For the veteran, such a plan would mean— I. Full medical and hospital services for himself The GI laws go only part of the way. They entitle the veteran to complete medical care for service-conconnected injuries or disabilities. They are far from adequate when it comes to non-service-connected illnesses, injuries, and disabilities. For these the veteran can get service-if he goes to one of the Veterans' Facilities (sometimes a distance of 100 miles or more); if there is a bed available; if he cannot afford to pay for care elsewhere. S. 1606 would fill in the gaps. It provides: services of the family doctor; specialist's services, laboratory services, special medicines, and appliances; hospital care up to 60 days (120 days if funds permit); dental services; and home-nursing services. (Note: The last two may be limited at the outset because of the shortage of dentists and nurses.) II. Free choice as to where, when, for what, and from whom he will get needed services Where? At the veterans' facility, if he prefers it and can get there or In his home town-at home, at the doctor's office, at a local outpatient clinic, or in a local or nearby hospital. When? He can call a doctor when he thinks he needs one. For what? For whatever ails him, no matter whether the illness is serviceconnected or not. From whom? From a doctor (general practitioner) of his own choice, and specialists if he needs them. III. Full medical and hospital care for his family All services listed above as available to the veteran, under S. 1606, are also available to each member of his family-his wife and children, and if they are dependent on him, to his parents as well. IV. Preference in the educational and training program proposed in S. 1606. Because there is a shortage of trained personnel in medical and allied fields, S. 1606 calls for grants-in-aid to educational institutions for postgraduate work in medicine or dentistry, and for training personnel for jobs in administration of personal health services, disability benefits, rehabilitation service, and related fields. The bill specifies that in such programs preference and priority shall be given to projects to aid servicemen get these types of special training. WHAT THE NATIONAL HEALTH ACT WOULD MEAN TO FARMERS The National Health Act (S. 1606, H. R. 4730) would provide: Prepaid personal health benefits for all members of the family, including doctors' services; hospitalization, up to $7 per day; laboratory and clinical fees; special appliances (such as eyeglasses); dental care; and home-nursing care. Adequate community-wide public-health services. Health services for the needy. Special health services for maternal and child care. Funds for expanded medical research and education. Health at least as good as that of city people There was a time-before the development of modern health services in the cities-when the country was the healthiest place to live. But the glowing pictures of healthy rural life no longer jibe with cold facts. Deaths of mothers in childbirth: One-third higher in rural areas than in large cities. Deaths of babies in their first year: One-fourth higher. Preventable deaths from diseases such as typhoid and diphtheria: Regularly higher in rural districts. Rejection rates for World War II: 53 out of every 100 farm boys rejected, as against 43 out of 100 in general. Under the National Health Act, farm areas could catch up and keep up with modern progress in health and medical science. Medical care at the time it is needed Too many farm families must wait with that trip to the doctor until after the crops have been sold and there's enough cash to pay the doctor. Dread of debt keeps countless farm families from seeking early medical care. Under the National Health Act, nothing would stand in the way of timely and complete care at the time sickness strikes. Family doctors within reach-even specialists The faithful country doctor is a familiar part of farm life. But there are far too few of them. One doctor for every widely scattered 1,700 persons in rural counties. The cities offer physicians more adequate incomes, more elaborate facilities. Under the National Health Act, good incomes for farm doctors and specialists would be provided through the insurance fund. Better hospitals would also be provided. Doctors would thus be attracted back to rural areas. Hospitals and public centers for farm families. Two out of every five counties lack satisfactory hospitals. Even more are without public-health services. There are fewer clinics, and equipment is poorer. Legislation providing for Federal aid for hospital construction is now before Congress. But passage of this legislation will assist in construction only, not in maintenance of hospitals. Scores of farm areas will be unable to build new hospitals unless the National Health Act-which would assure sufficient income to meet maintenance expenses-is also enacted. WHAT THE NATIONAL HEALTH ACT WOULD MEAN TO BUSINESSMEN Passage of the National Health Act (S. 1606, H. R. 4730) would put into effect most of the national health program recommended by President Truman. It provides for prepaid personal health insurance, as a part of the social-security system. Persons in business for themselves, as well as other workers, and their families, could get medical, hospital, and other services from the doctor or other practitioner or