Mr. CURTIS. Don't you think it would be well if we found out what has happened first before we start saying we have to throw more Federal money in it?

Mr. PEPPER. I think the survey of the Surgeon General's points out the need for more nurses in the country.

Mr. CURTIS. We need them, but the point I am making, and this is very crucial, is we have a tremendous growth in this area. We will get the actual figures in this hearing, but that is what we need to do. If we are moving rapidly it is entirely possible, throwing more Federal money could damage what is going on. I just raise the possibility.

Mr. PEPPER. I am sure the committee will make a careful study of any program. May I just say this, Mr. Chairman?

I am sure the able Member from Missouri has emphasized that the Hill-Burton bill was only intended as a Federal supplement to the private hospital construction program. We never proposed to take over the program. We just proposed to help, and I think that should be our role in everything, just help where it is needed, and not take over the whole role.

Mr. CURTIS. That is why I was raising it and pointing it up and suggesting that that attitude and philosophy is what would be well to

do in this field.

Mr. PEPPER. Mr. Chairman, that is what I am glad the able Member gave me a chance to protest. I say that old-age and survivors insurance is a compulsory insurance program, but payment is made by the employee and the employer out of their own revenues, their own funds. It is not the same, and I am glad that it is not, as the Federal Government imposing taxes upon the people, bringing the money into the Treasury, and reappropriating it the way we do for old-age assistance.

I am saying that with what is proposed in the King bill and recommended by the President, we simply require the employee and employer out of his own revenue, to pay into a special trust fund. That's not a part of the general revenues of the U.S. Government the way the funds are that go into the old-age assistance program. They are simply required payments.

Now, the Federal Government does require the payment to be made, but it is not a tax in the sense that we collect it out of general revenue, put it into the Treasury, and appropriate it out of general revenue to aid a desirable objective. I don't want the able Member to suggest that this is any kind of socialism. I prefer this to what is happening in my county and what we are doing through the appropriation of funds at Federal, State, and local levels.

Under social security the payments are compulsory because we found it in the public interest to require the payments to be made, but I don't want socialized medicine in this country and I believe this is the best way to get away from having to appropriate the money either out of the Federal Treasury or the treasury of the States or of the counties. I wasn't able to get this morning, Mr. Chairman, the amount of the State of Florida's contribution to hospital aid for the indigent. When the Kerr-Mills bill comes into effect in the State of Florida, the Federal and State Governments will be assisting my

county in meeting the costs of hospital aid to the indigent, including senior citizens. But this aid will be from tax revenues.

This bill proposes a way to provide these funds by payments into a trust fund by the people directly. It gets away, it seems to me, from what I call socialized medicine where the funds are appropriated out of public treasury for these things.

The CHAIRMAN. Mr. Herlong?

Mr. HERLONG. Mr. Chairman, I first would like to say that my distinguished colleague from Florida, for whom I have great personal affection and respect, although I find myself frequently in disagreement with him on political philosophy, has as usual done a masterful job in presenting his point of view.

I would like to call the gentleman's attention to one thing.

In connection with your remarks about the residence requirements in your own particular area in discussing what is being done by Dade County, I believe you said that you took care of tourists and that you gave the implication that in some of the other programs there were lengths of time necessary in order for a person to qualify for benefits under the program.

I simply want to call the gentleman's attention to the fact that under the provisions of the Kerr-Mills bill which was implemented by the Florida Legislature in the last session, the law does state that no resident of the State may be denied these benefits. It does not have any definite time length on that, and the Health, Education, and Welfare Department will not approve an agreement if there is any definite time length in the proposal of the State.

I am sure the gentleman understands that. He didn't mean to imply that there was any time length necessary for the Kerr-Mills bill. Mr. PEPPER. I am glad to have an opportunity to affirm publicly my great respect and admiration for my distinguished friend. He has his political philosophy and I have mine, but there is no friend for whom I have greater respect and esteem than I do for him. The fact that we don't happen to vote the same way on issues, of course, does not affect our friendship which I cherish very highly.

