In 1601 an English parliament made poor relief a compulsory tax, founding the pattern of the payor of last resort. The same parliaments wrote the other half: laws punishing the wandering poor and removing anyone likely to become chargeable. The episode follows both halves through the 1834 workhouse reforms, American towns and almshouses, federal hospital money, and court rulings that ended removal, to the 1986 duty with no settlement test.
The 1834 commission's finding that the old poor law was failing has been attacked for thin evidence, though the Act followed regardless. The 43 percent fall in real relief per head should not imply reduced dependency, since the number relieved rose, and whether Hill-Burton's free-care duty ever bound is disputed.



