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I am wondering whether you think, Doctor, that there is any reason for the creation of a council to advise the Secretary of Labor in this matter of making allotments to the several States, or do you think that it would be better to leave it as it is in the bill so that the Secretary of Labor himself makes the determination without the necessity of consulting with a council?

Dr. ELIOT. I believe that the way it is written in the bill would be satisfactory.

The Secretary of Labor, in all probability, would consult with the Children's Bureau, and the Children's Bureau would have taken up these and other matters with the Council.

That is set up in the bill.

While you were questioning Miss Lenroot on that same point, I was interested to see how the Public Health Service Act deals with the same matter, and there I find that the Surgeon General both makes the allotments and also establishes the regulation.

There is a paragraph in the Public Health Service law that points out that all regulations and amendments with respect to grants to States shall be made after consultation with the conference of the State health authorities, but it is the same individual who does the two things under the Public Health Service Act.

Senator DONNELL. That is all.

Senator PEPPER. Dr. Eliot, you have had long and intimate experience with this problem of maternal and child care in the country, have you not?

Dr. ELIOT. I have had a long experience.

Senator PEPPER. And it is your conclusion that we are not in any adequate and satisfactory way meeting the needs of the country in this field at the present time?

Dr. ELIOT. I am certain of that.

Senator PEPPER. And this is a deliberate judgment of the Children's Bureau out of all your knowledge and experience and from the wide and broad prospective which the Children's Bureau has had on these problems?

Dr. ELIOT. It is.

Senator PEPPER. This matter of leaving out the means test is not some testimony which suddenly and arbitrarily was arrived at, but was reached as a deliberate conclusion after a great deal of study had been given both sides?

Dr. ELIOT. That is true, Senator Pepper. And I would like to say, if you go back in the history of the Children's Bureau to the earliest days when Miss Lathrop was the Chief of the Children's Bureau, and read the reports made then and the recommendations on how services for mothers and children of this country should be expanded, there appears throughout the record that the policy of the Children's Bureau has been to make health and welfare services available to all children and mothers in this country.

Senator PEPPER. In the various public health programs being carried out in the country, is the means test applied in the administration of those programs?

Dr. ELIOT. Not in the public health programs as a whole.

Senator PEPPER. That is what I mean, in the public health programs.

Dr. ELIOT. Not as a rule, Senator Pepper. I think sometimes when the programs are left to the States, certain of the States may have some form of tests which define the eligibility of people for the services. Under the Social Security Act as you have already brought out in this hearing, there is no prohibition against a means test.

On the other hand, as far as our programs are concerned, many of the States have not applied a means test. Some have.

Under the crippled children's program, some of the States have in their laws provisions for court action before a child may receive the benefits of the program.

Now, in the course of that court action, sometimes the judge, sometimes the physician, and sometimes some other worker may decide whether or not a child is eligible for care.

The Children's Bureau has taken the position, and the Secretary of Labor has issued a regulation, that with respect to diagnostic services for crippled children there shall be no eligibility test, that it shall be open to all.

Senator PEPPER. Getting to the cost of the program, we have already mentioned what is set up in the bill for the first year of the bill's operation and what is proposed for the second year.

It is contemplated that the expenses of the program will increase gradually over a period of, say, some 10 years?

Dr. ELIOT. That is right.

Senator PEPPER. Before it reaches what may be called its full momentum?

Dr. ELIOT. That is right.

Senator PEPPER. But the number of children estimated for 1947 is something like $43,000,000.

If every one of them took advantage of this program and got all of the care that this program contemplated, it would cost a little over $1,000,000,000?

Senator DONNELL. Nearly $2,000,000,000.

Dr. ELIOT. About a billion and a half.

Senator DONNELL. Did you not say $48?

Dr. ELIOT. $1,600,000,000.

Senator DONNELL. $1,600,000,000?

Dr. ELIOT. Yes.

Senator PEPPER. Less than $2,000,000,000?

Dr. ELIOT. That is right.

Senator DONNELL. I do not figure it that way. Forty-three million at $48 a person.

Dr. ELIOT. That is if every child received the care. I think you are right on that.

Senator DONNELL. That is over $2,000,000,000-$2,064,000,000.
Dr. ELIOT. Now, it is not our feeling-

Senator PEPPER. That would be the cost expended by the States and the Federal Government?