The reason that I insinuated that there was a time limitation, I say to my distinguished colleague from Florida, is because Mr. MacNair on the telephone within my hearing turned to one of his assistants when I asked if there was a limitation in the State program and they said a year, but probably he was referring to the present program in the State and I am delighted to learn that the Kerr-Mills bill does not have any residence limitation because that would be very discriminatory against a lot of people who come to live with us.

May I just say this? I commend the Kerr-Mills bill. I think it serves a great need. It has a valuable part and place in the overall picture, but I affirm this, Mr. Chairman, that if this King bill were the law of the land we would have to appropriate less money out of the Federal Treasury to implement the Kerr-Mills bill than we are going to have to do if this requirement to pay program is not in effect because a great many of these people who are retirees under old-age and survivors insurance if we had the King bill in effect would have the hospital bill paid for out of that fund.

If we don't have that fund they don't have adequate means and they are going to be calling upon the Kerr-Mills bill. I don't appear here in any sense of the work against the Kerr-Mills bill.

I think it has its place in the picture, but I think to the extent that we can require the employees and employers to provide the money out of private payments, then to that extent the burden upon the KerrMills bill and the Public Treasury, Federal and local, will be less in the future.

I appreciate my colleague giving me an opportunity to make that

statement.

The CHAIRMAN. Any other questions?

Mr. ALGER. Mr. Pepper, you referred to the Wagner-MurrayDingell bill.

If I am not in error that covered all ages?

Mr. PEPPER. That is right and it covered medical as well as hospital facilities.

Mr. ALGER. Let me ask my question.

We have taken so long. Would you expand or amend the KingAnderson bill to strike the age limit, or have you changed your mind? Mr. PEPPER. NO; I said in my opening statement, I will say to the able gentleman from Texas, that while I strongly supported the Wagner-Murray-Dingell bill at that time, now I would not support the Wagner-Murray-Dingell bill, that comprehensive program for all ages and the provisions of doctor's care as well as the hospital. Mr. ALGER. You changed your mind?

Mr. PEPPER. I would like to believe that I have the intelligence to try to profit by experience and by added knowledge, and I think now the thing to do is to experiment with this bill and after some time the people of this country and this able Congress and this distinguished committee will be able to decide whether it should be changed in one respect or not, but I am now advocating only the King bill and the recommendations of the President.

Mr. ALGER. Mr. Pepper, one other thing and I don't mean to start another speech with you, but we found out from Mr. Myers that if we don't take any entrants into the social security bill it is $330 billion behind. I thought you might be interested in that.

Mr. PEPPER. That we are 330 what?

Mr. ALGER. You seem surprised the people aren't here today to protest this particular addition to social security. Some of us think many who will pay are not even born yet and others aren't paying anything before receiving. When a new entrant enters this program today, that is if a man first started working today and first started paying social security, he would be among those who must pick up the tab which Mr. Myers says is $330 billion in the hole.

Mr. PEPPER. I will say to the able gentleman, though, that there are a good many millions of Americans living today who read the newspapers and know pretty well what is going on and know if this bill is enacted who would have to pay the taxes, some of them for 20 or 30 years, and I don't know of any mass protest from those who would pay against the adoption of this program.

One other thing, Mr. Chairman.

Mr. ALGER. I have another question.

Mr. PEPPER. I am sorry. I beg your pardon.

Mr. ALGER. You don't suppose that any of these people, the millions over 65 that will never have contributed to this and will be covered, will protest either, will they?

Mr. PEPPER. I don't suppose they would. I don't suppose they would, and I am interested that their sons, and their grandsons, and daughters are not protesting very loudly either.

Mr. ALGER. We seem to be rather heavily stacked with those who are over 65.

Mr. PEPPER. You can look around your room and you can see the agenda of your witnesses and see how many young men and women who would be paying are coming here to ask this honorable committee not to adopt this bill because they would be burdened with a tax that many of them will have to pay for two or three decades. Mr. ALGER. You don't consider this a gift then, do you?

Mr. PEPPER. As a gift?

Mr. ALGER. Yes.

Mr. PEPPER. Well, if you mean that there are some people who would now be covered. I believe the last amendment of the bill did blanket in some of the people over 65 who didn't pay as they went along. Mr. ALGER. Millions of them.

