In other civilizations, there is and has been an abiding respect for the aged, and the aged are accorded status and esteem in the social organization.

One hundred years ago in the United States, when our economy was more agricultural and rural, there was always an extra bed or enough food for the older folks at the farm home of their elder son, or of one of the many children, or relatives. This is not true in today's America with its urban population and less cohesive family structure. Today the number of farm families has declined to fewer than 4 million.

The vast majority of persons 65 and over live in urban communities. The modern industrial worker lives in anything but stable economic circumstances. Unemployment repeatedly reaches levels of 5 and 7 percent, thus forcing even high seniority workers to face the specter of plant migration and joblessness generated by automation.

In a society where problems are evaluated on a rational basis rather than on an emotional basis, and on grounds of humanitarianism rather than political and economic expediency, the solution to providing medical care for the aged should be comparatively simple.

A nationwide insurance system would be the permanent solution. Since the aged still comprise a comparatively small, although increasing proportion of the population, the cost would be small if spread among all those currently working.

This is the essence of any equitable and effective insurance system, spreading the risk. This is the basis on which we have founded our pension plans.

Persons now 65 and over who desire to retire may do so and their retirement benefits are provided by current contributions.

We already have in the United States, as everyone knows, a nationwide insurance system in the form of old-age and insurance benefits. This is the ideal mechanism for providing for the health needs of the aged.

Our social security mechanism is sufficiently flexible and experienced for the task. Social security actuaries have estimated the probable cost and the tax modification required to make the plan a reality. Western civilization has created some outstanding examples of health coverage on a far broader basis than the coverage we are suggesting today, and I am confident that our social security technicians can draw on the extensive experience and thinking of the British, Swedish, Danish, German, and other experts.

American unionism has always been interested in the English system of national health insurance. The British, as you know, provide comprehensive national health coverage from the cradle to the grave. We, here in America, are merely recommending a modified, incomplete form of health care for the aged. We do not even include surgical coverage, nor drugs at home.

One reason for our interest in the British experience is that the British, by and large, are somewhat more conservative, as a people, than we. The British experiment is the result of the Beveridge Report prepared in 1942 by Sir William Beveridge, a member of the Liberal Party which, of course, is not to be confused with the liberal wing of the New Deal or the New Frontier. The British Liberal Party is much closer in its thinking to the Tories.

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But the British National Health Service was instituted as a result of the backing of a politician hardly to be classified as an archradical or leftwinger.

Sir Winston Churchill, as a wartime Premier, stated in 1943:

You must rank me and my colleagues as strong partisans of national compulsory insurance for all classes, for all purposes, from the cradle to the grave. In the debate preceding establishment of the National Health Service in England, while there was some criticism by the Conservatives, the British Tories backed the program from start to finish and have supported it to this date.

When the plan was put into effect nearly 19,000 of Britain's 22,000 doctors signed up. In addition, 96 percent of all the dentists in England, Scotland, and Wales also joined the program.

I summarize the British experience with a far more comprehensive program for one major reason. No one in his right senses would consider Sir Winston Churchill a flaming Socialist. No one, except perhaps the American Medical Association, would view the British Tory Party as a vanguard of socialism.

Knowing that the National Health Service was instituted with the support of the Tories and has had its support ever since, I doubt that the British counterpart of the Republican Party can be accused by our American conservatives and the AMA of wanting to sacrifice their thousand-year-old conception of freedom.

The British have had a somewhat longer experience with democracy, freedom, and liberty than the AMA.

In recent years in Canada a number of the Provinces have instituted complete coverage for persons over 65 and under 65.

In Quebec, I believe the program was instituted in the last year and is paid for entirely out of the tax receipts. There is no contribution by individuals.

A humane and realistic approach to the tragic story of the aged, unable to finance their own medical care under our uneconomic system of medical economics, would have been possible in this country years ago had it not been for the activities of the American Medical Asso

ciation.

