WHY CHARITY?
Why should there by any necessity for almsgiving in a civilized
community? It is not the charitable mind to which I object. Heaven
forbid that we should ever grow cold toward a fellow creature in need.
Human sympathy is too fine for the cool, calculating attitude to take
its place. One can name very few great advances that did not have human
sympathy behind them. It is in order to help people that every notable
service is undertaken.
The trouble is that we have been using this great, fine motive force for
ends too small. If human sympathy prompts us to feed the hungry, why
should it not give the larger desire--to make hunger in our midst
impossible? If we have sympathy enough for people to help them out of
their troubles, surely we ought to have sympathy enough to keep them
out.
It is easy to give; it is harder to make giving unnecessary. To make the
giving unnecessary we must look beyond the individual to the cause of
his misery--not hesitating, of course, to relieve him in the meantime,
but not stopping with mere temporary relief. The difficulty seems to be
in getting to look beyond to the causes. More people can be moved to
help a poor family than can be moved to give their minds toward the
removal of poverty altogether.
I have no patience with professional charity, or with any sort of
commercialized humanitarianism. The moment human helpfulness is
systematized, organized, commercialized, and professionalized, the heart
of it is extinguished, and it becomes a cold and clammy thing.
Real human helpfulness is never card-catalogued or advertised. There are
more orphan children being cared for in the private homes of people who
love them than in the institutions. There are more old people being
sheltered by friends than you can find in the old people's homes. There
is more aid by loans from family to family than by the loan societies.
That is, human society on a humane basis looks out for itself. It is a
grave question how far we ought to countenance the commercialization of
the natural instinct of charity.
Professional charity is not only cold but it hurts more than it helps.
It degrades the recipients and drugs their self-respect. Akin to it is
sentimental idealism. The idea went abroad not so many years ago that
"service" was something that we should expect to have done for us.
Untold numbers of people became the recipients of well-meant "social
service." Whole sections of our population were coddled into a state of
expectant, child-like helplessness. There grew up a regular profession
of doing things for people, which gave an outlet for a laudable desire
for service, but which contributed nothing whatever to the self-reliance
of the people nor to the correction of the conditions out of which the
supposed need for such service grew.
Worse than this encouragement of childish wistfulness, instead of
training for self-reliance and self-sufficiency, was the creation of a
feeling of resentment which nearly always overtakes the objects of
charity. People often complain of the "ingratitude" of those whom they
help. Nothing is more natural. In the first place, precious little of
our so-called charity is ever real charity, offered out of a heart full
of interest and sympathy. In the second place, no person ever relishes
being in a position where he is forced to take favors.
Such "social work" creates a strained relation--the recipient of bounty
feels that he has been belittled in the taking, and it is a question
whether the giver should not also feel that he has been belittled in the
giving. Charity never led to a settled state of affairs. The charitable
system that does not aim to make itself unnecessary is not performing
service. It is simply making a job for itself and is an added item to
the record of non-production.
Charity becomes unnecessary as those who seem to be unable to earn
livings are taken out of the non-productive class and put into the
productive. In a previous chapter I have set out how experiments in our
shops have demonstrated that in sufficiently subdivided industry there
are places which can be filled by the maimed, the halt, and the blind.
Scientific industry need not be a monster devouring all who come near
it. When it is, then it is not fulfilling its place in life. In and out
of industry there must be jobs that take the full strength of a powerful
man; there are other jobs, and plenty of them, that require more skill
than the artisans of the Middle Ages ever had. The minute subdivision of
industry permits a strong man or a skilled man always to use his
strength or skill. In the old hand industry, a skilled man spent a good
part of his time at unskilled work. That was a waste. But since in those
days every task required both skilled and unskilled labour to be
performed by the one man, there was little room for either the man who
was too stupid ever to be skilled or the man who did not have the
opportunity to learn a trade.
No mechanic working with only his hands can earn more than a bare
sustenance. He cannot have a surplus. It has been taken for granted
that, coming into old age, a mechanic must be supported by his children
or, if he has no children, that he will be a public charge. All of that
is quite unnecessary. The subdivision of industry opens places that can
be filled by practically any one. There are more places in subdivision
industry that can be filled by blind men than there are blind men. There
are more places that can be filled by cripples than there are cripples.
And in each of these places the man who short-sightedly might be
considered as an object of charity can earn just as adequate a living as
the keenest and most able-bodied. It is waste to put an able-bodied man
in a job that might be just as well cared for by a cripple. It is a
frightful waste to put the blind at weaving baskets. It is waste to have
convicts breaking stone or picking hemp or doing any sort of petty,
useless task.
