these objections, still the American Dental Association believes that the provisions of two other bills, S. 190 and S. 1099 are far more likely to improve the dental health of the American people. The reason for this statement is the fact that the bill does not contain specific provisions regarding dental research, nor regarding the provision of dental health education to the public, nor regarding the provision of dental care in accordance with the four principles adopted by the house of delegates of the American Dental Association. Therefore since S. 1318 will not permit the establishment and maintenance of a comprehensive dental health plan, the American Dental Association cannot support it in its present form. 1. Section 102 of S. 1318, starting on page 2, line 21, does not specifically earmark funds for dental programs. If dental programs are to be developed by the Children's Bureau, then their continuity and assurance of stability can only be achieved by having a specific sum of money earmarked each year for the maintenance of the dental programs. The amount to be used for dental programs out of the first year's appropriations should preferably be a specific sum of money, although it may be more practicable to specify that the amount to be used for dental programs the first year shall be a portion or percentage of the total amount appropriated. S. 1318 should be amended to provide that funds for dental programs shall be earmarked in the appropriation bill each year. 2. Section 103 (a), paragraph 10, on page 7, lines 6 to 13, provides for the creation of a general advisory council on the State level to be appointed by the State health agency, to be used for consultation and advice concerning State plans; however, there is no provision or requirement in S. 1318 that the general advisory council on the State level must at least contain one dentist. S. 1318 should be amended to provide that section 103 (a), paragraph 10, be amended to provide for a general advisory council appointed by the State health agency, at least one of whom must be a dentist. 3. Section 105 (2), on page 10, line 12, provides for an advisory committee on the national level to be appointed by the Chief of the Children's Bureau; however, it does not specifically provide for a dental advisory committee, nor does it provide that if only one advisory committee is created that there must be at least one dentist on the advisory committee. S. 1318 should be amended to provide for the creation of a dental advisory committee. 4. Section 101, starting on page 1, line 8, and continuing through to page 2, line 2, specifically provides that one of the purposes of the bill (S. 1318) is to provide dental services; however, there are several places in the bill in which reference is made to medical care only and the proper mention of dental care has been omitted. S. 1318 should be amended wherever needed to include the words, "dental care" in addition to the words, "medical care." This amendment has already been agreed to by Dr. Martha M. Eliot and is set forth in further detail in her testimony before the House Committee on Labor. 5. There are various provisions in the bill setting forth specific provisions regarding physicians, and which omit any reference to dentists. An example of this may be found in section 103 (a), paragraph 6, page 6, lines 9 to 13, in which there is a specific provision regarding the types of payments that may be made to individual physicians, though there is not a similar provision regarding payments to be made to individual dentists. S. 1318 should be carefully reviewed and in every case in which specific provisions have been made regarding physicians, and a similar provision is necessary in regard to dentists, the bill should be amended to make proper provisions for dentists. The American Dental Association wishes to again call the attention of this committee to the fact that the two bills, the dental research bill, S. 190, which has passed the Senate, and the dental grants-in-aid bill, S. 1099, together with their respective companion bills in the House, H. R. 3816 and H. R. 3414, will give to the American people a comprehensive program for dental health service far superior to the proposals of the Maternal and Child Welfare Act of 1945, S. 1318 and H. R. 3922. Senator DONNELL. In other words, you do not think that the bill clearly shows that all children are entitled to dental services? Dr. CAMALIER. That is right. Senator DONNELL. It uses the term "dental" at various points. For instance, line 2 on page 21 uses the word "dental," and again over on page 5, line 8, it uses the word "dental." But I share with you, Doctor, the query, at any rate, as to whether or not this bill is free from ambiguity on that, because I observed that the location of the word "dental" on page 21 is in this connection: including medical, nursing, dental, hospital, and related services and facilities required for maternity care, preventive health work, and diagnostic services for children et cetera. Is it the practice, insofar as possible, to see that proper dental care is given to women who are about to become mothers? Dr. CAMALIER. Well, yes, they try to do that. Senator DONNELL. So that this bill, at least, is susceptible of construction that the dental care referred to in line 2, page 21, is that which is limited to the dental services required for