pelled to come under this system the freedom of the practitioner to participate or not is academic as there is nothing else he can do except not to practice. This country has been made great by men willing to sacrifice security for liberty. Let us not reverse this action. This statement contains pages 1 and 2, and are both signed by me. EDWARD H. MCLEAN. Subscribed and sworn to before me this 16th day of April 1946. [SEAL] My commission expires March 18, 1950. ANNE M. WISE, Notary public for Oregon. APRIL 5, 1946. Senator JAMES E. MURRAY, United States Senate Office Building, Washington, D. C. DEAR SENATOR MURRAY: May I add my voice to the many who must be com mending you for your efforts to enact a workable national health service program. Up to December 1944 it never occurred to me that medical costs can be so high and out of reach of even the so-called better-paid white-collar workers. It was then that my wife became paralyzed from an unknown cause and steadily grew worse. At enormous expense, we did everything possible to get her well again Unfortunately, all our efforts did not produce the desired result. Today, lacking access to the necessary places of treatment only because there just isn't enough money to handle this prolonged situation, she is without the attention she deserves ! and is apparently doomed to spend what time remains for her in pain and discomfort and despair. It is most shameful that so rich a nation, so bountifully endowed with the i good things of life, should neglect even the least of its citizens in so inhuman a way. We denounced the Japs and the Nazis for failure to provide adequate medical treatment to our soldiers in captivity. Shall we continue to look away while those we hold responsible for the health of our Nation fail to furnish modera facilities and implements of health except for a price few of us can afford? The fear and doubt and utter loneliness that grip this family of four today in the shadow of the Nation's capitol, the fading hope in little children that they will yet see their mother whole again-these things are a grave reflection on the democracy and humanity of a democratic nation. May your good fight succeed. Very truly yours, WASHINGTON 11, D. C. BERNARD PLATT. Senator ROBERT F. WAGNER, Washington, D. C. NEW YORK 28, N. Y., April 12, 1946. DEAR SENATOR WAGNER: As a physician practicing in New York City. I wish to let you know that I am unconditionally in favor of the national health bil (S. 1006) which you are so efficiently sponsoring. Despite the statements of the representatives of some medical associations, I know that the majority of the American physicians are ready to back the us tional health bill. With respectuous regards, I am, Sincerely yours, HECTOR J. RITEY, M. D. STATEMENT OF SAMUEL RUBIN, PRESIDENT OF FABERGÉ, INC., NEW YORK, PREPAKED FOR THE SENATE EDUCATIONAL AND LABOR COMMITTEE, ON THE NATIONAL HEALTE ACT, APRIL 10, 1946 Business has for a number of years tacitly recognized the need for health insurance for workers. Most such industrial health insurance plans have been installed to cut operating losses due to absenteeism and low levels of produ tivity resulting from sickness. As a businessman, I believe that all busines stands to profit from the passage of national health insurance legislation. According to the Department of Commerce, the annual cost of absenteeism due to sickness reaches something over $4,000,000,000 a year-an amount which represents a serious loss to the national economy. More specifically, it represents debits in the ledger of every businessman―a proportionate reduction in . profit. In man-days of sickness, the loss is about 500,000,000 each year-enough to produce a sizable number of the refrigerators, radios, and houses we are impatiently waiting for. Though many industries have adopted health insurance plans of their own, the extent of coverage has not been sufficient to make much of a dent in the losses reported by the Department of Commerce. As a matter of fact, the President of the United States recently pointed out that "Only about 3 or 4 percent of our population now have insurance providing comprehensive medical care." If health coverage were greater, business losses due to illness would unquestionably decline. Though industry has recognized the need for health insurance in its own plans, the plans themselves fall far short of the "comprehensive medical care" advocated by the President. I have been informed by officials of the underwriting company that the health insurance plan adopted by my firm is one of the most comprehensive in all industry. It is certainly true that our plan possesses many unique features. Specifically, we have tackled the problem of doctor's billsboth for home and office calls-by providing reimbursement after the first two visits. We include substantial benefits for dependents. We provide life insurance for all employees, including total disability