How to Remedy a Depopulation; Healthcare Policy

WHEN a state is depopulated by particular accidents, by wars, pestilence, or famine, there are still resources left.

The men who remain may preserve the spirit of industry. They may seek to repair their misfortunes, and calamity itself may make them become more industrious.

This evil is almost incurable, when the depopulation is prepared before-hand by interior vice and a bad government.

When this is the case, men perish with an insensible and habitual disease= born in misery and weakness, in violence, or under the influence of a wicked administration, they see themselves destroyed, and frequently without perceiving the cause of their destruction.

Of this we have a melancholy proof, in the countries desolated by despotic power, or by the excessive advantages of the clergy over the laity.

In vain shall we wait for the succour of children yet unborn, to re-establish a state thus depopulated. There is not time for this; men in their solitude are without courage or industry.

With land sufficient to nourish a nation, they have scarcely enough to nourish a family. The common people have not even a property in the miseries of the country, that is, in the fallows with which it abounds.

The clergy, the prince, the cities, the great men, and some of the principal citizens, insensibly become proprietors of all the land which lies uncultivated= the families who are ruined have left their fields; and the labouring man is destitute.

In this situation they should take the same measures throughout the whole extent of the empire, which the Romans took in a part of theirs; they should practise in their distress what these observed in the midst of plenty; that is, they should distribute land to all the families who are in want, and procure them materials for clearing and cultivating it. This distribution ought to be continued so long as there is a man to receive it; and in such a manner, as not to lose a moment, that can be industriously employed.

Chapter 29= Hospitals

A MAN is not poor because he has nothing, but because he does not work. The poor man has an employment, is as much at his ease as he who without labour has an income of a hundred crowns a year.

He who has no substance, and yet has a trade, is not poorer than he who possessing ten acres of land, is obliged to cultivate it for his subsistence. The mechanic, who gives his art as an inheritance to his children, has left them a fortune, which is multiplied in proportion to their number. It is not so with him, who having ten acres of land, divides it amongst his children.

In trading countries, where many men have no other subsistence but from the arts, the state is frequently obliged to supply the necessities of the aged, the sick, and the orphan. A well-regulated government draws this support from the arts themselves. It gives to some such employment as they are capable of performing; others are taught to work, and this teaching of itself becomes an employment.

The alms given to a naked man in the street do not fulfil the obligations of the state, which owes to every citizen a certain subsistence, a proper nourishment, convenient cloathing, and a kind of life not incompatible with health.

Aurengzebe* being asked, why he did not build hospitals, said, “I will make my empire so rich, that there shall be no need of hospitals.” He ought to have said, I will begin, by rendering my empire rich, and then I will build hospitals.

The riches of the state suppose great industry. Amidst the numerous branches of trade, it is impossible but some must suffer; and consequently the mechanics must be in a momentary necessity.

Whenever this happens, the state is obliged to lend them a ready assistance; whether it be to prevent the [157] sufferings of the people, or to avoid a rebellion. In this case hospitals, or some equivalent regulations, are necessary to prevent this misery.

But when the nation is poor, private poverty springs from the general calamity; and is, if I may so express myself, the general calamity itself. All the hospitals in the world cannot cure this private poverty; on the contrary, the spirit of indolence, which it constantly inspires, increases the general, and consequently the private misery.

Henry 8th resolved to reform the church of England so he ruined the monks, of themselves a lazy set of people, that encouraged laziness in others; because, as they practised hospitality, an infinite number of idle persons, gentlemen and citizens, spent their lives in running from convent to convent.

He demolished even the hospitals, in which the lower people found subsistence, as the gentlemen did theirs in the monasteries. Since these changes, the spirit of trade and industry has been established in England.

At Rome, the hospitals place every one at his ease, except those who labour, except those who are industrious, except those who have land, except those who are engaged in trade.

Wealthy nations need hospitals because fortune subjects them to many accidents. Transient assistances are much better than perpetual foundations.

The evil is momentary; it is necessary, therefore, that the succour should be of the same nature, and that it be applied to particular accidents.