Senator DONNELL. Now, just what do you mean by saying that doctors' services alone take three times as much in the average medical 'dollar?

Dr. FOREMAN. If you begin at the beginning of that paragraph:

Blue Cross hospitalization is good as far as it goes, but it does not go very far. If one belongs to an eligible group, it costs a family about $24 a year, but covers only the hospital bill.

In other words, the Blue Cross does not give the service for the medical care, but just for the hospital bill, and yet doctors' services alone take three times as much in the average medical dollar. In other words, the services part of the average dollar spent for medical costs, altogether, doctors' and hospital services, the medical care, the doctor's part is three times as much as the hospital part.

Senator DONNELL. I think that you have clearly explained that. I did not understand it, and I understand what you mean. Doctor, what is the authority that you have by way of statistical information that justifies that statement?

Dr. FOREMAN. The studies put out by the various organizations, including particularly the bureau of the Department of Agriculture studies on human nutrition.

Senator DONNELL. How recently have those studies been made? Dr. FOREMAN. My understanding is in the last year or so, I will be glad to present them for the record.

Senator DONNELL. Would you present those and file them for the record?

Dr. FOREMAN. I will be very glad to.

Senator DONNELL. Is it not a fact, Doctor, that in large part the documentation of your statement here, so far as statistics are concerned, is based on the report of the committee having to do with the costs of medical care, published in 1935?

Dr. FOREMAN. Not by any means.

Senator DONNELL. Have you seen that publication?

Dr. FOREMAN. Yes.

Senator DONNELL. That is one of the leading publications on that subject?

Dr. FOREMAN. Yes.

Senator DONNELL. And is there anything any more modern on that, that involves a general compilation of statistics on that subject?

Dr. FOREMAN. Well, the costs of medical care, of course, are being worked on, and Dr. Michael Davis, who is an old friend of mine, has been working on this for years, as you know, and he is bringing out regular publications, and whether they are compiled in as complete a document as that since then, I have not seen it; but I am sure that more and more figures are being brought out all of the time, which I have seen.

Senator DONNELL. It is a fact, however, is it not, Doctor, that in considerable part the figures which you have used in your statement are based on this publication issued in 1935?

Dr. FOREMAN. That is one of the publications.

Senator DONNELL. And I am not asking you at this moment, unless you care to, to indicate which particular portions of your statement are based on that, and which are based on more modern statistics.

Dr. FOREMAN. I will be glad to file that with the committee.
Senator DONNELL. Would you do that, that is very fine.

Referring to that statement that you have given us this morning, you mentioned that you have not examined S. 1606 for several weeks. Dr. FOREMAN. That is correct.

Senator DONNELL. Did you come here from Georgia to testify on this matter?

Dr. FOREMAN. No, sir.

Senator DONNELL. Are you located here in Washington, D. C.? Dr. FOREMAN. Yes, sir.

Senator DONNELL. And you did not in the last few days, then, study 1606?

Dr. FOREMAN. I did not go back to the original bill, Senator. I did go over the President's statement and over certain other things. Senator DONNELL. How recently was the statement which you have presented this morning prepared?

Dr. FOREMAN. In the last week.

Senator DONNELL. In the last week?

Dr. FOREMAN. Yes, sir.

Senator DONNELL. Were you assisted in the preparation of that statement?

Dr. FOREMAN. Yes, sir.

Senator DONNELL. Would you mind telling us who assisted you? Dr. FOREMAN. We have a research division in our Washington office, and we have some volunteers in the Washington Committee, and the Washington Committee is composed of 400-odd people, and tha: volunteer group with our paid services in the office gets it up. Miss Peggy Hobbs is in charge of our legislative research, and she was responsible for getting this up for me.

Senator DONNELL. Did you personally prepare any part of this statement, Doctor?

Dr. FOREMAN. I went over it, and it was brought to me in draft. and I went over it and changed it according to my ideas of what I wanted to say. I did not do it originally, the original work on it.

Senator DONNELL. Does the document as it now stands and as you read it, in substance, in the major points at any rate, stand precisely as it was when it was brought to you?