A well-conducted jail should not only be self-supporting, but a man in
jail ought to be able to support his family or, if he has no family, he
should be able to accumulate a sum of money sufficient to put him on his
feet when he gets out of jail. I am not advocating convict labour or the
farming out of men practically as slaves. Such a plan is too detestable
for words. We have greatly overdone the prison business, anyway; we
begin at the wrong end. But as long as we have prisons they can be
fitted into the general scheme of production so neatly that a prison
may become a productive unit working for the relief of the public and
the benefit of the prisoners. I know that there are laws--foolish laws
passed by unthinking men--that restrict the industrial activities of
prisons. Those laws were passed mostly at the behest of what is called
Labour. They are not for the benefit of the workingman. Increasing the
charges upon a community does not benefit any one in the community. If
the idea of service be kept in mind, then there is always in every
community more work to do than there are men who can do it.
Industry organized for service removes the need for philanthropy.
Philanthropy, no matter how noble its motive, does not make for
self-reliance. We must have self-reliance. A community is the better for
being discontented, for being dissatisfied with what it has. I do not
mean the petty, daily, nagging, gnawing sort of discontent, but a broad,
courageous sort of discontent which believes that everything which is
done can and ought to be eventually done better. Industry organized for
service--and the workingman as well as the leader must serve--can pay
wages sufficiently large to permit every family to be both self-reliant
and self-supporting. A philanthropy that spends its time and money in
helping the world to do more for itself is far better than the sort
which merely gives and thus encourages idleness. Philanthropy, like
everything else, ought to be productive, and I believe that it can be. I
have personally been experimenting with a trade school and a hospital to
discover if such institutions, which are commonly regarded as
benevolent, cannot be made to stand on their own feet. I have found that
they can be.
I am not in sympathy with the trade school as it is commonly
organized--the boys get only a smattering of knowledge and they do not
learn how to use that knowledge. The trade school should not be a cross
between a technical college and a school; it should be a means of
teaching boys to be productive. If they are put at useless tasks--at
making articles and then throwing them away--they cannot have the
interest or acquire the knowledge which is their right. And during the
period of schooling the boy is not productive; the schools--unless by
charity--make no provision for the support of the boy. Many boys need
support; they must work at the first thing which comes to hand. They
have no chance to pick and choose.
When the boy thus enters life untrained, he but adds to the already
great scarcity of competent labour. Modern industry requires a degree of
ability and skill which neither early quitting of school nor long
continuance at school provides. It is true that, in order to retain the
interest of the boy and train him in handicraft, manual training
departments have been introduced in the more progressive school systems,
but even these are confessedly makeshifts because they only cater to,
without satisfying, the normal boy's creative instincts.
To meet this condition--to fulfill the boy's educational possibilities
and at the same time begin his industrial training along constructive
lines--the Henry Ford Trade School was incorporated in 1916. We do not
use the word philanthropy in connection with this effort. It grew out of
a desire to aid the boy whose circumstances compelled him to leave
school early. This desire to aid fitted in conveniently with the
necessity of providing trained tool-makers in the shops. From the
beginning we have held to three cardinal principles: first, that the boy
was to be kept a boy and not changed into a premature working-man;
second, that the academic training was to go hand in hand with the
industrial instruction; third, that the boy was to be given a sense of
pride and responsibility in his work by being trained on articles which
were to be used. He works on objects of recognized industrial worth. The
school is incorporated as a private school and is open to boys between
the ages of twelve and eighteen. It is organized on the basis of
scholarships and each boy is awarded an annual cash scholarship of four
hundred dollars at his entrance. This is gradually increased to a
maximum of six hundred dollars if his record is satisfactory.
A record of the class and shop work is kept and also of the industry the
boy displays in each. It is the marks in industry which are used in
making subsequent adjustments of his scholarship. In addition to his
scholarship each boy is given a small amount each month which must be
deposited in his savings account. This thrift fund must be left in the
bank as long as the boy remains in the school unless he is given
permission by the authorities to use it for an emergency.
One by one the problems of managing the school are being solved and
better ways of accomplishing its objects are being discovered. At the
beginning it was the custom to give the boy one third of the day in
class work and two thirds in shop work. This daily adjustment was found
to be a hindrance to progress, and now the boy takes his training in
blocks of weeks--one week in the class and two weeks in the shop.
Classes are continuous, the various groups taking their weeks in turn.
