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To this day the relatives of the victim of this outrageous neglect do not know of the injustice that was done them. They believed that eighty-five dollars a week would insure the best of attention, -- and so it would have done had the trusted owner been deserving of the confidence placed in him. (22) From a reliable source I learn that the owner of the run-for-gain sanatorium discussed, brags that his profit during a recent year amounted to $98,000. My informant, a man conversant with the question at issue, figures that a profit of six dollars a week from each patient would have enabled this acquisitive owner to make the $98,000 he professes to have made. But let us cut the reported brag in two, just to be on the safe side. Does any one believe that an inefficient owner of a sanatorium deserves to receive a yearly profit equal to the salary of the President of the United States?

As to my own experience at this institution: during the first weeks of it, my relatives were obliged to pay forty dollars a week for my care. Under the circumstances it was not an unreasonable figure -- for, both by day and night, I required an attendant; nor do I even affirm that the eighty-five dollars a week, wrung from the rich man, was in itself exorbitant. But is it right for the owner of a sanatorium to demand and accept either forty or eighty-five dollars a week, and then permit the helpless patient to be subjected to indignities and neglect? I know of a sanatorium where the owner refuses to take any patient who cannot afford to pay one hundred dollars a week. He caters to the wealthy, and secures a sufficient number of patients to fill his hospital. I respect that man. He deserves success, for he gives each patient better care than he could possibly get in the most self-sacrificing household. To expect him to reduce his rates would be as unreasonable as to expect the owner of real estate, simply because a church or hospital is to be erected thereon, to sell it below the market price. The law of supply and demand (together with a culpable lack of State supervision) regulates the rates now charged by owners of sanatoriums. Therefore the lowering of rates to a fair figure can be brought about only when Psychopathic Hospitals and co-operative, or endowed, sanatoriums shall have entered the field of competition. That such institutions will reduce the prevailing exorbitant charges, and force the existing type of owner to treat his patients and their relatives fairly, is at least indicated, if not proved, by the fact that the Psychopathic Hospital at Munich, Germany, -- the finest of its kind in the world -- charges for the most scientific treatment known, not more than $16.66 a week, and as low as $9.52; with a minimum of $4.97 per week for patients unable to pay more. And as stated in the Consular Report (Appendix II) "the treatment and medical services are precisely the same to all, according to condition and necessities."

Not so, however, in a majority of private institutions. The quality of the food, for instance, is likely to vary with the fee paid. The poorer patients are, in a way, the buzzards of the flock. The coarsest cuts are their accustomed portion. To this the attendants themselves can testify, for they are often forced to eat veritable husks -- the crumbs which fall from the owner's table. In my opinion the food served at the State Hospital was far better than that served to many patients at this. run-for-profit sanatorium: and the food served at the large private hospital, conducted not for personal profit, was, on the whole, as good as any man might need or desire.

This comparison is illuminating. The owner of a private sanatorium is but human, and it is extremely difficult for him to see any advantage in supplying food of quality or variety, when, by so doing, his profit will be decreased by thousands of dollars during a single year. The management of an incorporated and endowed institution, whose only possible profit is to be found in their agreed salaries, would not be likely to impose in this way upon their insane charges and patrons. No corrupting desire for gain would influence them. It is highly desirable, therefore, that all private hospitals for the insane should at once be brought under rigorous State supervision, requiring that such institutions be duly incorporated under laws which will protect patients against abuse and patrons against extortion, -- at the same time permitting a trustworthy owner to make a fair profit on his investment. Or, better still -- and eventually I hope to behold it -- let there be no hospitals at all run for private gain. I do not advocate a hasty change. It will be years before there are in operation a sufficient number of Psychopathic Hospitals, "mental wards" in General Hospitals, and co-operative sanatoriums to render useless the existing type of run-for-gain institutions. In the meantime Public Opinion, through proper channels, should so far as possible force owners of private hospitals to reduce their charges to a fair figure and, at the same time, treat all patients with consideration and honesty.