The Market as Supplier of Healthcare for the Poor in the 19th Century: Spas as Philanthropic Healthcare Institutions.

Anders Ottosson, University of Gothenburg

During the 19th century the number of healthcare institutions increased dramatically. Overall, this development can be understood as a response to the growing capitalistic economy. More and more people could afford healthcare services. However, this did not solve the complex “social question”: how to provide healthcare for those who could not pay for themselves? Previous research, at least in a European context, has shown that the increasing number of somatic hospitals, in praxis, was reserved mainly for the poor and that they came about due to both philanthropic and governmental initiatives, where the latter also had to rely on “private” solutions to make ends meet financially. In that sense it was a “mixed economy of welfare”. This paper will focus on an institution often overlooked as a provider of healthcare in the 19th century: Spas. Like the somatic hospitals they grew in numbers and sizes but unlike the hospitals both the poor and the well-off came to the spas. Although they were run as private joint stock companies (with their own jurisdiction), the spas had a social obligation to help the unfortunate. Samples from Swedish spas show that the surrounding parishes used them to take care of their poor, i.e. they were send there to undergo the many different cures offered. This becomes extra interesting since the sick and poor legislation placed the responsibility for the poor on the parishes. How did such a commercialized sick- and poor relief institution function? How was the surplus accumulated to provide healthcare for those who had nothing give in return?

No extended abstract or paper available

 Presented in Session 75. Health in Institutional Settings