The best instructors obtainable are on the staff, and the text-book is
the Ford plant. It offers more resources for practical education than
most universities. The arithmetic lessons come in concrete shop
problems. No longer is the boy's mind tortured with the mysterious A who
can row four miles while B is rowing two. The actual processes and
actual conditions are exhibited to him--he is taught to observe. Cities
are no longer black specks on maps and continents are not just pages of
a book. The shop shipments to Singapore, the shop receipts of material
from Africa and South America are shown to him, and the world becomes an
inhabited planet instead of a coloured globe on the teacher's desk. In
physics and chemistry the industrial plant provides a laboratory in
which theory becomes practice and the lesson becomes actual experience.
Suppose the action of a pump is being taught. The teacher explains the
parts and their functions, answers questions, and then they all troop
away to the engine rooms to see a great pump. The school has a regular
factory workshop with the finest equipment. The boys work up from one
machine to the next. They work solely on parts or articles needed by the
company, but our needs are so vast that this list comprehends nearly
everything. The inspected work is purchased by the Ford Motor Company,
and, of course, the work that does not pass inspection is a loss to the
school.
The boys who have progressed furthest do fine micrometer work, and they
do every operation with a clear understanding of the purposes and
principles involved. They repair their own machines; they learn how to
take care of themselves around machinery; they study pattern-making and
in clean, well-lighted rooms with their instructors they lay the
foundation for successful careers.
When they graduate, places are always open for them in the shops at good
wages. The social and moral well-being of the boys is given an
unobtrusive care. The supervision is not of authority but of friendly
interest. The home conditions of every boy are pretty well known, and
his tendencies are observed. And no attempt is made to coddle him. No
attempt is made to render him namby-pamby. One day when two boys came to
the point of a fight, they were not lectured on the wickedness of
fighting. They were counseled to make up their differences in a better
way, but when, boy-like, they preferred the more primitive mode of
settlement, they were given gloves and made to fight it out in a corner
of the shop. The only prohibition laid upon them was that they were to
finish it there, and not to be caught fighting outside the shop. The
result was a short encounter and--friendship.
They are handled as boys; their better boyish instincts are encouraged;
and when one sees them in the shops and classes one cannot easily miss
the light of dawning mastery in their eyes. They have a sense of
"belonging." They feel they are doing something worth while. They learn
readily and eagerly because they are learning the things which every
active boy wants to learn and about which he is constantly asking
questions that none of his home-folks can answer.
Beginning with six boys the school now has two hundred and is possessed
of so practical a system that it may expand to seven hundred. It began
with a deficit, but as it is one of my basic ideas that anything worth
while in itself can be made self-sustaining, it has so developed its
processes that it is now paying its way.
We have been able to let the boy have his boyhood. These boys learn to
be workmen but they do not forget how to be boys. That is of the first
importance. They earn from 19 to 35 cents an hour--which is more than
they could earn as boys in the sort of job open to a youngster. They can
better help support their families by staying in school than by going
out to work. When they are through, they have a good general education,
the beginning of a technical education, and they are so skilled as
workmen that they can earn wages which will give them the liberty to
continue their education if they like. If they do not want more
education, they have at least the skill to command high wages anywhere.
They do not have to go into our factories; most of them do because they
do not know where better jobs are to be had--we want all our jobs to be
good for the men who take them. But there is no string tied to the boys.
They have earned their own way and are under obligations to no one.
There is no charity. The place pays for itself.
The Ford Hospital is being worked out on somewhat similar lines, but
because of the interruption of the war--when it was given to the
Government and became General Hospital No. 36, housing some fifteen
hundred patients--the work has not yet advanced to the point of
absolutely definite results. I did not deliberately set out to build
this hospital. It began in 1914 as the Detroit General Hospital and was
designed to be erected by popular subscription. With others, I made a
subscription, and the building began. Long before the first buildings
were done, the funds became exhausted and I was asked to make another
subscription. I refused because I thought that the managers should have
known how much the building was going to cost before they started. And
that sort of a beginning did not give great confidence as to how the
place would be managed after it was finished. However, I did offer to
take the whole hospital, paying back all the subscriptions that had been
made. This was accomplished, and we were going forward with the work
when, on August 1, 1918, the whole institution was turned over to the
Government. It was returned to us in October, 1919, and on the tenth day
of November of the same year the first private patient was admitted.