Dr. ELIOT. Yes. That would be the total expenditure.

Senator PEPPER. It would be an expenditure of some $2,000,000,000 for both?

Senator DONNELL. $2,000,000,000.

Senator PEPPER. Some $2,000,000,000 it would be, then.

Dr. ELIOT. Yes.

Senator DONNELL. Yes. And of that, the States are required, under the act as written, to contribute only $5,000,000.

Dr. ELIOT. Yes; that is right. That is right, as it is written.
Now, of course, at the end of a 10-year period-

Senator PEPPER. But you would have authority under the act to require the contribution of more, if you saw fit to do so?

Dr. ELIOT. I do not think the act so specifies.

Senator PEPPER. You do not think that is contemplated. The rest of it would be borne by the Federal Government?

Dr. ELIOT. It could be. Yes.

I would like to add to that point that it is inconceivable that we can provide the facilities and services to give that complete care to 43,000,000 children at the end of 10 or 15 years. It is out of the question.

Senator PEPPER. Dr. Eliot, it would stagger the imagination to calculate what the benefits to this country would be from a program that could not, under reasonable estimate, cost more than $2,000,000,000 to all the children of America, would it not?

Dr. ELIOT. Yes. I think it would stagger the imagination.

Senator DONNELL. I would like to call attention in the record to the fact that if the program should cost $2,000,000,000 a year and the State should contribute only $5,000,000 of that fund, that it would be one-fourth of 1 percent contributed by the State and 9934 percent by the Federal Government.

Senator PEPPER. So in that case it would be 9934 percent pure? Senator DONNELL. Practically Ivory soap.

Senator PEPPER. Dr. Eliot, we thank you very much.

Dr. ELIOT. Senator Pepper, before I leave, may I make one additional comment?

Senator PEPPER. Surely.

Dr. ELIOT. And that is that the cost of war for 8 days is $2,000,000,000.

Senator PEPPER. Very good.

Thank you very much.

Mr. Lawrence Gourley; is he here?

You are from the American Osteopathic Association?

STATEMENT OF LAWRENCE L. GOURLEY, LEGAL COUNSEL, DE

PARTMENT OF PUBLIC RELATIONS, AMERICAN OSTEOPATHIC ASSOCIATION

Mr. GOURLEY. That is right. I am the legal counsel for the department of public relations.

Senator PEPPER. We are a little pressed for time here.

Mr. GOURLEY. I understand that.

Senator PEPPER. We appreciate your coming, and will welcome your

statement.

Mr. GOURLEY. Thank you. I will be very, very brief.

I say I am legal counsel for the department of public relations of the American Östeopathic Association, and I am also speaking for Dr. Chester D. Swope of that department.

I was very glad to hear the chairman of this committee say that it was your intention either to refer to or include in this hearing that part of the testimony on title I of S. 1606.

Senator PEPPER. Yes. We will let the record show that Senator Donnell and Senator Pepper, the acting chairman of this hearing, have been conferring about the best way to bring together the testimony under S. 1606 relative to this subject embodied in S. 1318 in one hearing, and we are going to let the clerk of the committee make inquiry as to what is the most feasible way of doing that; whether we will have to do it by reference to given volumes of the testimony under S. 1606, or whether we will actually, physically, reincorporate that testimony in this record we will work out.

Owing to the fact that it is not possible to reprint the testimony on maternal and child health in the record of the hearings on S. 1606, it has been decided to publish the names of those who have testified on that bill from April 2 through June 21, 1946. All testimony on maternal and child health in the S. 1606 hearings shall be considered part of the record on S. 1318.

WITNESSES TESTIFYING ON TITLE I OF S. 1606, APRIL 2 THROUGH JUNE 21, 1946 April 2: Hon. Claude Pepper, United States Senator from Florida. April 3:

Watson B. Miller, Federal Security Administrator.

Dr. J. W. Mountin, Medical Director, United States Public Health Service. April 4: Arthur J. Altmeyer, Chairman, Social Security Board.

April 9:

Caroline F. Ware, American Association of University Women.

