Your Life is Their Toy - Emanuel Josephson

Open Hospital—A Remedy

The remedy for the "closed" hospital and allied rackets is obvious and simple. It consists in the elimination of hospital monopolies and their conversion into "open" hospitals.

The "open" hospital gives the patient complete freedom of choice of physician from the ranks of doctors licensed to practice. Competition, made possible by freedom of choice of physicians, puts an end to exorbitant fees and charges demanded by the merchants-in-medicine and the hospital bosses. The patient is no longer forced to content himself with neglect and medical treatment of inferior caliber in order to secure the advantages of hospitalization. No longer is he robbed by numerous needless consultations, the object of which is often solely the physician's desire to retain or purchase hospital position. No longer are the health and life of the public subject to the convenience, whims and caprices of a monopolizing group of merchants-in-medicine.


The advantages to the patient of the elimination of the racketeering "closed" hospital system and its replacement by an honest "open" hospital regime were made clear by a letter written, on October 1, 1926, by the late Dr. Royal S. Copeland, U.S, Senator. Professor of Ophthalmology of the University of Michigan and of the Flower Hospital Medical School, and former Commissioner of Health of New York City, for publication in the Medical Alliance Review. Senator Copeland wrote as follows:

"I have always believed that the hospitals should be more generally used by the medical profession. At many times hospitals have closed wards to the detriment of the profession and of the public.

". . . There should be worked out some method by which a reputable physician could take a patient to a nearby hospital, I recall an experience of my own. A patient came to me for an operation for a cataract. He lived right next door to the hospital. When I asked the privilege of operating that patient in that hospital, I was told it was impossible because they had a "closed" staff. This poor old man was obliged to come way over to Manhattan to a hospital where I operated, in order that he might have an operation which could have been done in his very door-yard. I hope some way may be worked out by which hospitals may be given a greater usefulness, by permitting the profession generally to make use of them.

"Cordially yours,

"Royal S. Copeland'


Senator Copeland drives home by illustration some of the significance to the public of the "closed" hospital racket which is expressed in a more abstract form by an authority on the hospital problem, Commissioner of Hospitals of New York, Dr. S.S. Goldwater, who wrote as follows:

"The key to nearly everything that makes for efficient medical practice today is in the hands of the hospitals. Their duty is plain—they must open wide the door of opportunity so that the entire medical profession may enter in, for the fruits of medical progress belong of right to the many, not to the few."

"It is to the credit of the open hospital that it brings into touch with an organized medical institution many physicians who under a more restricted or exclusive hospital system would be deprived of those helpful and stimulating medical contacts without which they are in danger of deteriorating in medical knowledge and proficiency."

The political pressure of the medical and social service rackets led Commissioner Goldwater to forget to put his theories into practice in the hospitals of New York City.


Former Commissioner of Health of New York City, Dr. Louis I. Harris, aptly depicted the significance of the "open" hospital reform to the public, as follows:

"The public is entitled to the highest type of diagnostic skill and treatment that are available.

"Now, if the hospital facilities in any community be monopolized by small groups, then an array of doctors must, willy-nilly, carry on their bedside practice in thousands of homes without guidance and without the benefits of that diagnostic equipment and intellectual knowledge which services in the hospitals give.

"The public have much to complain about in this situation.

"The public have a very peculiar interest when it is treated by a great army of doctors who are denied the opportunity to acquire skill in diagnosis and treatment because hospitals are closed to them. It is necessary , therefore , to have hospital privileges f open to all physicians in the community "


The late Newton D. Baker, Ex-Secretary of War, on the Wilson Cabinet, pointed out that hospitals which are tax-exempt and solicit funds from the public are the property of the public and that their private management and monopoly constitutes a usurpation of public function. He urged that these hospitals be operated as publicly owned utilities for the benefit of the public.

The merchants-in-medicine, the A.M.A. and the A.C.S., are bitterly opposed to the "open" hospital system. It would mean an end to their monopoly of hospital business. Without that monopoly they would no longer he able to extract from the public extortionate fees. They would also lose the selective advertising which the hospitals now give them. Their business would suffer severely; and that is one thing that the medical merchants cannot stomach.

As might be expected, all types of false and specious arguments in defense of the "closed" hospital and in attack on the "open" hospital have been made by medical bosses and organizations. Foremost among these fallacious defenses is the pretense that the "closed" hospital protects the patient and his life.


If the hospital bosses were really sincere in their pretended desire to protect the health and life of the public, they would "open" their hospitals to all the physicians of the community and their patients. Especially would they "open" their hospitals to the physicians whom they pretend are not adequately competent. For those physicians are licensed to practice medicine and do render services to the ill in their offices and in the patients' homes under difficulties, without check or supervision. If they were invited, or induced, to bring their patients into the hospitals, their work could be watched and supervised, and the patients protected.

Another argument advanced against the "open" hospital is the allegation that it cannot be efficiently administered. This is belied by the hundreds of "open" hospitals in all parts of the country— in large cities and in small towns—that are efficiently providing hospitalization for the public. Many of the leading hospital administrators, one of whom has been quoted, are among the staunchest advocates of the "open" hospital system.

The conversion of the hospital monopolies of the country to "open" hospitals is entirely within the power of the public. The public should repossess themselves of their hospital property and convert it to their own use, instead of permitting it to be monopolized and used against themselves. By increasing the number of effectively available physicians for service to it, under the oft superior conditions offered by properly administered and utilized hospitals, the public would assure itself of responsible and competent services at reduced costs.

For protection of the health and lives of the public, the provisions of the law which shield hospitals against the consequences of negligence should be eliminated.

These reforms would be as welcome to the rank and file of the medical profession as they should be to the public; and they would redound to the benefit of all concerned. The hospital would become an institution for the rendition of considerate, personal and responsible care to sentient human beings instead of a medical and surgical factory.

Barring aid from the hospital funds or from the government, the monopolistic "closed" hospital system is on its last legs. It has been dealt a knock-out blow by the depression and by the growth and recognition of private hospitals and sanitaria. This is the true significance of the petition of the Committee of 4^0 which was falsely publicized as a plea for the reduction of the cost of medical care, to the public. The petition actually constituted a plea to the government by a group of dominant medical merchants to prevent injury to their businesses which would result from bankruptcy of their "closed" hospital monopolies, by governmental subsidy of the monopolized hospitals.

The signers of the petition were some of the "leaders" of the "closed" hospital monopoly. Instead of seeking to reduce the cost of medical care to the public, this group of supposed "revolters" are merely seeking a perpetuation of their hospital monopolies for further exploitation of the public.

If the public will take full advantage of the financial embarrassment of the hospital which gave birth to the plea of the Committee of the 430 bosses of medicine, it will force into bankruptcy the "closed" hospital system and destroy it.

There should be no difficulty in the community taking over the voluntary hospitals. It has built and supported them by its contributions from both private and public purses. By tax exemption alone, the community presents these hospitals each twenty to thirty years with a gift equal to their entire value. In its 1940 budget, for instance, New York City is providing over four million dollars for payment to voluntary hospitals for the care of the indigent. Obviously these hospitals are rightly the property of the public and can be repossessed from their usurpers with little legal formality.