I think better of your organization apparently than you do. I hope your viewpoint is not right, and I think we ought to look into it. Dr. RAVETZ. Thank you. I think it is very complimentary. I feel that my fellow colleagues are doing a remarkable job in trying to provide all the medical care that is needed in the community, but I think that the problem is just too overwhelming. They can't do it alone and they must have assistance from the Federal Government. Mr. KING. Some of the arguments used by the medical association in opposition to H.R. 4222, such as there is no choice of physicians, there is no choice of hospitals, and the Government is in and will get in further, are not all these things true in connection with the medical bill passed last year?

Does a patient on relief or an indigent have the choice of his physician after going to the hospital?

Dr. RAVETZ. No, sir; he does not have a choice of his physician before he goes to the hospital. I could get Mr. Curtis' testimony by a member of one of our committees of the Philadelphia County Medical Society, of which I am a member, in which he pointed out that in Pennsylvania they only allow a doctor to get-he gets a dollar and a half a visit but he is only allowed to make $500 a month.

So, in the poorer sections, when he reaches the $500 he cuts off all his relief patients. This doctor testified how this patient went from doctor to doctor and they refused to see her.

I can give you the doctor's name right now. She went from doctor to doctor and they refused to see her and she wound up in the hospital. She wound up in a hospital and an intern who did not know public assistance regulations wrote a prescription for capsules.

Then she went from drugstore to drugstore to drugstore and they would not fill a prescription because it was capsules. They only get paid by ingredients, not for the capsules. They refused to fill the prescription for capsules.

As a consequence, she finally wound up with this doctor who treated her and gave her a prescription on DPA and it was in pill form so that the druggist could count them out. She finally got care.

But this is the experience of a respectable member of the Philadelphia County Medical Society. He is a member of the committee on chronic and long-term illness. He gave us this instance that happened.

Mr. KING. And they have no choice at all?

Dr. RAVETZ. They have absolutely no choice.

Mr. KING. And the government, as you stated, prescribes rules and regulations, the local government, as to what a doctor can do and what he cannot do?

Dr. RAVETZ. There are many rules, as I have pointed out, in Pennsylvania. They are not allowed to prescribe vitamins for a patient. Who needs vitamins more than an elderly patient? They are only allowed to prescribe certain antibiotics. They are only allowed a certain number of visits a month. They go in the home, they are allowed to see only a certain number of patients.

If there are more than that number they won't get paid if they see more. There are all types of harassing regulations and controls.

Mr. KING. Now with respect to H.R. 4222, when advertisements appear in magazines, periodicals, and newspapers that state under H.R. 4222, a patient will not be able to have his or her own physician, will not have a choice of the hospital they will go to and their doctors will be regimented and their practice interfered with by the Government, that is a form of deceit, is it not?

Dr. RAVETZ. It is deceit, distortion, misstatement, and hypocrisy. Mr. KING. The bill does not provide for that sort of control. It specifically provides against that sort of control. So, you are not too far wrong, Doctor, when you state that deceit and misrepresentation are resorted to in releases that comes out of the public relations department of the American Medical Association.

That is all I have.

Mr. CURTIS. Mr. Chairman, may I ask unanimous consent that we have the advertisement placed in the record? I think in that way those who read the record may see it.

Mr. KING. Without objection.
(Advertisement referred to follows:)

Speaking for 180,000 physician-members... the AMA believes you deserve to know exactly where we doctors stand on the question of:

AID F

MEDICAL

D FOR THE AGED

HERE'S WHAT WE FAVOR:

The doctors of America believe that our aged citizens who need medical care should get it, whether or not they can afford to pay for it.

We favor a program of medical aid for the aged sensibly designed to help those who need help — that allows millions who can afford it to pay for their own medical care.

Such a program was enacted by Congress last year. It's the Kerr-Mills law, which has the enthusiastic support of America's doctors. Specifically, the law provides for Federal grants-in-aid to the individual states, enabling them to provide health care for those among the elderly who need help. The benefits of this locally administered program also include the 21-million Americans eligible for Old Age Assistance... and protect all other senior citizens who cannot meet the costs of a serious or long-lasting illness.

The Kerr-Mills law represents a common-sense approach to solving a problem that concerns us all. As doctors, we support it--because our first consideration is the health and life of our patients. As Americans, we endorse it - because helping those who need help is the obligation of all decent people.

HERE'S WHAT WE REJECT:

As Americans-not simply as physicians—we are deeply concerned about the dangers of Socialized Medicine. And we are not crying "wolf" when we apply that term to the currently proposed legislation which would establish a COMPULSORY health-care program for everyone covered by Social Security (regardless of need). The Socialist Party itself calls this Socialized Medicine. And we believe they have a more expert knowledge of socialist definitions than do those who describe the Social Security approach as “just a method of financing aid for the aged."

This COMPULSORY health care program adds up to nothing more than Socialized Medicine controlled by a bureau of the Federal Government... paid for by increased Social Security taxes, burdening both present and future generations. Confined at first to the aged, it would inevitably be expanded to cover all Americans.

Moreover, when the Federal Government enters the privacy of the examination room-controlling both standards of practice and choice of practitioner - the cost includes loss of freedom. Your doctor's freedom to treat you in an individual way. Your freedom to choose your own doctor. When the physician is socialized, his patient is socialized as well.

HERE ARE MORE REASONS WHY WE BELIEVE SOCIALIZED
MEDICINE FOR THE AGED SHOULD BE REJECTED:

It would lower the quality of health
care, with remote and impersonal
bureaucratic control replacing the
confidence and closeness of the
doctor-patient relationship.

