Polly Dogood

Upon the Seamen's Hospitals

Wherein the Author discovers that the Founders' Government ran a Health Plan, recalls the Hospital her Grandpapa got built by a small Piece of Cunning, and compares both with what the present Congress has done to yours.

To the Readers of this Publick Blog,

On the 16th of July 1798, President John Adams signed "An Act for the relief of sick and disabled Seamen." I had never heard of it until this Week, and I suspect you have not either, so let me tell you what it did.

From the first of September that Year, no Ship arriving in an American Port could be "admitted to an entry" until her Master had paid the Collector of Customs "twenty cents per month for every seaman so employed; which sum he is hereby authorized to retain out of the wages of such seamen." Lie about the Number of your Crew, and it cost you $100. With the Money, the President was to provide "for the temporary relief and maintenance of sick or disabled seamen," and whatever was left over was to build Hospitals.

It was compulsory. Every Sailor paid, every Sailor was covered, and the Government ran it. The National Institutes of Health, in its own History, calls it "the first prepaid medical care plan in the United States." By the next Year a Doctor was treating Seamen in Boston Harbour, and Hospitals followed at Norfolk and at Charlestown. The Navy was added in 1799. The Service it began grew into the Marine Hospital Service, and then into the Public Health Service, and a one-room Laboratory in one of its Hospitals on Staten Island grew into the National Institutes of Health itself.

I will be honest, as I always am. It covered only Sailors. The Sailors paid for it out of their own Wages. It was passed partly to keep a Navy afloat in a Quarrel with France, and its early Hospitals were chosen, a Historian of the Service admits, as much for Politicks as for Medicine. And Mr. Adams had signed the Sedition Act two Days before, so I do not offer these Gentlemen to you as Saints. I offer them as Proof of a simple Thing. The Men who wrote the Constitution, sitting in the first Congresses under it, did not think it Socialism for the Government to see that a working Man who fell sick was cared for. They thought it ordinary Sense, and a Ship's Captain could not land his Cargo until it was paid.

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Grandpapa's Hospital

My own Family has a Hand in this Story too, though I must give the Credit where Grandpapa gave it. In 1751 his Friend Dr. Thomas Bond wished to build a Hospital in Philadelphia for the sick Poor, and could not raise the Money. Grandpapa wrote that the Hospital was "ascrib'd to me, but was originally his."

What Grandpapa did was persuade the Pennsylvania Assembly to promise £2,000 of the Publick's Money, but only if private Donors gave as much first. The Members who doubted the Scheme voted for it all the same, supposing the Condition would never be met, and that they might have the Credit of Charity without the Expense. Then Grandpapa went round the Town telling every Subscriber that "every man's donation would be doubled," and it was met very quickly. The Hospital was to care for the sick Poor "free of charge for diet, attendance, advice, and medicines." He confessed afterward that he did not remember any of his political Manoeuvres "the success of which gave me at the time more pleasure," nor any for which he "more easily excus'd myself for having made some use of cunning."

When the Cornerstone was laid in 1755, Grandpapa wrote the Inscription. The Hospital was built, it says, "By the Bounty of the Government, And of many private Persons ... For the Relief of the Sick and Miserable." The Government and the People together, for the Sick and Miserable. I cannot improve on it.

What the present Congress has done

Now consider our own Congress.

In July of last Year it passed a Law which, by the Reckoning of the Congressional Budget Office, cuts close to $1 trillion from Medicaid over ten Years and will leave some 10 million more Americans without Insurance by 2034. The same Office found that the poorest tenth of Households will lose about $1,200 a Year under that Law, while the richest tenth gain about $13,600. Middling Households gain something too, I grant, but I note which End of the Table got the Roast.

Then Congress let the Help that so many People used to buy their own Insurance expire at the End of last Year. For those who kept the same Plan, the Kaiser Family Foundation found, the Payments more than doubled. Some three million fewer People signed up. A Survey released last Week by the Commonwealth Fund finds that 11.2% of working-age Adults now have no Insurance at all, up from 8.9% two Years ago. In January the House voted 230 to 196 to restore that Help, with seventeen Republicans joining. It has not become Law.

And here is the Part I most wish you to know. Most of the Medicaid Cuts have not happened yet. The new Paperwork Requirements begin by January of 2027, and three Quarters of the Money is cut in the last five of the ten Years. The Congress that will decide whether to let them stand is the one you elect next Tuesday.

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Here is the plainer Version.

The Founders' own Congress made every Sailor's Health its Business, and would not let a Ship land her Cargo until the Sailors were covered. Grandpapa got the Government to match the People's Charity, Pound for Pound, so the sick Poor of Philadelphia could be treated free. Neither of them thought a sick working Man's Care was beneath the Notice of the Republic.

The present Congress has taken from the sick and the poor and given to those who were neither, and has left the Bill to be paid after the Election, when it hopes you will not be watching. You are watching now. On the 3rd of November, send a Congress that remembers what the Founders' Government was for: the Relief of the Sick and Miserable, by the Bounty of the Government, and of many private Persons.

P.S. The Seamen paid 20 cents a Month in 1798, which I am told is something over $5 in today's Money. Several of my Readers inform me that their Insurance now costs a good deal more than that, and that no Ship of State has yet been refused Entry on their Account.