payments. We pay for extensive hospitalization up to 70 days. And we include part-time employees in the benefits of the plan. In addition, we think preventive medicine is so important that we are now establishing a system of periodic check-ups which will give the employee the benefit of the best medical attention. Preventive medicine results in a higher on-the-job rate, and a higher level of production. We know now that we will catch our anemic and fatigued workers in advance, and give them a chance to build up to normal. A healthy worker is a good worker. Finally, our plan is entirely paid for by the firm-there are no deductions from employees' wages. We feel that such an arrangement is worth our outlay many times over, in increased working efficiency and general morale. May I say, parenthetically, that our plan was worked up with the full cooperation with the union in our industry-the United Gas, Coke and Chemical Workers of America (CIO). I cite the health insurance plan adopted by my firm as evidence merely because it is considered one of the most advanced in the country. Yet this plan falls short of the highly desirable benefits provided by the Wagner-MurrayDingell bill. A brief comparison shows that only the national health plan would provide adequate medical service as long as needed, for any illness. Only the national plan would fully encourage early medical care during illness and the receipt of preventive service. Only the national plan would fully take care of specialists' fees. Only the national plan would provide adequate dental care, and home nursing. And finally, only the national plan would take care of dependents in a comprehensive way. So, in essence, industrial health plans may be considered only a first step toward the kind of coverage business would find most desirable. In my opinion, health insurance is not properly a business obligation; it should be a Government obligation, like the postal system or social security. Unfortunately, many industries have been unable to provide any health coverage whatever for employees. Most industrial health plans have been set up by large corporations. Small and independent businesses, by and large, have been in no position to afford health insurance programs. This means that the great majority of American workers have been left out in the cold. Hence small business in particular bas a great deal to gain from the national health program. All businessmen will find that the National Health Act is good business for American business. In my judgment, business profits directly reflects the degree of personal security attained by workers. Fear of high medical bills makes poor customers. For a long time, family breadwinners have recognized the importance of life insurance. Industry has recognized the importance of health insurance for company work. ers. National health insurance, sponsored by the Federal Government, is long overdue for every American. A nation is as wealthy as its people are healthy. MICHELE SARTORI, M. D., D. D. S., DEAR SENATOR: In spite of all the screams of some of the members of my profes sion and the pressure brought upon other members to protest the Wagner-Murray bill, I have full confidence that the bill will pass, for it is good for the people and that is what counts most. I am devotedly, M. SARTORI MARCH 25, 1946. Hon SHERIDAN DOWNEY, United States Senator, Washington, D. C. I can't say that I approve of the mechanics of the Wagner-Murray bill (S. 1606), but I do approve of its intent. There is no valid reason why 150,000 doctors should dictate to 150,000,000 people the solution of a social problem. In order for you to arrive at a decision, you must divide the question into its two component parts: 1, social; 2, medical. The social problems of the people are ably administered by the Congress who has the necessary information as to the needs of all the people. The problem of the methods of treatment and prevention of human ills is the responsibility of the medical profession and should not be subject to governmenta dictation. The argument put forth by organized medicine that the people would get inferior medical care under compulsory health insurance is rather an admitted indictment of the medical profession for it has long been an accepted fact that the doctor gives his medical service to rich and poor alike. ness. Free enterprise in medicine does not mean the same thing that it does in busiFree enterprise to the doctor means enough minimum security so that br has opportunity to advance in the science of medicine and carry out its ideals and i not be compelled to evaluate a patient on the basis of his wealth rather than his illness. The high cost of medical care is a handicap to the patient and the doctor because the diagnosis and treatment are handicapped by the patient's inability to pay. This health bill does not set a precedent in the field of medicine. We already: have State and