that maternity care. Dr. CAMALIER. That is right, and it is extremely important, if you had that, to take into consideration that when the funds are not earmarked for dentistry we do not get our proportionate share at the State level. Senator DONNELL. You think the bill is ambiguous as to whether or not it covers dental care for children? Dr. CAMALIER. Yes. Senator DONNELL. On page 5, line 8, where I mentioned the word "dental," that is simply in the connection that the methods of administration to be specified in the State plans shall be such as are necessary for the proper and efficient operation of the plan, including methods relating to the establishment and maintenance of standards for professional personnel, rendering medical, dental— et cetera types of care. Dr. CAMALIER. Yes, sir. Senator DONNELL. So that that again does not specify with any clarity whether or not the children are to be beneficiaries of the dental care? Dr. CAMALIER. That is right. Senator DONNELL. And that is one of the points, Doctor, that you are making? Dr. CAMALIER. Yes, sir. Senator DONNELL. Í have not seen your statement but I assume you have given it in some detail in your printed statement. Dr. CAMALIER. Yes, we have. Senator PEPPER. Dr. Camalier, we are very much obliged to you for pointing out deficiencies in the bill in respect to the provision of dental care. Of course, I can assure you that I for one am just as much interested in fully adequate dental care being provided to the children of the country as any other of the services. We will give very particular attention to your suggestion as to how we can make it clearer in the bill that adequate dental services shall be provided for the children. It is your opinion, is it not, that the children of the country at the present time for one reason or another are not getting all the dental care that they should have? Dr. CAMALIER. That is true; yes. Senator PEPPER. And you welcome a plan that will make it possible for the children to get dental care that they should have? Dr. CAMALIER. Yes; and may I add that the American Dental Association has foreseen that contingency and we have presented these two bills to Congress. Senator PEPPER. Your research bill we have already approved in the Senate, as also in this committee. I am one of the introducers of your S. 1099, the dental care bill, and I am very strongly for it. Dr. Camalier, we did not put in a means test in S. 1099, did we? Senator PEPPER. We all recognize that the reason we have not put the means test in, and the reason that some of us do not favor a means test, is the difficulty of defining the means test so that it will not mitigate against people who ought to have the services that are provided in legislation. That is correct, is it not? Dr. CAMALIER. That is correct. Senator PEPPER. It is such a difficult thing to determine, as Dr. Oppenheimer pointed out a bit ago, whether people are able to provide the medical services that they really need, is it not? Dr. CAMALIER. Yes, sir. Senator PEPPER. We have the financially indigent and then we have the medically indigent. Somebody might be making a fair income and yet if, as Dr. Oppenheimer pointed out, they have to provide constant care for crippled children over a period of years, they really would not be able to do it without burdening their whole family. Now, Doctor, do you recall having seen the figures that two-thirds of the children of the country are parts of families which have weekly incomes of less than $40? Dr. CAMALIER. No, sir; I had not seen those figures. Senator PEPPER. I have seen those figures, and I have some reason to believe in their accuracy. Have you also heard that the majority of the children are in rather large families, and by some coincidence it is the poorer people who have the larger families in the country? Dr. CAMALIER. Yes; I have noticed that. I might say, though, in that connection, that I am sure it would be of interest to your committee to know that here, in the District of Columbia, the Dental Society sponsored the dental clinics they have here, and I think there are 14 or 15 of them, and we found out that in the service rendered, the poor families were not always getting the services in the clinics. So naturally there would have to be some differentiation made. So the health officer, with the aid of the Dental Society, worked up a very simple plan which I think is working very well in that it merely asks the parent, when they receive the dental slip, whether they can afford to have their work done by a private dentist or must they go to the clinic. Then the parent states whether they cannot afford it or can afford it. That is approved by the teacher and the principal, as I understand. Dr. Oppenheimer will bear me out on that. The result has been that the school children here, the poorer ones, are getting the service, whereas before that plan was put into effect others got the service that really were not entitled to it. So I think you will find from Dr. Ruhland and Dr. Murphy that the system in the District is working very well. Senator PEPPER. Do I understand, Dr. Camalier, that it is your advice to us that you do favor this bill in principle, provided we make it clear that the needed dental services are made available? Dr. CAMALIER. Yes, sir; and our objections met. We insist, however, that the passage of S. 190 and S. 1099 would better