from the hospital of their choice, and have the bills paid from insurance funds. The National Health Act leaves open the question as to how the costs of healthinsurance benefits are divided among workers, employers, and the Government, all of whom already spend money for medical care. The total costs of the insurance benefits are estimated at about 3 percent of earnings, up to $3,600 a year, at the beginning; they might be as much as 4 percent later. Congress will, no doubt, want to hear from the public how these costs should be met. For businessmen, such a plan would mean I. Health protection for businessmen and their families The health services provided to insured persons include: All needed care from a family doctor; specialist's services; laboratory services, special medicines, and appliances; hospital care up to 60 days in a year (120 days if funds permit); dental and home-nursing services (somewhat limited at outset because of possible shortage of dentists and nurses). II. Lower business costs A national health-insurance program will give all business firms the advantages of a health program for their workers. Contributions employers make to the health insurance fund will be offset by reduction in their business costs. Factory health programs have lowered costs of production appreciably but the cost of these programs, if operated by individual firms, places small business at a serious disadvantage. (a) Decreased labor turn-over and absenteeism.-Absenteeism is highest among workers in poor health. One day's illness costs the employer an esti mated one and one-half times the amount of the sick worker's daily wage. Approximately 500,000,000 man-days are lost each year due to illness. Factory health programs have lowered absenteeism and labor turn-over. (b) Higher productivity.-Workers with poor health are less productive than workers in good health. Health insurance means prompter and more adequate care and therefore better health. Also, workers who do not worry about medical care for their families are better workmen. (c) Decreased workmen's compensation premiums.-Experience indicates that healthy workers have fewer industrial accidents and less industrial disease. Industrial accidents in factories with health programs have been reduced, on the average, by more than 40 percent. Workmen's compensation premiums, over a period of time, would become lower as the rate of industrial accidents declined. III. Increased prosperity for the community and for business Better health and less time lost due to illness will increase productivity and family incomes. Families may spend more of their incomes for current needs when their medical bills are paid by the insurance funds and they need not keep reserves against illness. Small businessmen in particular will gain from such increased consumer demand; all businessmen will gain from the increased economic stability and prosperity of the community. WHAT THE NATIONAL HEALTH ACT WOULD MEAN FOR MATERNAL AND CHILD CARE Passage of the National Health Act (S. 1606, H. R. 4730) would put into effect most of the national health program called for by President Truman. It includes a plan of prepaid personal health insurance, as a part of the social-security system; it also strengthens the community-wide public health and maternal and child health programs. The health of mothers and children would be protected and improved, under the bill, through— I. Adequate medical care and personal health services The health services provided to insured persons include: All needed care from a family doctor; specialist's services, including services of obstetricians and pediatricians; hospital care up to 60 days (120 days if funds permit); laboratory services, special medicines, and appliances (such as eyeglasses); dental and home-nursing services-which, however, may be limited at the outset because of the shortage of dentists and nurses. Children whose fathers or mothers work in gainful employment and women whose husbands are in gainful employment (except railroad and Government employment) will be insured and entitled to these health services. Other children and mothers may become insured and entitled to these health services if premiums are paid on their behalf by a public agency, such as a State public assistance agency or a State agency administering a maternal and child-health program. II. Special maternity and child-health services Federal financial aid is made available to the States for community-wide maternal and child-health programs, including: Well-baby clinics and demonstration projects; health education; services to locate crippled or physically handicapped children; special health services not provided under the health insurance system-such as long-continued hospital or institutional care and training; provision of needed medical care for mothers and children who are not insured, as workers or dependents of workers-either by paying insurance premiums on their behalf, or otherwise; training of personnel for State and local maternal and child-health work. The amount of Federal financial aid would depend on the relative wealth of the State, with more Federal aid given to the poorer States, which now generally have the highest rates of maternal and infant deaths and of poor health among children. III. Other measures to improve the health of the community Federal financial