⚫ It would lead to the decline, if not
the end, of voluntary health in-
surance programs.

The Socialized Medicine for the
Aged legislation now before Con-
gress would lead to a further cut in

IF YOU AGREE WITH US that a compulsory health-care program for
any segment of our population would be bad for the nation, we urge you
to write your Senators and Congressman. Urge thèm to reject Socialized
Medicine in any form...to use our present program of medical case for
the aged, administered locally, that helps those who need help.

take home pay because of even greater increases in the Social Secu rity tax already rising and sched. uled to reach 9% of payroll within just eight years.

It would create a vast and costly complexity of new bureaucratic task forces, supervising medical care from Washington, DC... far-removed from the essential understanding of local and individual needs.

Mr. KING. If there are no further questions, thank you, Doctor, for giving us your views.

Dr. RAVETZ. Thank you, Mr. Chairman.

Mr. KING. Dr. Twente.

Congressman Williams, you and your guests are most welcome. Mr. WILLIAMS. May I be recognized for a brief introduction? Mr. KING. You certainly may.

STATEMENT OF HON. JOHN BELL WILLIAMS, A REPRESENTATIVE IN CONGRESS FROM THE STATE OF MISSISSIPPI

Mr. WILLIAMS. Mr. Chairman, members of the committee, I deem it a great privilege to have the opportunity to introduce to this committee two of my very dear friends and distinguished medical men in the State of Mississippi.

Dr. George Twente, who practices medicine in the city of Jackson in my district, and Dr. H. A. McClanahan, of Columbus, in the State of Mississippi, not in my district but an oldtime friend of mine.

Before proceeding to outline briefly their qualifications, I would request the committee for permission to insert a copy of a telegram in the record at this point.

Mr. KING. Without objection.

Mr. WILLIAMS. I shall read the text of it:

Drs. GEORGE E. TWENTE and H. H. MCCLANAHAN,

Care of Congressman John Bell Williams, New House Office Building, Washington, D.C.:

Congratulations to you both on testimony in opposition to H.R. 4222 which I received from Rowland's office. You have done a wonderful job of representing our State and my own views.

Mr. KING. Very well.

Ross R. BARNETT, Governor of Mississippi.

Mr. WILLIAMS. Dr. George Twente is not a native of Mississippi. He was born and raised in Illinois and educated in Illinois. Mr. MASON. That is why he is so good.

Mr. WILLIAMS. He was educated at the University of Illinois, interned and took his residency at St. Louis City Hospital, served in the military service during World War II as a major, and came to Mississippi about 14 years ago.

He is a fellow in the American College of Surgeons, diplomat on the American Board of Surgeons. He is an instructor in surgery at the University of Mississippi School of Medicine and consultant in cardiac surgery to the Mississippi State Crippled Children's Service. His practice is limited to general and thoracic surgery.

Dr. McClanahan is a native Mississippian, born at Columbus, where he now practices. He received his M.D. from Rush Medical College, interned at Indiana Medical Center and took his residence at the University of Chicago.

Dr. McClanahan has a master of science degree from the University of Tennessee and has served on the faculty of three great medical schools: the University of Mississippi, the University of Tennessee, and Indiana University.

He was a medical officer in the Navy during World War II, and—I might add-a combat officer with the Marine Corps.

He returned to Columbus after the war to enter private practice of internal medicine. He presently serves as chairman of the board of trustess of the Mississippi State Medical Association.

Mr. Chairman, it is a privilege to have the opportunity to introduce these men to this committee and I can assure you that they are well qualified to speak on this legislation.

Mr. KING. And they are well sponsored.

Mr. MASON. Very well sponsored, I would say, by my friend from Mississippi.

Mr. WILLIAMS. You are entirely too charitable.

Mr. KEOGH. Permit me to join in those remarks, Mr. Chairman. Mr. KING. Proceed, Doctor.

STATEMENTS OF GEORGE E. TWENTE, M.D., AND H. H. McCLANAHAN, JR., ON BEHALF OF THE MISSISSIPPI STATE MEDICAL ASSOCIATION

Dr. TWENTE. We are deeply grateful for the privilege of appearing before your committee to discuss the views of our association, a 105year-old scientific professional society of about 1,400 physicianmembers, with respect to H.R. 4222 and similar bills pending before the Congress.

These policy positions are those of our association established by the board of trustees and reaffirmed on four occasions by our house of delegates during the period 1958 through the present year. The viewpoint of this testimony is, therefore, an accurate reflection of what Mississippi physicians believe and support in their unified goals of providing the best possible medical care to all citizens of our State without qualification or regard as to age, race, sex, creed, or political persuasion.

Purpose of testimony: Our objective in offering these views is to Join with all concerned in fulfilling every valid obligation to the aging, with full respect for the dignity of the individual. We believe, too, that your committee seeks these same meritorious goals with serious.

concern.

As physicians, we recognize and accept our traditional professional obligations. We emphasize our concern for the aging and are, of course, grateful for the determining contribution which our profession has been able to make in extending the human lifespan.

In substance, this was the theme of the discussion I was privileged to present to your committee on July 17, 1959, when H.R. 4700 was under consideration. We have further substantial progress to report in the positive program of achievement in the field of service to the aging which continues to gain momentum in Mississippi.

We express our appreciation for the significant work of this committee and we applaud your sponsorship of H.R. 12580, later enacted by the Congress as Public Law 86-778 in 1960.

Mississippi has joined with other States in implementing this program which was wisely and appropriately associated with title I of the Social Security Act.

We further applaud your committee's prudence and judgement in declining to place health services for the aged under title II, with attendant loss of flexibility, restricted application to the aged them