Senator DONNELL. Very well; I will proceed. Doctor, may I ask you one question before you begin your statement? I am not informed as to the nature of the sciences which Reverend McPeek mentioned. Dr. LAWLESS. Diseases of the skin, that would be dermatology; syphilology would be venereal diseases.

Senator DONNELL. Yes; I assumed it had something to do with that. Go right ahead.

INADEQUACY OF HEALTH CARE

Dr. LAWLESS. The Congregational Christian Churches, because of their experience gained in religious and educational work in certain sections of the country, have become acutely aware of the large amount of suffering caused by the inadequacy of medical care and the economic results of illness. Statistics released by the Selective Service System as well as data compiled by other qualified and recognized organizations and individuals, lend further support to these views.

Some indications of our health status are clearly shown from statistics of the Selective Service System. Between 30 and 40 percent of all male registrants were rejected from full military service. It must be revealed that these figures refer only to males. Inasmuch as the female rate of illness is usually higher than that of males, the figurese above do not reveal the true picture. It is possible that if a complete survey of the entire Nation were made on the same basis, a much more astounding condition of health would be disclosed.

It is significant that many of the rejections were due to remedial defects and probably would not have existed had there been available the facilities which the Wagner-Murray-Dingell bill will provide. Referring to the Medical Annuals of the District of Columbia, it has been estimated that nearly 7,000,000 persons on an average are incapacitated every day.

Senator DONNELL. That is in the United States?

Dr. LAWLESS. In the United States.

Senator DONNELL. Thank you.

Dr. LAWLESS. We are also confronted with the increased span of life now being enjoyed by the peoples of this country. In 1900 17 percent of the total population were 45 years or more; in 1940, 26.5 percent are over 45 years of age. The fact is that 85 percent of our chronically ill are over 35 years of age. Thus with the increasing span of life our responsibilities for their care also increase. The passage of the national health bill would provide a ready answer for this increasing responsibility.

WEAKNESSES OF VOLUNTARY PLANS

The opposition point of view:

The establishment of voluntary nonprofit prepayment plans for the costs of hospitalization and voluntary nonprofit prepayment plans for medical care. Senator DONNELL. May I interrupt? That does not seem to be a complete sentence, as I read it. Is that right?

Dr. LAWLESS. This?

Senator DONNELL. What you have quoted.

Dr. LAWLESS. I have only quoted a part of the sentence. That is that they are offering against this bill this idea.

Senator DONNELL. The thought I had difficulty getting was, what is the meaning of that sentence?

Dr. LAWLESS. That is the opposition point of view.

Senator DONNELL. And I also observe, immediately following what you have just read, that there appears in the typewritten copy which Rev. Mr. McPeek has furnished me, the words 'Against this." I would like to understand what the proposition is, and I cannot understand incomplete sentences.

Dr. LAWLESS. The American Medical Association is, of course, in favor of establishment of voluntary nonprofit prepayment plans. Senator DONNELL. I get your point. Thank you.

Dr. LAWLESS. Against this we offer these figures and facts:

Voluntary hospital care plans cover about 23,000,000 persons with only partial protection. Medical-care insurance covers only four to five millions.

Voluntary plans are lacking in forceful appeal to those most in need of them.

They appeal especially to the poorest risks and thereby present a cost item above the ability of the ones most in need to meet.

Neither do they fill the need of increased hospitals, laboratories and research facilities.

INADEQUATE LOCAL FACILITIES

The second opposition point:

The provisions of health and diagnostic centers and hospitals necessary to community needs is an essential of good medical care. Such facilities are preferably supplied by local agencies, including the community, church and trade agencies which have been responsible for the fine development of facilities for medical care in most American communities, up to this time.

May I present a picture of a community in a western State. The nearest civilian hospital 40 miles away is owned by a large mining concern, to serve its own health needs. They refuse service to many people on the grounds that space is not available and the medical staй too small, or that they lacked the necessary funds. They came to depend upon a nearby military hospital, which could only accept those who presented emergency problems, thus many waited too long and came too late. This could be magnified thousands of times.

