REAL ESTATE
AND
NEW YORK, DECEMBER 19, 1914
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CITY HEALTH DEPARTMENT UNDER FIRE I
Two Views Expressed Before the Society of Medical Jurispru¬
dence—Held that Property Interests are Jeopardized by System
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THE activities of the Department of
Health were disctissed at the animal
meeting of the Society of Medical Juris¬
prudence, last Monday night, both sides
of the question coming up for considera¬
tion. Laurence M. D. McGuire, presi¬
dent of the Real Estate Board, took the
part of the householder, and said in part:
"Few know and perhaps still fewer
realize the tremendous power of the
Board of Health, originally organized
for the purpose of making and enforc¬
ing sanitary regulations. Although from
the first it was contemplated that its
extraordinary powers were only to be
used in times of plague or pestilence, it
has become, by legislative enactment and
by judicial interpretation, the most pow¬
erful department of the city govern¬
ment. It has, in fact, become the per¬
sonification of the police power of the
State, and as this vague and indefinite
power has never been clearly established
and defined by constitutional limitation,
it may accurately be said that the de¬
partment may, at any time, by majority
vote of its members, suspend all consti¬
tutional guarantees of individual and
property rights.
Legislation Proposed.
"Two years ago two lives were lost by
elevator accidents. It was seriously
proposed, in consequence, to enact legis¬
lation to compel a safety automatic
closing device on all elevator doors at
a cost of many millions of dollars, al¬
though there was no possible way of
connecting either accident with any
failure on the part of elevator doors as
equipped to properly close. In fact, the
expenditure of millions has been forced
from property owners and rent payers
of the city.
"The Board of Health may imprison
or may" fine individuals and order the
destruction of property and yet is sub¬
ject to no court review and its resolu¬
tions, when adopted, have always the
force of law. One cannot enjoin the
Board of Health, as other departments
of city government, and no suit can be
brought against it or against its officials.
It has the power to remove and imprison
any person suspected of having disease
deemed by it to be contagious or in¬
fectious. It has the power to order
buildings vacated, to close streets, ave¬
nues, even whole sections of the city.
It can isolate New York from other sec¬
tions of the country and impede com¬
merce to the injury of business and do
all by a resolution of its own board,
either by the adoption of sanitary regu¬
lations or by a declaration of imminent
peril.
Power of the Board.
"It is neither entirely a city or State
body. One member is Health Officer of
the Port of New York, appointed by the
Governor; another the Police Commis¬
sioner, and the third and executive mem¬
ber the City Commissioner of Health.
Therefore, the Board of Health has prac¬
tically behind it the power of the State,
the city, and naturally the police force.
"The constantly increasing budget ap¬
propriations will partly illustrate the
Last Monday evening, at the an¬
nual meeting of the Society of
Medical Jurisprudence, at Hosack
Hall, 17 West 43d street, the activi¬
ties of the Department of Health
were dwelt upon at length, Lau¬
rence M. D. McGuire, president of
the Real Estate Board of New
York, taking the viev^rpoint of the
householder; Dr. E. Eliot Harris,
president of the American Society
of Medical Economics, that of the
physician, and Dr. Haven Emer¬
son, Deputy Commissioner of
Health of the City of New York,
that of the Department of Health.
growing activities. In 1905 the depart¬
ment expended $1,763,873.89; in 1906, $1.-
889,321.15; in 1907. $2,079,413.40; in 1908,
$2,507,212.89; in 1909, $2,584,603.27; in
1910, $3,768,115.41; in 1911, $3,830,243.68;
in 1912, $3,076,343.47; in 1913, $3,366.-
365.39; in 1914, $3,534,240.50. and in 1915
the department requested $3,621,738.58.
"In a period of ten years the expendi¬
tures have increased approximately $2,-
000,000, which increase has added about
three points to the tax rate throughout
the whole city. Each year there has
been a substantial increase in its ex¬
penditures and there is expended for
administrative purposes alone, in the
main ofiice, $144,000 yearly.
Work of Department.
