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r. LINDER. That is clear.

nator DONNELL. And the power to spend money as pointed out Mr. Justice Cardozo has been indicated by the Supreme Court to as a necessary incident of the power to lay and collect taxes; ther words, if Congress has the power to collect, inferentially, e is an iplied power to spend money which it has laid and cold the taxes to secure it. That is correct, is it not?

r. LINDER. Correct.

nator DONNELL. I regret to say that it is 3:15, and in comnce with my promise to you, we shall excuse you, but we shall reciate greatly your coming back to continue not only with this titutional question as to which there are some further questions I re to address to you, but I have no doubt that the committee would to hear with respect to quite a number of other points, and I e you will come prepared to stay a sufficient length of time to uss them with us.

r. LINDER. I have an appointment in Washington on the 25th of il.

o you know anything about the calendar of the committee? enator DONNELL. The next meeting is to occur next Tuesday.

r. LINDER. I have to be back in Washington on the 26th, in the

rnoon.

enator DONNELL. Could you appear with us in the morning of , day?

r. LINDER. I can appear in the morning, and I could start at clock and keep going as long as you want.

2

enator DONNELL. Would you be kind enough to make a note of and I am sure that the committee will see that requisite notice iven Mr. Linder, and if that should not prove convenient, an ropriate date suitable to both himself and the committee can be nged.

fr. LINDER. I will be happy to come again. I should like, as a it of personal privilege, to take 1 minute on one point. enator DONNELL. Certainly.

(r. LINDER. I should like to make clear my personal view with sect to the American Bar Association. If anything that I have I here indicates any personal hostility to the organization, as such, gret it. I regard the American Bar Association as an organizaof lawyers. Many lawyers who belong to the American Bar ociation are my friends and are well known to me and both proionally and otherwise. I think the American Bar Association, far as it deals with technical matters, dealing with subjects within realm of civil and criminal jurisdiction, contributes, takes posiis that are frequently taken by the National Lawyers Guild. wever, in the tremendously important field of social legislation, in of those with respect to that whole body of legislative matter ch so directly affects the interests of the people of the United tes, I think it is true that during the last 10 years, at least, the erican Bar Association has consistently taken a view which, in the nion of the National Lawyers Guild, is a view not in the interests the people of this country.

he American Bar Association has regarded the Social Security as unconstitutional. Its representative here this morning apred before the United States Supreme Court and argued the un

constitutionality of that statute. Not persuaded by the United Sta Supreme Court and unmindful of the fact that that decision is ba ing upon him, he still continues his assertions about the const.. tionality.

The American Bar Association, in connection with this spec legislation, I think, has taken a position which serves the inters. of the people of our country very badly.

In echoing the position of the American Medical Association. American Bar Association, I think, has taken a very unfortu:. position and it is a matter of some regret to me that they have done =

I think in taking that position, however, the American Bar A-ciation does not bespeak the views of the overwhelming maj: of the lawyers in this country.

I will be glad to come back here, Senator.

Senator DONNELL. The committee will be in recess until 10 a. z Tuesday, April 9, 1946, in room 301, the Banking and Currency C mittee room.

(Thereupon, at 3:20 p. m., Friday, April 5, 1946, the comm.” recessed to reconvene Tuesday, April 9, 1946, in room 301, the Ba ing and Currency Committee room, at 10 a. m.)

NATIONAL HEALTH PROGRAM

TUESDAY, APRIL 9, 1946

UNITED STATES SENATE,

COMMITTEE ON EDUCATION AND LABOR,

Washington, D. C. he committee met at 10 a. m., pursuant to call of the Chair, the 10rable James E. Murray (chairman) presiding.

resent: Senators Murray, Wagner, Ellender, Aiken, and Donnell. he CHAIRMAN. The hearing will come to order.

'he first witness this morning is Fiorello H. LaGuardia, former sident of the United States Conference of Mayors, and formerly yor of the city of New York. We welcome you here this morning, LaGuardia, and we are glad to have your testimony for the record.

TEMENT OF FIORELLO H. LaGUARDIA, FORMER PRESIDENT OF THE UNITED STATES CONFERENCE OF MAYORS

Ir. LAGUARDIA. Mr. Chairman and gentlemen of the committee, indeed is an opportunity that I have long sought. I have been ting for this for the last 20 years, and I want to congratulate the mittee on reaching the stage where at least citizens can come and t on something that should have happened many years ago. he highest function of government is the protection and preserion of life. That is accepted, but it stops short of the real preserva1 of life. Great progress has been made in the last 10 or 12 years I what today is accepted as a national policy only a few years ago e matters that were left to private generosity and charity.

APPROPRIATIONS FOR TITLE I ARE LOW

take it that there is little opposition to the provisions in the early t of the bill on maternal and child health, on the contributions and leral grants for tuberculosis and venereal disease. Am I correct in

t?

The CHAIRMAN. Yes.

Ir. LAGUARDIA. I just want to point out and I speak from actual erience your authorization for appropriations is extremely low. ave spent a great deal of money during the past 12 years and I am y proud of what we accomplished in New York City, and the prom which I left for my successor.