Dr. Clark Foreman, president, Southern Conference for Human Welfare. April 11:

Rev. Jack R. McMichael, executive secretary, Methodist Federation for Social Service.

Dr. Allan M. Butler, associate professor of pediatrics, Harvard Medical School.

April 16:

William Green, president, American Federation of Labor, accompanied by Nelson Cruikshank, director, social-insurance activities. American Federation of Labor.

Edward H. Weyler, Kentucky State Federatian of Labor.

Mrs. Herman H. Lowe, American Federation of Women's Auxiliaries of Labor. Dr. W. Montague Cobb, national medical committee of the National Association for the Advancement of Colored People.

The American Association of Medical Social Workers.

The American Public Health Association.

American Society for Research in Psychosomatic Problems.

Connecticut Independent Citizen's Committee.

Bowling Green Local 22 of the Farmers' Union.
Girls' Friendly Society, United States of America.
Medical Society of the State of Pennsylvania.

April 17:

Dr. R. L. Sensenich, chairman of the board of trustees, American Medical Association.

Dr. Franz Goldman, Yale University School of Medicine.

Dr. George Carrington, Medical Society of North Carolina Committee. Dr. R. C. Kash, Martha Gaston Hospital, Lebanon, Tenn.

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April 18:

Dr. Ernst P. Boas, chairman of the Physicians Forum.
Louisiana State Medical Society.

Dr. Harold T. Low, president, Association of American Physicians and
Surgeons.

Dr. E. I. Robinson, president, National Medical Association, accompanied by Dr. Paul B. Connelly.

April 19: Dr. Edward H. Cary, chairman of the board of trustees, National Physicians Committee.

April 22:

Dr. Vlado A. Getting, secretary, Association of the State and Territorial
Health Officers, and Commissioner of Public Health, Boston, Mass.
Dr. Alice Hamilton, National Consumers League.

April 23:

Dr. John P. Peters, secretary, Committee of Physicians for Improvement of Medical Care.

Dr. Carl O. Flagstad, chairman, legislative committee, American Dental Association, accompanied by Dr. Alan O. Gruebbel, secretary of the council on dental health, American Dental Association; Dr. Harold Hillenbrand, editor of the Journal of the American Dental Association; and George H. Fox, general council of the American Dental Association, and Secretary of the committee on legislation of the American Dental Association.

Dr. Maurice Kaufman, accompanied by Dr. Seymour J. Schoenfeld, secretary, dentists committee for the passage of the Wagner-Murray-Dingell bill.

April 24: Beatrice F. Jacobs, chairman of the health and education committee, the League of Women Shoppers.

April 25:

Hon. Clinton P. Anderson, Secretary of Agriculture.

Charles F. Brannon, Assistant Secretary of Agriculture.
James Patton, president, National Farmers' Union.

Mrs. Jerome Evanson, director of education, North Dakota Farmers Union. April 26:

George. Hecht, president, Parents Institute, Inc.

Dr. T. Duckett ones, American Council on Rheumatic Fever of the American Heart Association.

Hazel Corbin, registered nurse, general director, Maternity Center Association.

Mary Oxholm, chairman, Spokesmen For Children, Inc.

May 1:

Hon. Lewis B. Schwellenbach, Secretary of Labor.

Dr. Martha M. Eliot, Associate Chief of the Children's Bureau of the
United States Department of Labor.

May 2:

James B. Carey, secretary-treasurer, Congress of Industrial Organizations, accompanied by Robert K. Lamb, legislative representative of the United States Steel Workers of America.

Edward F. Poss, grand worthy president, Fraternal Order of Eagles. May 3:

Gen. Omar N. Bradley, Administrator, Veterans' Affairs.

Fred Bailey, legislative counsel, the National Grange, accompanied by Lloyd C. Halverson. May 6:

John H. Hayes, president-elect of the American Hospital Association, accompanied by George Bugbee, executive director of the American Hospital Association.

Rev. Alphonse H. Schwitalla, S. J., president of the Catholic Hospital Association, accompanied by M. R. Kneifl, executive secretary, Catholic Hospital Association.

May 7:

Rt. Rev. Msgr. John O'Grady, secretary, National Conference of Catholic
Charities.

Hon. Arthur Lewis Miller, a Representative in Congress from the State of
Nebraska.

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