson, “whether there is a local health officer at any post of entry in the United States who, if a case of plague, cholera or yellow fever should appear on a ship, would not think three or four times before he reported it. And if he did report it, asthe law requires him to do, his act would cost him his position. Business interests would cause his removal.”
This is not mere talk. Nor is it simply prophecy. It is history. So long as New Orleans was subject to periodical outbreaks of yellow fever, the health authorities were compelled not only to fight the disease, but to fight the business interests that denied its existence. Dr. Hutchinson says that business interests once caused the removal of the State health officer of Louisiana, merely because he insisted that yellow fever existed in the State—which it did.
Dr. Hutchinson himself, as State health officer of Oregon, in 1905–6, had to fight big business to conserve public health. Big business whipped him. His experiences were not novel, but one of them will be related for the simple reason that it was not novel, and therefore shows the sort of opposition that health officers, all over the land, are compelled to encounter.
Soon after taking office Dr. Hutchinson began an investigation of the water supplies of the chief cities of Oregon. His report showed that the water that private corporations were serving to municipalities carried typhoid infection.
Immediately the business interests of the State turned their guns upon him. Through the newspapers, which they controlled by reason of advertising contracts, they denounced him as an “enemy of the State.” “The fair fame of the commonwealth” was being traduced by a reckless maligner. He was even dared to show his face in one city. An attempt was made to remove him from office, but the governor happened to be a man who could not be browbeaten, and Dr. Hutchinson remained.
But while the business interests of Oregon were not able to get the governor, they got somebody. The cityofficials who could have purified the water took no step to do so. If they had merely recognized the existence of infected water and urged the people to boil it, some service would have been performed. But the municipal officials upheld the “fair fame” of their various communities by denying that the water was infected. Notwithstanding their denials typhoid soon broke out. The outbreak at Eugene, the seat of the State university, was particularly severe. Several students died.
Yet the San Francisco plague case must long stand as the classic illustration of the manner in which business fights government when a great disease comes. Black plague—the deadliest known to the Orient; a disease that, more than once, has killed 5,000,000 persons during a single outbreak—appeared in San Francisco in 1900. The local board of health quarantined the Chinese district, and the news went out over the country. The horror of horrors had arrived! The black plague! It sent a shudder over the land.
It sent a greater shudder over the business interests of San Francisco. These business interests quickly saw visions of quarantines against the State and cessation of tourist traffic. An appeal was made to a Federal Judge to declare the quarantine illegal. He promptly did so. In giving his decision, he went out of his way to make this statement:
“If it were within the province of this court to decide the point, I should hold that there is not now, and never has been, a case of plague in this city.”
The local board of health that discovered the plague was removed, as was the State board of health that confirmed the prevalence of the disease. The governor of the State sent a remarkable message to the Legislature in which he denounced those who said plague existed inSan Francisco, and appointed a committee of physicians and big business men to go to the California metropolis and make an “impartial” investigation. The business men on the committee included the biggest bankers and merchants in California. They reported in the most positive terms that there was no plague.
Dr. Kinyoun, the Marine Hospital Surgeon in charge, held his ground. Dr. Kinyoun was shortly transferred to Detroit. His successor said there was plague. His successor was shortly transferred to a distant city.
Of course, no one now denies that black plague was in San Francisco precisely when Dr. Kinyoun said it was. Even the eminent bankers and merchants who certified that it wasn’t there admit that they were in “error.” It is nowhere denied that there were more than 200 cases. It is nowhere denied that there were more than 100 deaths.
Such is the situation that has been imposed upon us by a system that places private profits above human life. Having painfully accumulated the knowledge with which we could combat the great disease, we are unable to apply it because we do not own and therefore cannot manage our own country.
“We look with horror on the black plague of the Middle Ages,” said Professor Norton. “The black plague was but a passing cloud, compared with the white plague visitation.”