H.L. Mencken

Baltimore Evening Sun/May 4, 1910

What does it cost Lord Baltimore, in hard cash and by the year, to be so charitable? How much does he dole out to his unfortunates and his incompetents? Two millions? Five? Six? Ten? No one seems to know; no records are kept by any central authority. The money comes pouring in from the State and city treasuries, from endowments and from private contributions, and it is poured out again in the same lavish manner. No one seems to have any authority to inquire into either its collection or its expenditure. How much, for instance, does the Salvation Army, with its junk wagons and its organized begging, rake in every twelve-month? And what is done with the money? 

Some notion of the colossal cost of public charities in a city the size of Baltimore may be gained from the fact that there are, at present, more than 30 orphan asylums within the city limits—all crowded and nearly all constantly asking for aid. In addition, there are no less than 39 hospitals, most of which receive the poor without charge, and 23 free dispensaries. Finally, there are 30 “homes” of various species—for the aged, the insane and the crippled, for out-of-works, convalescents and veterans of the wars. 

Who is The Gainer?

Who profits by all of this outpouring of alms? Certainly not the average, hardworking, thrifty Baltimorean. The thousands given to the local hospitals, for example, bring him no personal benefit. If he falls sick himself he must pay for lodging and attendance—and the bill he gets is ordinarily so large that paying it keeps him on short commons for a year afterward.

At one of the largest local hospitals, I am informed, the minimum charge for a private room is now $30 a week. If the patient is so ill that he needs a special nurse he must pay her $25 a week more, and give the hospital $6 or $7 a week for boarding her. And, in addition, be must pay his own private physician for visiting him, and must meet the staggering hills of the surgeons, learned consultants and other pundits called in to give aid. 

What does the patient get with his $30 room? Little more than the tiny, cheerless room itself and the few victuals his agonies permit him to eat. True enough, he has the services of a day and night staff nurse, and of the hospital’s staff of resident physicians, but each of those staff nurses has ten or a dozen other patients, to look after, and most of those resident physicians are both extremely young and extremely busy. If the patient is sick enough to need real nursing, he must hire his own nurse. The result is a copious outpouring of his currency. Six weeks in hospital are just about as expensive as six weeks in Europe.

It is but natural then to assume that the hospitals make enormous profits on their private patients—profits beside which the gains of a Washington hotelkeeper on Inauguration Day must seem puny. But do these profits go into the pockets of the eminent chirurgeons who run them? Very seldom. Nine times out of ten those gentlemen get little more than glory out of their endeavors. The real beneficiaries, of course, are the free patients—and fully half of the latter are shiftless negroes. 

The Dependent African.

The city negro, as everyone knows, is a far from healthy animal. Maladies serious and trivial constantly pester him, and he is an incessant patron of the dispensaries and free wards. Of the 90,000 odd negroes in Baltimore it is probable that not 10,000 ever pay for medical attendance. Why should they? They are able to get all of it they need, with medicines, board in hospital and nursing thrown in, without money and without price. 

Ambitious and skillful young surgeons stand ready to excise their appendices free of charge: there are free beds for them in comfortable wards; they may have all of the castor oil and quinine pills they care to swallow for the mere asking; and if, perchance, their assiduous swallowing reduces them to helpless invalidism, there are agreeable and salubrious asylums for them, wherein the struggle for existence need not worry them.

The light-hearted Afro-Baltimorean, indeed, is the chief beneficiary of Lord Baltimore’s charity. Sick or well, his hand is always out. He comes into the world under the benign auspices of the public treasury, he is fed and clothed at the public expense whenever he approaches starvation or orphan asylums, almshouses and jails; he is boarded and lodged and is given the best of care when he is sick, and when, finally, he goes to his reward, the city stands ready to relieve his relatives of the expense of burying him.

Many a Baltimore darky who earns say, $200 a year by his occasional labors, gets as much more from the public in the form of charity. The sojourn in hospital, which would cost a well-to-do white man $500, costs the lowly ex-chattel not a cent. Directly or indirectly, he is constantly profiting by the industry and greater efficiency of his betters. What his average annual profit in that direction comes to it is hard to say, but it cannot be much less than $100 a year. Accepting that as a fair estimate, and assuming the number of aided negroes to be 25,000—certainly no extravagant guess—the annual cost to the city works out to $2,500,000 a year.