Dr. FOREMAN. In substance it stands as it was brought to me. Senator DONNELL. And you had not personally prepared it at ths: time?

Dr. FOREMAN. I did not.

Senator DONNELL. Now, Doctor, was there any portion of this document that was prepared by or under the auspices of any United States Government agency?

Dr. FOREMAN. Not so far as I know, as I say, Miss Hobbs is responsible for getting it up and so far as I know she had the work done in the office and with whatever voluntary help she could get at home. Senator DONNELL. Would you mind telling us who Miss Hobbs 3 and what her training is?

Dr. FOREMAN. Miss Hobbs is a woman who is a college graduate. who comes into our office and works on legislative work in the afternoon and works at home in the morning and in the evening.

Senator DONNELL. Does she have the background of educationa experience in college or university?

Dr. FOREMAN. She does.

Senator DONNELL. Has she had social-service work that she has been engaged in?

Dr. FOREMAN. To a certain extent; yes, sir.

Senator DONNELL. Would you mind telling us just briefly what her experience is?

Dr. FOREMAN. Her experience since she left college has been work as a writer and a certain amount of social service, I think; I am not absolutely certain how much she has done in social service, but she is a very intelligent girl who knows how to get the facts out in a certain case. We have to appear on a number of bills, of which this is one, and her job is to get together the facts for me on any particular bill as it comes up. So when I asked her to do this, she got in touch with the people among our membership who were willing to help her, and I do not know who those were.

Senator DONNELL. It is Mrs. Hobbs, is it not?

Dr. FOREMAN. Yes.

Senator DONNELL. What was her maiden name, Stein?

Dr. FOREMAN. No.

Senator DONNELL. What was her maiden name?

Dr. FOREMAN. I regret to say that I do not know. She was married since I have known her.

Senator DONNELL. Was she with the Department of Agriculture at one time?

Dr. FOREMAN. I feel perfectly sure she was not.

Senator DONNELL. You are quite sure she was not?

Dr. FOREMAN. That is right.

Senator DONNELL. Now, Doctor, do you know what educational institutions she attended?

Dr. FOREMAN. Bennington College.

Senator DONNELL. Where is that located?

Dr. FOREMAN. In Vermont.

Senator DONNELL. Is that a senior college or is it a junior college? Dr. FOREMAN. It is a full college.

Senator DONNELL. What degree did she receive from it?

Dr. FOREMAN. A. B.. I think.

Senator DONNELL. Has she received any subsequent degrees?
Dr. FOREMAN. No.

Senator DONNELL. What is her age, if you know?

Dr. FOREMAN. I do not know, Senator, but I think it is in the thirties.

Senator DONNELL. Do you know how many years of experience she has had since she left the college?

Dr. FOREMAN. You mean how long she has been out of college, I should say about 10 years, but I would like to point out that she was not alone involved in preparing this, but was merely to get together whatever authorities and research she could and work with me on getting it ready.

Senator DONNELL. She prepared the assembling of the data from other persons in your organization, and you were not one of the. persons in the organization who participated in the assembling of it as it was presented to you by Mrs. Hobbs, is that correct?

Dr. FOREMAN. It was discussed with me, in advance, as to the kind of testimony I wanted to present.

Senator DONNELL. And you wanted to present this?

Dr. FOREMAN. This is not the first time I have discussed this bill, I have been in a joint debate with the American Medical Association on the bill previously.

Senator DONNELL. Now, Doctor, this is not said critically but merely as a matter of information; you realize, of course, that this is a highly important measure, and in fact you characterize it as the main measure to carry it out, and you have come before the United States Senate Committee to give us the benefit of your views, and yet several weeks have elapsed since you have examined this document, S. 1606, and you are unable to state with any certainty where you derived the information as to the method of financing that was proposed. Am I correct in those statements?

Dr. FOREMAN. You mean that I cannot now give you the reference for all of the figures here?

Senator DONNELL. I am talking about the financing of the health insurance program, as to how that is to be done.