The hospital is on West Grand Boulevard in Detroit and the plot embraces
twenty acres, so that there will be ample room for expansion. It is our
thought to extend the facilities as they justify themselves. The
original design of the hospital has been quite abandoned and we have
endeavoured to work out a new kind of hospital, both in design and
management. There are plenty of hospitals for the rich. There are plenty
of hospitals for the poor. There are no hospitals for those who can
afford to pay only a moderate amount and yet desire to pay without a
feeling that they are recipients of charity. It has been taken for
granted that a hospital cannot both serve and be self-supporting--that
it has to be either an institution kept going by private contributions
or pass into the class of private sanitariums managed for profit. This
hospital is designed to be self-supporting--to give a maximum of service
at a minimum of cost and without the slightest colouring of charity.
In the new buildings that we have erected there are no wards. All of the
rooms are private and each one is provided with a bath. The rooms--which
are in groups of twenty-four--are all identical in size, in fittings,
and in furnishings. There is no choice of rooms. It is planned that
there shall be no choice of anything within the hospital. Every patient
is on an equal footing with every other patient.
It is not at all certain whether hospitals as they are now managed exist
for patients or for doctors. I am not unmindful of the large amount of
time which a capable physician or surgeon gives to charity, but also I
am not convinced that the fees of surgeons should be regulated according
to the wealth of the patient, and I am entirely convinced that what is
known as "professional etiquette" is a curse to mankind and to the
development of medicine. Diagnosis is not very much developed. I should
not care to be among the proprietors of a hospital in which every step
had not been taken to insure that the patients were being treated for
what actually was the matter with them, instead of for something that
one doctor had decided they had. Professional etiquette makes it very
difficult for a wrong diagnosis to be corrected. The consulting
physician, unless he be a man of great tact, will not change a diagnosis
or a treatment unless the physician who has called him in is in thorough
agreement, and then if a change be made, it is usually without the
knowledge of the patient. There seems to be a notion that a patient, and
especially when in a hospital, becomes the property of the doctor. A
conscientious practitioner does not exploit the patient. A less
conscientious one does. Many physicians seem to regard the sustaining of
their own diagnoses as of as great moment as the recovery of the
patient.
It has been an aim of our hospital to cut away from all of these
practices and to put the interest of the patient first. Therefore, it is
what is known as a "closed" hospital. All of the physicians and all of
the nurses are employed by the year and they can have no practice
outside of the hospital. Including the interns, twenty-one physicians
and surgeons are on the staff. These men have been selected with great
care and they are paid salaries that amount to at least as much as they
would ordinarily earn in successful private practice. They have, none of
them, any financial interest whatsoever in any patient, and a patient
may not be treated by a doctor from the outside. We gladly acknowledge
the place and the use of the family physician. We do not seek to
supplant him. We take the case where he leaves off, and return the
patient as quickly as possible. Our system makes it undesirable for us
to keep patients longer than necessary--we do not need that kind of
business. And we will share with the family physician our knowledge of
the case, but while the patient is in the hospital we assume full
responsibility. It is "closed" to outside physicians' practice, though
it is not closed to our cooperation with any family physician who
desires it.
The admission of a patient is interesting. The incoming patient is first
examined by the senior physician and then is routed for examination
through three, four, or whatever number of doctors seems necessary. This
routing takes place regardless of what the patient came to the hospital
for, because, as we are gradually learning, it is the complete health
rather than a single ailment which is important. Each of the doctors
makes a complete examination, and each sends in his written findings to
the head physician without any opportunity whatsoever to consult with
any of the other examining physicians. At least three, and sometimes six
or seven, absolutely complete and absolutely independent diagnoses are
thus in the hands of the head of the hospital. They constitute a
complete record of the case. These precautions are taken in order to
insure, within the limits of present-day knowledge, a correct diagnosis.
At the present time, there are about six hundred beds available. Every
patient pays according to a fixed schedule that includes the hospital
room, board, medical and surgical attendance, and nursing. There are no
extras. There are no private nurses. If a case requires more attention
than the nurses assigned to the wing can give, then another nurse is put
on, but without any additional expense to the patient. This, however, is
rarely necessary because the patients are grouped according to the
amount of nursing that they will need. There may be one nurse for two
patients, or one nurse for five patients, as the type of cases may
require. No one nurse ever has more than seven patients to care for, and
because of the arrangements it is easily possible for a nurse to care
for seven patients who are not desperately ill. In the ordinary hospital
the nurses must make many useless steps. More of their time is spent in
walking than in caring for the patient. This hospital is designed to
save steps. Each floor is complete in itself, and just as in the
factories we have tried to eliminate the necessity for waste motion, so
have we also tried to eliminate waste motion in the hospital. The charge
to patients for a room, nursing, and medical attendance is $4.50 a day.
