In the early nineteenth century, there was little demand for the services of general hospitals in America. Almost no one who had a choice sought hospital care. Hospitals were regarded with dread, and rightly so. They were dangerous places; when sick, people were safer at home. The few who became patients went into hospitals because of special circumstances, which generally had to do with isolation of one kind or another from the networks of familial assistance. They might be seamen in a strange port, travelers, homeless paupers, or the solitary aged -- those who, traveling or destitute, were unlucky enough to fall sick without family, friends, or servants to care for them. Isolation was also related, but, in a converse fashion, to the kindred institutions of pesthouse and asylum. There, isolation (or respite) from the community was the intent rather than the occasion of removal to an institution.
--Paul Starr, The Social Transformation of American Medicine. Basic Books: 1982. p. 72. (The situation in 2013 is left as an exercise for the reader.)
--Paul Starr, The Social Transformation of American Medicine. Basic Books: 1982. p. 72. (The situation in 2013 is left as an exercise for the reader.)
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