meet the situation. Senator DONNELL. I understand there would be a very important modification on that, that you do not favor in principle the grants of public moneys to people who do not need those moneys. Dr. CAMALIER. Yes; that is just common sense. Senator PEPPER. Are you able to give us any test of need? Dr. CAMALIER. That is the only one, so far, that I just gave you, in the District of Columbia. I think this problem can be worked out at the State level. Senator PEPPER. That is, the statement of the people themselves as to whether they felt they were able to pay? Dr. CAMALIER. Yes; but I think studies along that line might develop it. I do not think anybody has given it real study. I can appreciate the difficulties, however, Senator. Senator PEPPER. You do appreciate the difficulties of trying to lay down a means test? Dr. CAMALIER. Yes, sir. Senator PEPPER. Thank you, very much. Mrs. Eleanor Vaughan, vice chairman, Congress of American Women. STATEMENT OF MRS. ELEANOR VAUGHAN, VICE CHAIRMAN, CONGRESS OF AMERICAN WOMEN, NEW YORK CITY Mrs. VAUGHAN. The Congress of American Women is a national organization of women from homes, industries, offices, professions, farms, schools and colleges. Our organization is a young organization, founded to give American women-without regard to race, religion, national origin or political party-an opportunity to participate with democratic women of all countries in rebuilding a free, democratic world out of earth-shattering war. We are affiliated with the Women's International Democratic Federation set up in Paris, France, last November with a membership of 81,000,000 women from 41 countries. At our first working conference, held in New York City on May 25, 1946, some 600 delegates from trade unions, women's clubs, professional and housewives' organizations, representing nearly half a million American women, unanimously adopted a resolution endorsing the Maternal and Child Welfare Act of 1945. As a woman's organization, we are vitally concerned with all matters relating to the health and welfare of our children, We feel that the hope of the world lies in the young people of today. Unhealthy bodies create unhealthy minds. Insecure children make insecure adults. Insecure adults fall easy prey to the kind of demagogic panaceas to economic maladjustments offered by the world's Hitlers and Mussolinis. It is only in the framework of stability, security, and good health that we can build a future generation prepared to create one world of genuine understanding and cooperation. As the United States affiliate to the largest international organization of women, we are eager for our country to set standards of leadership in the treatment of its children. Compared with children of war-torn countries, American children were little affected by the war. Our children's homes were not shattered into dust; we do not have millions of homeless orphans groveling in garbage cans and filching cigarette butts to exchange for a crust of bread. We have not the problem of repairing wounded bodies and bombshocked minds. Our tuberculosis rate has not risen 8 to 10 times as it has in some European countries. Set against the countries that felt the direct onslaught of Hitler's war machine, our task is simple. And, alone of all nations in the world today, the United States has the resources and technical knowledge to provide security and medical care to all its children. Despite these vast resources and technical knowledge, despite the comparatively minor impact the war had on American children, the condition of our children today is not something about which we can boast. For the record, we should like to state that the United States delegates to the Women's International Democratic Federation meeting in Paris last November were embarrassed by the inadequacy of our answers to questions women from other nations directed to us concerning the conditions of American children. We found that ordinary women, private citizens of France, Great Britain, China, Yugoslavia, Egypt, and so forth, consider the United States a land of boundless opportunity and a bountiful standard of living. Every home is alleged to have a tiled bath, every family a radio and automobile. Every American child is supposed to receive the best of medical care, a vitamin-rich diet, preventive health work, modern hosptalization when needed, and full opportunity for growth and development according to his individual abilities and aptitudes. Correcting these misconceptions women from all over the world have about childhood in the United States was an unpleasant task for the United States delegates to the Women's International Democratic Federation. They were forced to admit that the United States, the richest and most resourceful nation on the face of the earth, is so little concerned about the well-being of its mothers and children that such disgraceful conditions as the following exist (all figures from U. S. Government bureau sources): I. Despite a gradual reduction in maternal and infant mortality rates in the United States-3,000 mothers die needlessly each year as a result of childbirth; 31,000 babies die needlessly each year before they are 1 year old; 16,000 rural mothers were delivered in 1943 without a doctor in attendance; prenatal clinics exist in only one-quarter of rural counties; 1,800 counties have no public health unit; 1,000 of our |