Who Should Pay?
Not only did missionaries take the models of proprietary and voluntary hospitals to China, they also took a belief in philanthropy, entrepreneurship and user pays which characterized both the profit-making and charitable institutions in America. Avenues for fundraising or business in China, though, especially in the early days, were more limited. Unlike the seventeenth-century Jesuit missionaries to China, who favored a top-down approach and who had sought to influence imperial officials and the gentry, Protestant missionaries at the turn of the twentieth century concentrated their efforts on the lower, poorer classes.1 Thus, in the beginning, as far as donations were concerned the hospitals had to rely on their friends and supporters at home. Support from Chinese city and provincial authorities was limited, as were fees from private patients.