When I criticize the AMA here, I am not criticizing the role of the American doctor. The AMA has arrogated to itself the role of spokesman, and ultrareactionary spokesman, for the American doctor. The American doctor has won the respect of our people for his professional acumen and for the excellent scientific job he has done. But neither the doctor nor, certainly, the AMA, have ever been distinguished in the field of economics or broad social planning. The AMA is no longer a professional organization of physicians. It has become a high-powered, well-heeled lobbying group. Now the AMA has the right to be political if it wants to and it surely has the right to lobby if it wants to.

But when it does lobby and conducts huge nationwide campaigns whose success would jeopardize the health of millions of older Americans by delaying the health care they need, then the AMA is open to the strongest criticism.

This is a figure we secured several years ago from a book we considered authoritative. I believe AMA says they have about 70 or 75 percent of the doctors.

Our point is that only 60 percent of the doctors in this country belong to the AMA despite the tremendous social and professional pressures exerted on them.

In rural areas and in smaller communities, 90 perecnt of the doctors are members, but in the larger metropolitan communities, the percentage is closer to 50 percent.

If my union represented only 60 percent of the people in the bargaining unit, we would be hard pressed to speak in the name of all the workers.

Theoretically the AMA is guided by its house of delegates, but there is slight representation for general practitioners, small town and rural doctors, salaried doctors, or doctors under 40 years of age.

By and large, the AMA House of Delegates is composed of specialists, city dwellers, private practitioners, and middle-aged or elderly

doctors.

The AMA is run by a professional group of medical politicians who have been crying socialism ever since the end of World War I. I charge the AMA with prime responsibility for the failure of our aged citizens to receive adequate medical care in their old age. This is not the place for a detailed evaluation of the AMA, but I do think it essential to summarize its position on a number of salient issues over the years in order to demonstrate how consistently wrong it has been. Where the profession and public has needed leadership and vision, the AMA has offered only shabby shibboleths and economic dogmas that would incline Hippocrates to violate his own oath.

The last time the AMA had an original idea, outside the technical field of medicine, that merited praise, was in 1941. At that time, the house of delegates passed a resolution commending States which:

Adopted legislation to protect children under 16 years of age from the disastrous consequences of unsuitable work and bad industrial conditions.

The resolution also endorsed the Palmer-Owen child labor bill, which sought to place the above restrictions on the employment of children in this country by means of the Federal power to control interstate commerce.

This enlightened attitude did not last long. During the worst years of the depression when an attempt was made to secure health care through prepaying plans, an approach now approved by the AMA, the AMA openly opposed such activities.

The AMA Journal stated in one of its 1932 issues:

There is, moreover, a far greater concern than the rights of the physician to practice as his knowledge and training indicate is desirable

This is in regard to prepayment plans:

There is the question of Americanism versus Sovietism for the American people. There is the right of the American citizen to pick his own doctor and his hospital, to pay his own bills with his own money, to be responsible to a doctor who is responsible to him.

The point was that if he did not pay his own bill with his own money, it would be Sovietism.

In 1932, it was a question of:

"Sovietism" sneaking in through the back door because the doctor might be paid by the insurance company or Blue Cross and Blue Shield through prepayment rather than directly.

Today, even the AMA will admit its foolishness. Millions of Americans belong to prepayment plans, but "Sovietism" has not sneaked in through the back door, because of that.

On the contrary, prepayment may have made this a somewhat healthier, happier country than it would have been had we kept to the 1932 medical economics of the AMA.

In this and further quotations, you will note a recurrent reference to "Sovietism" and "socialism." I think I can speak as something of an authority on this subject.

My organization was given a charter in 1949 by the old CIO for one specific purpose: to drive the Communists out of the trade union movement in the electrical industry. We have succeeded in doing this to a great degree.

Today we are the numerically dominant union, and we achieved that status without help from anyone outside the labor movement. From this and other experiences I believe I know something about how to fight the Communists. I know something about Soviet Russia, too, from firsthand experience on several trips, and from fighting their stooges in the international labor movement.