Mr. PEPPER. But there is no difference in that blanketing from putting them under the Kerr-Mills bill. They don't pay for that either. They passed a period of earnings. They don't pay taxes and they are not paying for that either.

But what I wanted to say, if the able gentleman will permit me to do So, is there are then some who have said that maybe the amount of the tax that has been proposed will not carry adequately.

If I am not mistaken I thought I saw in the Post of yesterday that the able chairman indicated some fear of concern on his part to that effect.

As one of those advocating this bill, I am willing for it to stand on its own financial or fiscal bottom. I am perfectly willing as far as I am concerned as the introducer of a companion bill and an advocate of this measure to have you segregate the funds into a special fund and if they are not adequate, then increase the tax, unless we find it is undesirable to have it at all.

If so repeal it, but I don't want to jeopardize the rest of the social security system and if the able chairman and his committee feel that it will endanger the soundness and the stability of the general social security fund because the tax for hospital care is not adequate, then segregate it and let's let it pay its way as it goes along.

I will stand on that as a citizen and as a Member of this House and if I have that privilege will vote that way.

Mr. KEOGH. Mr. Chairman.

The CHAIRMAN. Mr. Keogh.

Mr. KEOGH. Senator, there seems to be an effort made to convey the impression that extending the benefits of the pending bill to those over 65 not within social security is something that is without precedent, but I would like to remind you and my colleagues on the committee that within the last 2 years we were faced with an amendment offered by one of the ranking minority members of this committee to provide full social security coverage to all those not now covered and over the age of 65, and I do not recall that there were any points made that this was a gift or was un-American, or was unprecedented, or anything like that.

I think the record should note that.

Mr. PEPPER. I thank the above gentleman from New York for making that observation.

The CHAIRMAN. Any further questions?

Mr. Burke?

Mr. BURKE. I just want to point something out for the record because apparently the gentleman from Missouri indicated that there had been some employees that had appeared here and opposed this bill or someone had appeared here who was an employer.

Of the witnesses that started to testify here Monday and right up through until today, the end of today, I do not find one employer testifying as an employer opposing this legislation or one employee. Your assessment of those people who are opposing this legislation is entirely

correct.

Mr. PEPPER. I thank the above gentleman for his observations. Mr. CURTIS. Mr. Chairman, the gentleman from Massachusetts didn't listen carefully.

When I pointed this out to the gentleman from Florida, I said, "If you will examine the list of witnesses for these hearings when we have completed them you will find that there are a bulk of the employer groups who will appear."

It is true that up to date we haven't heard employer witnesses, but as this agenda unfolds, and, of course, that is what we want to look to, not who happens to appear first, in the total 10 days of hearings I believe we have, and we will all look to that, of course.

Mr. PEPPER. The only opposition I have heard to this bill has come not from the employees and employers who pay the tax.

Mr. BURKE. Mr. Chairman, I believe a reading of the record by the reporter here will indicate the gentleman did not say, "When these hearings are completed."

Possibly he intended to say it, but he did not say it at the time.
Mr. CURTIS. The record will be there for everyone to read.
Mr. PEPPER. I thank the chairman and the committee.

The CHAIRMAN. We thank the gentleman.

Dr. Annis, you are to make the statement, I presume, for your group. Doctor, you have been before the committee before, but for this purpose will you generally identify yourself by telling us your name, address, and capacity in which you appear?

STATEMENTS OF DR. EDWARD A. ANNIS, PRESIDENT, AMERICAN MEDICAL ASSOCIATION, AND DR. NORMAN A. WELCH, PRESIDENT-ELECT; ACCOMPANIED BY DR. ERNEST B. HOWARD, ASSISTANT EXECUTIVE VICE PRESIDENT; AND BERNARD HARRISON, DIRECTOR, LEGISLATIVE DEPARTMENT, AMERICAN MEDICAL ASSOCIATION

Dr. ANNIS. Thank you, Mr. Chairman. I am Dr. Edward Annis, of Miami, Fla. I am president of the American Medical Association. I am here to present the views of the medical profession on H.R. 3920. With me are Norman A. Welch, of Boston, president-elect of the American Medical Association; our assistant executive vice president, Dr. Howard; and the director of the legislative department for the American Medical Association, Bernard Harrison.