"The department maintains a Bureau
of Education, of Statistics, of Public
Health, of Infants' Milk Stations, of In¬
fectious Diseases, of Sanitary Inspection
and of Food Inspection, a Laboratory, a
Bureau of Drugs and a Hospital Service.
In addition to the hospitals supervised,
it operates a tuberculosis sanitarium at
Otisville, N. Y. It is the largest em¬
ployer of physicians, surgeons and
nurses in the city, and I am informed
employs more than 1,200 physicians. In
the Bureau of Public Health there are
154 medical inspectors. In the Bureau
of Infants' Milk Stations there are 23
medical inspectors; Bureau of Infectious
Diseases, 74; Bureau of Sanitary Inspec¬
tion, 11; also 11 dentists, 15 veterinarians,
2 surgeons, 588 nurses, a large number
of sanitary and food inspectors, chem¬
ists, bacteriologists, bacteriological diag¬
nosticians and a pathologist, many clerks
and stenographers.
"There are 3 captains of boats, 7 boat¬
men, and deckhands, a number of phar¬
macists, 6 laboratory assistants and a
dietitian. All these are in addition to
the forces required in the various hos¬
pitals.
Justification of Expense.
"The justification for this enormous
expense is the claim and popular belief
that the department has succeeded en¬
tirely by itself in reducing the death rate
in the city. Credit unfortunately is not
given the advance of modern science,
or skill of outside physicians or to bet¬
ter housing facilities, or the greatly im¬
proved means of living, all of which in
some measure must be responsible for
the lengthening of life, though I am
informed that there is no betterment as
to human life above the age of 40.
"The Bureau of Child Hygiene cost
last year $501,000; Infants' Milk Sta¬
tions, $125,000; laboratory service, $166,-
914, and the cost for salaries in the drug
and chemical departments, $30,876. I
am unable to ascertain the cost of drugs
supplied but the cost of supplies for la-
iioratory service was $68,000.
"There is no objection to the city's
furnishing medical service to those who,
physically or mentally, are unable to take
care of themselves, or to those who
through misfortune are unable financi¬
ally to pay for such service. The objec¬
tion to these activities is that they ought
to be cither entirely charitable or at the
disposal of every citizen. If in the latter
case, then all surgeons, physicians, den¬
tists and druggists would be in the em¬
ploy of the city, and all citizens would
receive equal benefit. This would savor
of the socialist and would mean the con¬
fiscation of private property, but what
the city is doing will ultimately lead to
that and yet do the rankest injustice
to those who have to pay, without re¬
ceiving the benefit."
From the Physician's Standpoint.
Dr. E. Eliot Harris, president of the
American Society of Medical Economics,
in speaking for the physician, said:
"Public health is a branch of medicine
and as a specialty it should have to do
largely with that form of health, pro¬
tection and disease prevention that may
be classified as sanitation, vital-statistics,
food and drugs, contagious and infectious
diseases, and the necessary laboratory
service.
"From the viewpoint of the medical
profession, public health is a reasonable
ideal of the heart and soul of every true
physician. Public health service is a
part of medical ethics, it is an aim of
the County Medical Society, it is one of
the objects of the State Medical Society,
and it has a large place in the organiza¬
tion of the national body of medical
men. Even to this day you are sure to
find physicians laboring hard to born a
national board of health, with a secre¬
tary of public health as its head.
"All these creatures of the physician's
altruistic endeavors are the most vital
opponents of his economic interests; yet
he supports faithfully the cause which
produces the largest reduction in his
income. The people have saved and the
physicians have lost millions of dollars
through the work of the boards of
health, in lessening the contagious and
communicable diseases, known as ty¬
phoid, malaria, smallpox, diphtheria,
tuberculosis and diarrhoeal diseases.
The Board's Activities.
"The board's activities are not limited
to public health. They are actually en¬
gaged in individual and personal prac¬
tice of medicine and surgery. This in¬
vasion in the field of medicine is a fore¬
runner, the socialization of the practice
of medicine and should be plucked at its
birth. The shadow of socialism in medi¬
cine is exhibited in the growing activities
in the Department of Health in their