There is great need of hospitals in our country. We have county er county that has no hospital services at all, and some counties ve no medical service. It is not in keeping with the dignity of our

country, or what we pretend to be and what we hold out ourselves t be to the world. I am very glad to hear that those provisions are a least hopeful of favorable consideration.

HEALTH INSURANCE MOST IMPORTANT LEGISLATION EVER BEFORE CONGRES

Now we come to the health insurance. I consider that a most i portant piece of legislation, the most important piece of legislati ever before the Congress of the United States, second only to t original first commandments.

Now, gentlemen, in our country today the very poor and the v rich can get proper and complete medical and surgical care. Me cine has made such progress that it could afford to stop today a do nothing for 50 years, and the Government could not catch up w it. It is possible now to avoid diseases, to avoid sickness, and t is why your public health provisions in this law are so important. We have already eliminated what at one time were accepted as a of God, epidemics in cholera, malaria, yellow fever, and diphther Why, Senator, I remember when I was a boy out in Arizona, wh little children were infected with diphtheria, we knew that they wo die. We were quarantined and kept in our houses. Today diphther is not an epidemic disease at all. It is the same with yellow fe and the same with cholera, and it is the same with tuberculosis.

Tuberculosis can be licked in this country in 25 years if we ha proper controls as provided in this bill. That is not enough. medical side is not enough, but you must also have proper hous": proper nourishment in the prenatal stages, and in infancy and ch hood, and proper ventilation and sanitation, and then we will i tuberculosis. There is no question about that. It is just waiting: the Government to step in and do it.

We are greatly in need now of more public-health doctors a nurses, public-health nurses. I would like to see a program start immediately for the training of this personnel. In the unhappy that I have temporarily, I could use 10,000 public-health nurs this world. The conditions in some parts of the world are a trage I have come to talk about the health insurance. I hope nobody: believe that the provisions of this bill are shocking, are extreme, if I may use the pet expression which was used when I was a M ber of Congress, are paternalistic. I suppose today they would that they are communistic.

I do not care what you call it. It is a good plan and it is one t cannot be stopped. If this Congress does not do it, another Congr will, but I would like to see this Congress do it.

Now, I have just stated that in my city the very poor and the rich can get full benefit of all of the progress of medical science. 1 is because the city of New York maintains and operates public hospitals for the lower income group, and we have 20,000 beds. S of our hospitals operate in connection with universities, and b scientific research departments. The very best surgeons and the best doctors of the city are attached to these hospitals as visting geons, so that the people, the members of families with an income say under $1,800, will get this treatment.

HOSPITALS AND MEDICAL RESEARCH IN NEW YORK CITY

I have provided, and I will not bore the committee but I have the details here, something over $100,000,000 for hospital expansion in New York City, and for research. As I said we carry on the research with agreements with the New York University Medical School, Cornell Medical and Columbia Medical Schools. One is the Nightingale Cancer Hospital. I had the foundations completed when war broke out and it was stopped. We will resume construction. That will be a 500-bed cancer hospital, with research in connection with the Presbyterian Hospital of Columbia Medical School. Then recently there was authorized a custodian cancer hospital in connection with Memorial. There we will have 300 beds and we will take chronic cases for two purposes-one is to find ways and means of alleviating pain and suffering, and the other to see what can be done with these

cases.

Then we have the expansion of our present chronic-disease hospital which I built, and that has 1,200 beds, and there we carry on research in what is known as middle-age and old-age diseases, arthritis and hearts and things like that. Then we had the expansion of our tuberculosis service, rebuilding entirely a hospital, and we ought to take 1,800 or 2,000 there.

There is an expansion also at Kings County and Bellevue and the Tri-Borough Tuberculosis Hospital.

Then we have our medical research institute, and in connection with that we are building a hospital for research on tropical diseases. That is something that is spreading around the world now, and it requires a great deal of immediate and intensified research. We think that we can lick it.

I am very hopeful, gentlemen, that our public-health institute, the research institute, will be able, before long, to announce a startling discovery. We have been working on it for some time, and we had hoped to have it completed before this, because it would have saved a great many lives in the Pacific. That research is progressing very hopefully.

Now, in between the very rich and the very poor you have America. That is folks like you and me; and medical treatment, gentlemen, is necessarily and unavoidably extremely expensive. The cost of operating a hospital has increased from the time I took office on January 1, 1934, to the time I left, the end of 1945, I would say from 350 to 1400 percent. It costs a great deal to operate a hospital and a great deal for medical care. It is not that the doctors are getting rich on it, it just went up with the general cost of medical supplies and all costs have increased.

Before we had the sulpha drugs, we manufactured a pneumonia serum in our health laboratory and we distributed it on the prescription of a doctor, and the average family could not afford it.

You can take a simple tonsil operation that almost every child must have, and by the time it is over it will cost $100 or so. The routine dental attention of growing children costs money, and we figure that a baby in New York City, I do not know how much it is elsewhere, costs about $100 a pound, if you give it proper treatment and give the mother proper prenatal and delivery treatment.

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