THE ISSUE OF REGIMENTATION

The third opposition point is the regimentation of physicians. It is claimed by some that this regimentation of the medical profession will break the spirit of initiative of the profession. I ask you to consult the figures of the Army, which is the most highly regimented body in America, and they will reveal that a very high percentage of their medical personnel is applying for the opportunity to increase their knowledge of their chosen profession with more intensive graduate study.

ADVANTAGES OF THE NATIONAL HEALTH BILL, S. 1606

Doctor-patient relationship.-Facilitating the method of payment for medical care will improve, not hurt, this relationship. Citing a personal instance, I have at present a list of 14 cases of syphilis of the 85907-46-pt. 1- -29

brain whose span of productive living could be extended from 10 to 15 years. They are not receiving treatment due to lack of full facilities. Passage of the national health bill would provide for these.

Quality of medical care.-Not only will doctors and health services be more readily available to the public under S. 1606 than before, but the quality of medical care will be higher. Truly scientific care will t possible when patients have access to all facilities, institutional care. specialist care, laboratory procedures, et cetera.

Health education.-The majority of cases of venereal diseases, which could be reduced to insignificant proportions due to specific methods of treatment, was due to, among other factors, lack of proper heal. education. Such measures as proposed by S. 1606 will markedly reduce these diseases by increasing knowledge of the course and effect of diseases. This opinion reflects the experience of the venereal-disea control officers of the American Army.

Medical care for minority groups.-Compulsory health insura will help to make medical care equally available to all. The position of the minority groups, from a health point of view, is pathetic. Th wife of a minority group member who had given more than 30 years o his life as a public servant recently related to me her experience trying to have him admitted to St. Luke's Hospital on a spec service where the established rate was $80 per week. For him t demanded $1,500 per month.

Senator DONNELL. Doctor, by "minority group member," do yo mean a member of the Nego race?

Dr. LAWLESS. Negroes, Mexicans, Japanese, Chinese.
Senator DONNELL. I meant this particular person.

Dr. LAWLESS. That is a Negro. The next one will be a Japanese.
Senator DONNELL. Very well.

Dr. LAWLESS. A doctor made all arrangements to operate on a p tient in a well-known hospital, yet when she presented herself ad. -sion was refused. She was a member of a minority group.

Multiply these cases by 16,000,000 and you have a vivid picture of the plight of these minorities in more than 90 percent of Americ hospitals under today's plan for medical care.

The more recent advances in scientific medicine cannot reach th full advantages until all physicians are capable of applying then. practice. Under our present system, this opportunity is denied a lig segment of our medical personnel either because facilities for learn:: are not available, or if they do exist, they are denied them, for examp medical schools, medical societies, hospitals, hospital staff meeting clinics.

Tuskegee Institute and the National Tuberculosis Association and some of its State chapters have instituted annual postgraduate cour in an attempt to fill in the gap. Though the attempt is laudible, t results are highly disproportionate to the full needs. S. 1606 provič opportunities for graduate medical education by providing financ assistance to instutions of learning.

HEALTH IS A GOVERNMENT RESPONSIBILITY

The health of its nationals is a Government responsibility. W the physical and moral fibers of a people disintegrate it is reflected

the central government. Therefore, we urge a single responsible agency, the National Public Health Service, as the agency authorized to administer this service aided by members of the professional groups-doctors, nurses, dentists, and representatives of the recipients of these services.

I am testifying in behalf of the Church whose particular interest is not political or even economic, except secondarily, but which is primarily concerned with the alleviation of human suffering. In our extensive experience in educational fields we have observed the intense suffering of masses of people in certain sections of the Nation from neglected illnesses. The communities in which these people live show an utter lack of concern for the miseries of their fellow mankind. They are apparently unaware of the simple fact of the tremendous economic loss involved or the failure of a significant potential contribution to American life. It is the duty of the central Federal Government to arouse, stimulate, and even goad these backward localities to provide the opportunities to acquire and maintain good health and the full American expectancy of life. This is the birthright of every citizen.