But in all the years of our struggle, I never once heard of anything genuinely constructive done to fight the Communists initiated by AMA. When the AMA speaks out about fighting communism, I would like to know when and where they fought communism.

Today, as in the past, the approach of the AMA to the problem of medical care for the aged, and its inertia and apathy toward the health needs of the American people, is indisputably an asset to the Communists. We need intelligence, foresight, alertness, if we are to best communism and the Soviets. Hiding our heads in the sand of maximum fees will never do that.

In 1948, Walter Reuther and the IUE suggested to General Motors that we negotiate a profit-sharing plan. The IUE has been trying to negotiate that since 1950 with General Electric and Westinghouse. General Motors initiated a campaign denouncing our suggestion for profit sharing as socialistic and un-American.

General Motors to this day has a profit-sharing plan in effect for executives, a bona fide profit-sharing plan, which has paid out $793 million since 1950.

Yet General Motors in 1958 denied our request for profit sharing on the ground it was socialistic and un-American.

They had no legitimate argument against it, but they thought that by calling it socialistic and un-American they could crush support for the program.

My point here is that it is awfully easy to say something is socialistic because you don't like it, including profit sharing which is definitely not socialistic.

In 1931 the Judicial Council of the AMA proclaimed that organizations offering medical and hospital services on a dues paying basis, rather than directly to the doctor, are—

regarded as being economically unsound, unethical, and inimical to the public interest.

This would apply to the present volunteer group practice.

The house of delegates in 1933 stated that such a plan, if compulsory : Would encourage malingering, would create a vast political machine with all its evils, would inevitably lead to state medicine, and would reduce our professors to the status of government employees.

In November 1939, the AMA, through the redoubtable Dr. Fishbein. even attacked the desperately needed social security program, surely one of the most humanitarian undertakings in our Government's history.

Dr. Fishbein, speaking in Chicago at the Annual Conference of Secretaries of Constituent State Medical Societies, declared in part :

The introduction into this Nation of a Federal security plan whereby the Nation itself, as a Federal agency, will step intimately into the sickness and life of every person in the country, will be the first step in the breakdown of American democracy.

Indeed, all forms of security, compulsory security, even against old age and unemployment, represent a beginning invasion by the State into the area of personal responsibility, a weakening of national caliber, a definite step toward either communism or totalitarianism. The people of this country today have begun to awaken to the insidious approach of such new forms of government.

That statement was made only 2 years before we entered a worldwide conflict that proved that democracy was not in a state of decay in this country, as Hitler and the Nazis confidently assured each other.

The Fishbein statement was made 4 years before Winston Churchill, with far more political acumen than Dr. Fishbein or his associates have ever demonstrated, declared his support for a much more comprehensive plan than we recommend here. The good doctor's statement, made 22 years ago, repudiated over the years by both political parties and by nearly all thinking people, unfortunately represents the anachronistic thinking of the AMA today in its fight against medical care for the aged.

The tragedy is that these people whom we are discussing are our fathers and mothers and our freinds of not so long ago. We are talking about ourselves also, a few years from now. We seem to be able to find plenty of money for other and more impersonal functions. of our economy. Our Government subsidizes many phases of American life, and I assume that this is necessary.

For instance, in 1959 the subsidy to aid business generally through the postal service was $721 million.

The aviation industry was subsidized to the tune of $338 million. The shipbuilding industry won $157 million, and other defense industries latched on to $58 million.

Nobody claimed that such subsidies were the entering wedge for socialism, and yet, I suppose, a good argument could be made to that effect.

We have subsidized business, at the insistence of business, ever since this great country of ours was founded. During the early years of the railroads, we handed the railroads uncounted thousands of square miles of rich land on either side of the rights-of-way.

This giveaway program was for the public good-or was it?

Today we are spending billions of dollars to subsidize freedom in the rest of the world.

The American people since 1950 have actually given away some $50 billion to preserve free nations from the clutch of totalitarianism. We do not quibble about that here.