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Chapter 3. Free Enterprise and Resourcefulness: An American Success Story–The Daughters of Charity in the Northeast
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Chnptrr 3 Free Enterprise and Resourcefulness Tlrc>\!\tc~r\o f C h n ~ ! h 70!1111cr71~ t l i ~ j ~ ~ ( I I ! ~(o!/Jotirrbc>~J I ~ I / I I ! / I ~ P I ~ I P I ! ~ (IftJr~ znfe)ncrl econoin) of the ri/strtutroi/.The Szsfo-Se~-crni/t zs nufho)rsedfo ncrme Plr~\!on~!\, to h ! r ~ r ~ r i ~ n ~ ! t r cr~idd!\~riir\~ ~ P I I L , to crd~r~itPcrtic>~!tr %d/r(/rcr~g~ thein; to;0)ocu)ei/ecesscr)) f~,o-crzsrons crnd mcrke o~dri/n)) e\f~endrtu~esfo~ the esfnblzshinei/t, nitd to ~ecnz~e moite) comri/gf,ompnq-f~nfzenfs, doncrfzoi/s01 ot/r?)UJISP. . BiriMi~igor to~!\!d?~crblc~ ~c.l,ni~ ~rliot(I? \(~I!(~!OI!PIJb~ t / i ~ B o n ~ d - 1857B1-Ln7orfo1t h ~ ~c>girlcrtio~!, rlfth~ Trrr\twr o f t l i ~ R O ( / I P S ~ P I \t. LIIc~~ I '5 Hos@rtcrlofthe Srsfe~s of Chcr~zf).' In the second half of the nineteenth century Catholic hospitals, oxvned and conducted by cornrnuilities of votved Catholic Ivornen,tvere playing a rrlajor role in hospital foundation in the United States. In fact, Catholic sisters fo~mded a total of 299 hospitals l>et~veen 1829 and 1900.' The Protestarlt pride and rarrlparlt anti-Catholicism of the period could lead one to assurne that the United States Ivas the co~mtry least liltely to support the tvorlt of Catholic Ivornen through taxes let-iedon the hardtvorltirlg Protestarlt majority. One tvould be tvrong. In fact, unlike Britain, ~vhere Protestant dorrlirlarlce Ivas net-el-breached l>ya Catholic hospital system, or Australia, tvhere the large Catholic cornrnunity produced a net~vork of fine public hospitals o~vned and conducted l>ycornrn~ulities of Ivornen religious tvith virtually no go\-erilrnent aid in the rliileteeiltll century, in the United States the spirit of free eilterprise paradoxically f~lnctioned to support the sisters' efforts. Throughout the couiltry the sisters Ivere able to pro\-idethe best \-aluefor money in the care of the indigent sick, to corrlpete for public teilders to secure these rnonies, to gain coiltracts~vith insurers, railroad and rrliiliilgcompanies, federal govel -nrnent, and arrny. They attracted excellent doctors, collaborated tvith rrledical schools, and rail teaching facilities. Importantly, in return for Free Enterprise and Reso~lrcefillness 33 their private patients, they opened up hospital practice to pri\-aterrledical practitiorlers excluded l>ythe rrledical l>oards of corrlpetiilg hospitals. They thereby estal>lishedprivate hospital care as the province not of the rich but of the rnodest. By the end of the century patient fees Ivere ~vhat supported Catholic hospitals. They created the prototype for the rrloderil t1ventieth-cent~1ry hospital and laid the foundation for the ttventiethcentury dorrliilailce of pri\-ateinstitutional and rrledical care in the U.S. health care systern.The success of the sisters' nursing tvorlt,far rrlore than their tvorlt tvith schools or orphanages, is the story of the sisters corrliilgto understand the particularities of the Xrrlericail political and ecorlorrlic clirrlate to run the best l>usinessesin the rnarltet.Xrrlerica respected that. An Actije Path for Arrlericail Ibrnen Finding their place in the United States was a challenge for the Catholic sisterhoods. As one of the rrlost \-isiblesyrnbolsof Catllolicisrrland foreigil potver (Rorne), the "un-Xrnerican" identity of the nuns caused them a great deal of difficulty.Hotvet-el; the cholera epiderrlics of the first half of the nineteenth century, ~vhenthey \-olunteered to nurse the sick, and later their heroisrn during the Ci\-ilTl'ar, rrlade the nun a corrlplex and unstal>lefigure in the Xrrlericail psyche -vilified and rornanticized. In this chapter I exarrliile the impact of Catholic tvornen on the health and ~velfare of nineteenth-century Xrnericans, and their role in shaping the Xrrlericarl health care systern.I look closely at the Daughters of Charity of St. \'incent de Paul, the largest single cornrnunity of Catholic nursing Ivornen, as rrlajor health care providers for both the rliileteeiltll and the t~ventiethcenturies. The irrlportailce of the Daughters' epiderrlic nursing , their role in the care of irrlrrligrarltcornrnunities, their tvorlt during the Ci\-ilTl'ar, and, finally, their relationship ~vith rrledical rnen, are all irrlportarltelerrlerltsof their story-and of the story of Xrrlericail nursing. The Catholic nursing sisters, rrlost particularly the Charities, developed a successful rrlodel of hospital sei-\-iceprovision for the Xrrlericarl public. These tvornen created the health senices (to use a rrloderrl terrn), 1)uildirlg their rrlajor institutions through a corrlbiilatioil of sirrlple faith and...