This will be lowered as the size of the hospital increases. The charge
for a major operation is $125. The charge for minor operations is
according to a fixed scale. All of the charges are tentative. The
hospital has a cost system just like a factory. The charges will be
regulated to make ends just meet.
There seems to be no good reason why the experiment should not be
successful. Its success is purely a matter of management and
mathematics. The same kind of management which permits a factory to give
the fullest service will permit a hospital to give the fullest service,
and at a price so low as to be within the reach of everyone. The only
difference between hospital and factory accounting is that I do not
expect the hospital to return a profit; we do expect it to cover
depreciation. The investment in this hospital to date is about
$9,000,000.
If we can get away from charity, the funds that now go into charitable
enterprises can be turned to furthering production--to making goods
cheaply and in great plenty. And then we shall not only be removing the
burden of taxes from the community and freeing men but also we can be
adding to the general wealth. We leave for private interest too many
things we ought to do for ourselves as a collective interest. We need
more constructive thinking in public service. We need a kind of
"universal training" in economic facts. The over-reaching ambitions of
speculative capital, as well as the unreasonable demands of
irresponsible labour, are due to ignorance of the economic basis of
life. Nobody can get more out of life than life can produce--yet nearly
everybody thinks he can. Speculative capital wants more; labour wants
more; the source of raw material wants more; and the purchasing public
wants more. A family knows that it cannot live beyond its income; even
the children know that. But the public never seems to learn that it
cannot live beyond its income--have more than it produces.
In clearing out the need for charity we must keep in mind not only the
economic facts of existence, but also that lack of knowledge of these
facts encourages fear. Banish fear and we can have self-reliance.
Charity is not present where self-reliance dwells.
Fear is the offspring of a reliance placed on something outside--on a
foreman's good-will, perhaps, on a shop's prosperity, on a market's
steadiness. That is just another way of saying that fear is the portion
of the man who acknowledges his career to be in the keeping of earthly
circumstances. Fear is the result of the body assuming ascendancy over
the soul.
The habit of failure is purely mental and is the mother of fear. This
habit gets itself fixed on men because they lack vision. They start out
to do something that reaches from A to Z. At A they fail, at B they
stumble, and at C they meet with what seems to be an insuperable
difficulty. They then cry "Beaten" and throw the whole task down. They
have not even given themselves a chance really to fail; they have not
given their vision a chance to be proved or disproved. They have simply
let themselves be beaten by the natural difficulties that attend every
kind of effort.
More men are beaten than fail. It is not wisdom they need or money, or
brilliance, or "pull," but just plain gristle and bone. This rude,
simple, primitive power which we call "stick-to-it-iveness" is the
uncrowned king of the world of endeavour. People are utterly wrong in
their slant upon things. They see the successes that men have made and
somehow they appear to be easy. But that is a world away from the facts.
It is failure that is easy. Success is always hard. A man can fail in
ease; he can succeed only by paying out all that he has and is. It is
this which makes success so pitiable a thing if it be in lines that are
not useful and uplifting.
If a man is in constant fear of the industrial situation he ought to
change his life so as not to be dependent upon it. There is always the
land, and fewer people are on the land now than ever before. If a man
lives in fear of an employer's favor changing toward him, he ought to
extricate himself from dependence on any employer. He can become his own
boss. It may be that he will be a poorer boss than the one he leaves,
and that his returns will be much less, but at least he will have rid
himself of the shadow of his pet fear, and that is worth a great deal in
money and position. Better still is for the man to come through himself
and exceed himself by getting rid of his fears in the midst of the
circumstances where his daily lot is cast. Become a freeman in the place
where you first surrendered your freedom. Win your battle where you lost
it. And you will come to see that, although there was much outside of
you that was not right, there was more inside of you that was not right.
Thus you will learn that the wrong inside of you spoils even the right
that is outside of you.
A man is still the superior being of the earth. Whatever happens, he is
still a man. Business may slacken tomorrow--he is still a man. He goes
through the changes of circumstances, as he goes through the variations
of temperature--still a man. If he can only get this thought reborn in
him, it opens new wells and mines in his own being. There is no security
outside of himself. There is no wealth outside of himself. The
elimination of fear is the bringing in of security and supply.
Let every American become steeled against coddling. Americans ought to
resent coddling. It is a drug. Stand up and stand out; let weaklings
take charity.