National laws governing sanitation, public health, and workmen's compensation. I am sure no one will question their social value to the people nor the quality of the service rendered by doctors in these branches of medicine. In fact, the greatest advances in medicine have been deveoped in these Government agencies. ARTHUR H. SCHWARTZ, M. D. Copies sent to Senator Robert Wagner and Senator Murray. : NEW YORK, N. Y., March 7, 1946. Hon. ROBERT F. WAGNER, United States Senate, Washington, D. C. DEAR SIR: I wish to express my support for the health bill which was initiated by you in the Senate, commonly known as the Wagner-Murray-Dingell bill Respectfully yours, S. SCHWARZ, D. D. S. ART CRAFT JEWELERS, Providence 4, R. I. COMMITTEE ON EDUCATION AND LABOR, United States Senate, Washington, D. C. GENTLEMEN: Millions of our young men were physically unfit for military service, because and only because, they never received the medical care they could and should in a genuine democracy. Many millions more of our men women, and children; in fact, a much larger percentage then of our men l military age, are in desperate need of medical care but never did and never wil get same because of price and price alone, which is denied them in the richest country in the world. Let's stop fooling ourselves with beautiful phrases like democracy, free enterprise, rugged individualism, and institute real legislation such as S. 1606 and then, and then only, will we have real democracy, real enterprise, and real rugged individualists, and what's more important a real healthy and happy American family. I could cite a million reasons why this bill, S. 1606, should not pass, just like Hitler cited a million reasons why nazism is superior to democracy (real), but we know now what nazism brought to the world, and our enemies to this vital health bill, S. 1606, with their million reasons against it are endangering the health of our people no less than Hitler endangered the very lives of his people, with his beautiful phrases. S. 1606 can mean only one thing-a better health standard for all our people. We drafted millions of our young men against their will to give their lives for a miserable pay to save our skins-and in the name of democracy, we can ask the medical profession, also, to devote their lives (not give) to save our health, for the highest pay of any profession, and also in the name of democracy. Yours for a better health, HERMAN H. SOHN. NEW YORK 28, N. Y., April 8, 1946. Hon. JAMES E. MURRAY, The Senate, Washington, D. C. SIR: I am one of those who believe deeply and sincerely that the WagnerMurray-Dingell health insurance bill is an imperative safeguard for the American people. As the wife of a physician and as a social worker I have had occasion to observe the lack of opportunity most people have to obtain really adequate mèdical care. It is a farce to speak of widespread and adequate medical care for the vast majority of people under existing circumstances. For the poor even in large cities, the hospital clinics are inimical to real human dignity. For the lower middle class group medical care is prohibitive or is secured through actual sacrifice of other necessities. It is my humble belief that every American has a basic right to not only a livelihood but to an opportunity for the best medical care and education our democracy can afford. Incidentally, my husband is a well recognized psychiatrist with a substantial income. Both of us are heartily in favor of the bill. Respectfully yours, MRS. LUBA (LOUSS) WENDER. Dear SENATOR MURRAY: This is a confidential letter written for the purpose of seeking information on the proposed Wagner-Murray-Dingell bill on compulsory national health insurance and also to express some opinions of my own. I hope that this letter, at least the name of its writer, will be held confidential. I am a doctor, am in the Army, am a member of the American Medical Association. It is too bad that I should feel that I haven't freedom of speech in the United States of America, but in writing to a Senator on a political issue seems to be a privilege reserved only for civilians. Or is it? Personally, I would like a copy of the proposed legislation on national health insurance. In fact, I think much could be accomplished by mailing copies of the bill to every doctor in civilian life and in the Army. If these letters also enclosed a letter of information to all doctors explaining the bill, I am sure that if the bill is an honest attempt to bring good medical care to every person in the United States of America without destroying individual enterprise among doctors, without destroying initiative and the stimulus of competition, and without lowering but, instead, raising standards of medical practice, then I am sure that a large majority of the doctors would favorably endorse and urge such legislation. It might interest you to know how the majority of doctors feel, at least