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Justifiable State Expenditure


1. The care of the insane.

2. And all requiring special treatment.

3. Hospitals.

1. The most prominent item that may be put under the head of justifiable State expenditure is the care of the insane. As every unfortunate is an unwelcome addition to the public expense, each municipality often seeks to shirk the responsibility whenever it can by throwing him on another town, county or city. These municipal con flicts concerning the support of the insane and the ability of the State to care for them in a more considerate and intelligent manner, have led many States to undertake their care and support. In some of them buildings and i attendants are provided, and the particular municipalities from which inmates have come pay part of the expense. In other States the entire expense is borne by the State itself. In these there is a tendency among some munic ipalities to adjudge persons to be insane who are not, for the purpose of committing them to State institutions and escaping the need of supporting them at local ex pense. This can be remedied by making the expense of such persons chargeable to the municipality from which they come. Perhaps if this plan was adopted, persons would suffer from lack of proper treatment because they would not always be sent to these institutions. If worse results than those now experienced followed, then some other plan might be tried, or the present one be re newed.

2. The province of State assistance has a wider ap plication. It is justified in supporting the blind and all others requiring peculiar treatment, for by drawing them together they can be more skillfully and economically treated than they can be separately or in small numbers. Some municipalities that have no insane or blind hospi tals send them to private institutions for support and treatment at public cost.

3. These reasons do not justify the State in main taining either directly or indirectly ordinary hospitals. First, the treatment of such patients does not require special skill that cannot be easily provided. Second,

there is no need of erecting larger or more costly build ings than would probably suffice for local use. Third, those who are thus aided in most cases would be nearer their friends who, to some extent, would be interested in ministering to their wants and pleasure. Fourth, State aid removes its recipients still further from the donors, and interest in them is lessened. This is a potent reason against granting any public aid. At present, and espe cially in the larger cities, aid is rendered in a great variety of ways. Little or no system exists, and one of the con sequences is a great waste of money and labor. Some thoughtful persons assert that more than 5o per cent. of the money privately bestowed never reaches those for whom it was intended. The first step to reduce order out of the existing chaos is to minimize public aid and offi cialism that private assistance may expand and do more effective work. Fifth, another reason for not support ing such institutions, either wholly or partly by the State, is that it is difficult to discover any principle on which such appropriations are made for them. To a large ex tent these represent scrambles for money; the institu tions having the most influence getting the largest sums. It may be that State assistance in some States has be come so general to all kinds of charitable associations, the sudden withdrawal of it would cripple them. If this would be the effect of withdrawing it, the reason is the more imperative at least for reducing public assistance and basing it on a rational foundation. Many an asso ciation of this character is now resting on political quick sand, wholly uncertain whether $1o,000 or $1oo,000 or anything can be extracted from the next legislature for its support. It hardly need be added that so long as such ap propriations are based on no principle, they will be de moralizing to many, if not all, who are active in securing them.

treatment, public, insane, support and aid