Dr. FOREMAN. Well, I cannot now put my hands on it; no, sir. This 3 percent is the figure that I have been going on, that I felt and I still feel that I can verify the fact that one-half of it comes from the employer and one-half from the employee.

Senator DONNELL. I think that you will fail to find that in th title II. I may be in error in it, and if I am I stand corrected, but I do not think that you will find that. I think that you will find it ir S. 1050.

Dr. FOREMAN. It is possible that I and my assistant have beer confused on that.

Senator DONNELL. I think that that is all, Doctor.

Senator SMITH. Just one question, if I may. Doctor, what do you estimate would be the over-all cost of the compulsory health program' Have you made estimates on that?

Dr. FOREMAN. No, sir; I have not. I will be very glad to get up a figure.

Senator SMITH. I have heard such strange figures, and I would lik to know what the estimates are. It goes up as high as 3 billion or 4 billion dollars, and it is something that we ought to consider in relating it to our whole social program.

Dr. FOREMAN. What I have heard, and I cannot myself vouch for. is that it would be less than, or I think the cost would be very little more, if any, in total than the amount that is now being paid for a medical and health work, but because it would be for everybody and would be prepaid, the total medical bill would be lowered. In other words, as I understand it, the theory, and as I say this is hear-ay. Senator, and I am not prepared to give you the figures on it, was because we would have general coverage, with preventive care for all of the people, that the total medical bill of the country would be corsiderably lower than it is at the present time; and since it seems me that we can think of it as a national problem, that would seem * me to answer the fundamental part of your question as to wheth the country can afford health insurance.

Senator SMITH. Then you suggest as the philosophy behind the bill, that everybody should stop paying their doctors and go into th plan and get their health taken care of by the over-all Governme: program, that is your theory?

Dr. FOREMAN. My theory is, if the bill is passed practically everybody will take advantage of the bill, including practically all of the

doctors.

Senator SMITH. So that the doctor would no longer have the personal relationship with the patient as to his fees and so on, and there would be no difference in skills as far as the patient is concerned?

Dr. FOREMAN. I would say because the doctor does not have to deal with his patients on the fees, there would be a more personal relationship with the patient. The doctor would be assured of his money and therefore would think of his patient only in a professional capacity.

Senator SMITH. Well, would that apply to any professional job? You might say that the lawyers do not have any fees in a law case. Why not put them on a basis of a nice, pleasant relationship, where you just call your lawyer and the Government pays him? I am trying to get the philosophy of this bill.

Dr. FOREMAN. The Senator has given me caution, and I am not prepared to answer the legal question.

Senator SMITH. Well, we will leave that out.

Dr. FOREMAN. But as far as the medical is concerned, I am absolutely convinced that the people would get better medical care under this bill, and that it would be of great benefit to the people in this country, particularly the southern people.

Senator SMITH. That is all I have.

Senator DONNELL. Doctor, may I ask you, for a moment, do you know a lady named Peggy Stein?

Dr. FOREMAN. Yes.

Senator DONNELL. Connected with the Department of Agriculture? Dr. FOREMAN. I know her casually.

Senator DONNELL. Is she here today at the hearing?

Dr. FOREMAN. No, I do not think she is.

Senator DONNELL. Did she participate at all in the preparation of this document from which you have testified?

Dr. FOREMAN. So far as I know she did not.

BILL COLLECTING UNDER EXISTING SYSTEM

Senator DONNELL. Doctor, referring just for a moment to one statement concerning which I asked you a question before, you state in your statement on page 6:

Doctors will not have to spend so much of their time and energy trying to collect bills.

Is that one of the major points you are emphasizing here in advocacy of the Federal compulsory health insurance as distinguished from the present plan?

Dr. FOREMAN. No.

Senator DONNELL. You do not regard that as particularly serious, nor do you think that doctors seriously interfere with their efficiency by trying to collect bills under the present system?

Dr. FOREMAN. I would say from my experience with doctors that they do have very great difficulty in getting payment of bills. Senator DONNELL. Yes.

Dr. FOREMAN. There is considerable loss by doctors, and that represents a problem for doctors in maintaining a professional attitude to