Senator DONNELL. Doctor, have you examined with what you consider reasonable care the specific provisions of S. 1606?

Dr. LAWLESS. The epitome edition of it, as we find in the National Health Act, 1945, Senate committee, No. 2.

Senator DONNELL. I am not familiar with that publication.

Dr. LAWLESS. That is printed for the use of the Committee on Education and Labor, United States Government Printing Office, Washington, 1945.

Senator DONNELL. Would you mind letting me see that just a moment, sir. [Witness hands document to Senator Donnell.] This relates to the National Health Act of 1945. I see. Now, Doctor, have you studied the question as to whether or not there is any limitation in S. 1606 upon the number of patients whom a doctor may receive in communities in which the per capita plan of payment is adopted? Dr. LAWLESS. I think the Surgeon General's office has been given the right to limit that number to about 500. I think that is the figure. Senator DONNELL. Is there anything in S. 1606 that mentions the number?

Dr. LAWLESS. There is something there about his ability to control the patients and the amount of the pay.

Senator DONNELL. Are you referring to subdivision (j) of section 205, or does the epitome to which you refer go into detail?

Reverend MCPEEK. The publication states the objectives.

Senator DONNELL. I see. Doctor, are you familiar with the digest of the bill to which Mr. McPeek referred?

Dr. LAWLESS. Which digest was that?

Senator DONNELL. I do not know.

Reverend MCPEEK. I believe that he is not.

Senator DONNELL. You do not think you are familiar with that digest?

Dr. LAWLESS. I am familiar with this digest and the digest as given by Senator Wagner.

Senator DONNELL. I see. You have been practicing medicine in Chicago for a number of years?

Dr. LAWLESS. Twenty-three.

Senator DONNELL. Twenty-three years. And you have studied at the University of Kansas and Talladega and European schools of medicine.

Dr. LAWLESS. That is right.

Senator DONNELL. What schools of medicine?

Dr. LAWLESS. The University of Paris, the University of Vienna, and the University of Freiburg, in southern Germany.

Senator DONNELL. And you have specialized in these two specialties, dermatology and syphilology?

Dr. LAWLESS. That is right.

Senator DONNELL. Is there anything further you have to present, Doctor, that you think would be of value at this time?

Dr. LAWLESS. No; we made no attempt to bring figures, because from the reports I read you had all the needed figures. We wanted to emphasize that our position is a humanitarian position and that this bill would provide what the American people have been lacking, especially when we read these reports of 26.4 percent of the young fellows between 18 and 35 who have been returned because of deficiency in education, 24 percent for venereal disease, 17 percent for mental deficiency. There must be something wrong with the medical care of an American young person. We think that this bill may provide an answer for it.

Senator DONNELL. Reverend Mr. McPeek, is there anything further you would like to say?

Rev. Mr. McPEEK. I would like to reiterate what I did say, that our approval is given in principle. I do not believe we attribute anything to the particular formulation of the law. However, as Dr. Lawless has said, we have studied the principles of it, and we support ther entirely.

We wish again to make it clear we are speaking for a limited group of the members of our churches.

Senator DONNELL. Yes, sir. Unless you gentlemen have something else to offer, I thank you very much indeed for your courtesy in coing before the Committee.

The next witness is Dr. Joseph P. Anderson.

STATEMENT OF JOSEPH P. ANDERSON, EXECUTIVE SECRETARY AMERICAN ASSOCIATION OF SOCIAL WORKERS

Senator DONNELL. Dr. Anderson, for the record will you pleidentify yourself as to the capacity in which you appear here, and a to your previous experience, and educational background along t line that we are considering.

Mr. ANDERSON. My name is Joseph P. Anderson. I am the exe tive secretary of the American Association of Social Workers.

First as to myself. I was a practicing social worker for sore: years working in private and also public agencies in settlement ho in council for social agencies, as Director of the Emergency Rel»! Administration for two counties in Pennsylvania. I also worked! the housing authority in Pittsburgh, and with the veterans' ho in Washington, and then took my present job in May of 1943.