those with whom I have come in contact, about the American Medical Association. We feel that the A. M. A. does not represent the opinions of American doctors. We are of the opinion that the A. M. A. is controlled by a politcal minority; but, as individuals, we are unable to do much about it. We are disappointed that the A. M. A. neglected to take advantage of its golden opportunity to propose a plan for the improved medical care and health of the American people but instead seems to be encouraging "individual enterprise" for certain insurance com panies with their high cost, uncomprehensive hospitalization, and médical care plans. We are aghast at the cheap, untrue propaganda being distributed by the National Physicians Committee for the Extension of Medical Service to confuse the public and the doctors too. We feel that the day has arrived when the word "charity" should be struck out of our national medical affairs. It is time that all Americans can face the future without fear of costly illness and the fear of the humiliation of accepting charity. We are disgusted with the management of countless organizations subscribing donations for the treatment, prevention, and for research of various diseases, organizations where most of the money goes for administrative purposes. An article in McCall's Magazine and reprinted in Reader's Digest for April 1946 by Albert Maisel entitled "Urgently Needed-A National Health Fund" illustrates what I mean. It might interest you to know that many doctors able to think clearly and not poisoned by concepts of "political medicine" want national health insurance to succeed. However, we doctors are asking questions. We have had enough regimentation in the Army to last us a lifetime. We don't want more of the same in civilian life. With your permission, I want to ask some questions and make some suggestions: 1. Will the appointments of the Federal Security Administrator and the Surgeon General of the Public Health Service be political appointments and leave office at each change of administration? To remove the possible taint of political control over national health and the medical profession, I suggest that appointments to these important posts must be ratified by a two-thirds vote of the United States Senate and that their appointments be for. 6 years, impeachment for inefficiency accomplished by a simple majority vote. 2. Will lesser workers in the administrative department of this health itsurance department be selected under civil-service requirements? 3. Will seriously ill people be able to get immediate care from their physicians or will they have to go through hours of "red tape" before care is authorized? 4. What provisions will be made to pay a doctor his fees and still retain case histories, examinations, diagnosis, and treatment rendered as confidential records of the doctor or the hospital not open to public scrutiny? How will this private and secret doctor-to-patient relationship be maintained and still prevent dis honesty and cheating by both doctors and their friends to fatten a doctors income? 5. Will the amount of treatment any one person can have in a year be limited? 6. Will the Government pay the entire bill for a patient or will the patient be classified according to his income tax and be required to pay a certain per centage of his bill based on his income bracket? To me the latter part of the above question is a feasible answer to prever! dishonesty and to prevent daily social visits to the doctor's office. 7. Will the doctor be restricted as to the number of patients he can see in a day or the number of operations he can do in a month? This question was raised in National Physicians Committee propaganda. If so, what will be done in epidemics, severe catastrophies, etc., when doctors to save lives may work 48 to 72 hours without sleep? Or what will happen f communities with insufficient numbers of doctors? 8. Will patient's have freedom of choice of doctors and hospitals? 9. Will only hospitals approved by the A. M. A. (or the Government) be acceptable? 10. Will hospitals not up to standard be put on the black list? 11. Can a doctor refuse to take a patient he does not care to treat? 12. Will rates of fees for services rendered be fixed to the extent that if a doctor exceeds this charge, he is subject to punishment under law, or will h rates that the Government will pay be fixed for any certain type of work, b if the doctor wants to give extra service and a patient is willing to pay mo for superior, more experienced and better care, then such arrangements cent be made without being labeled "black market" or unlawful? 13. Will fee rates be made flexible so as to vary with the changing purch ing value of the dollar or be fixed regardless of inflation, deflation, the laws of supply and demand? 14. Will "bonuses" or "gifts" so prevalent in today's black market racks be condoned? If not, how can they be prevented? |