aid is made available to the States for adequate community-wide public health services, including sanitation, control of communicable diseases, preventive health services-all of which would benefit mothers and children as well as the rest of the community. Federal financial aid is made available to the States for medical care for needy persons-State public assistance agencies could provide medical care for needy mothers and children who are not insured, as workers or dependents of workers either by paying insurance premiums on their behalf, or otherwise. Research on the causes, prevention and treatment of disease would be encouraged and aided through grants from the health insurance fund. The CHAIRMAN. Congressman Dingell, do you have a statement that you would like to make? Mr. DINGELL. Yes, Mr. Chairman, I would like to make my state ment. The CHAIRMAN. You may proceed. STATEMENT OF HON. JOHN D. DINGELL, A REPRESENTATIVE IN CONGRESS FROM THE STATE OF MICHIGAN Mr. DINGELL. Mr. Chairman, I consider it a high honor to be associated with Senators Wagner and Murray in the sponsorship of such an important piece of legislation as the national health bill.'" I think it is customary for a witness to qualify himself before testifying on a bill. For many years I have been vitally interested in health legislation. As a member of the House Ways and Means Committee I helped to frame the public health and maternal and childhealth provisions in the original Social Security Act of 1935 and the amendments of 1939 which extended these provisions. I have followed closely the problems of medical benefits, occupational accidents and diseases under Federal and State workmen's accident compensation laws, both as a legislator and as a lifetime member of the International Typographical Union. OPPOSITION OF AMERICAN MEDICAL ASSOCIATION I want to confine my remarks today to the health-insurance provision-title II of the bill-pending before this committee because that is the part I presume you are going to hear most about during these hearings. That is the part against which the American Medical Association and its satellite organization-the National Physicians Committee has been shooting at right along; laying down a deadly barrage of baseless propaganda for the sole purpose of creating fear and confusion among the American people. The object of this campaign is to perpetuate a system which is as selfish as it is deficient if it is not altogether outmoded. The American Medical Association- Senator SMITH. I just want to register an objection to an attack upon the opponents of the bill as being wrongly motivated at this point. I am not objecting to the bill at the moment, but I do not like to start off with damning your enemies. I want to hear a constructive presentation of what is here and not what others may think about it. Mr. DINGELL. May I be permitted to ask the question whether I, as a Member of the House, must come here and have a Senator purge my statement? That is my opinion, whether I am right or wrong. The CHAIRMAN. The Senator has concluded his objection. Senator SMITH. I did not intend to hurt the witness' feelings. Mr. DINGELL. Mr. Chairman, I submit that my opinions as contained in my statement are not subject to censorship by Senator Smith, whether he agrees with my views or not. As a Member of the House of Representatives, I will not be subjected to the purging of my expressions. The statement will appear in the committee hearings unexpurgated or not at all. I am not insistent that the Senator agree with me. These statements, however, are my views. Am I privileged to go ahead and make my statement? Mr. DINGELL. The American Medical Association and the National Physicians Committee have attacked the health insurance provisions of the bill as "socialized medicine," "state medicine,” and “political medicine." In my opinion, those who peddle such nonsense are either woefully ignorant or inexcusably rigid in their stand-pat attitude. I say this because anyone who studies the bill carefully, section by section, and line by line, will find that these charges are not true. For instance, section 205 (a) and (b) specifically provides for free choice of doctor by the patient and free choice by the doctor as to whether he wishes to enter into the system full time, part time, for 10 patients, 1 patient or not at all. Is this state medicine? Of course not. Moreover, section 205 (g) of the bill specifically gives each doctor the right to choose the method by which he wishes to be paid for the services he renders. Is this political medicine? Of course not. Section 205 (i) guarantees that payments to the doctors shall be adequate and shall vary with skill, experience, and responsibility involved in furnishing service. Is not this fair and proper? Of course it is. These various sections as well as others in the bill are concrete answers to the many false charges that have been hurled against the bill. I want to warn members of the committee that the health-insurance features of this bill have been the subject of more willful misrepresentation and misinformation than any other piece of legislation I have ever seen presented in all my 13 years in Congress. The National Physicians Committee, formed specifically to preserve the A. M. A.'s tax-exempt status under the income-tax laws, is spending hundreds of thousands of dollars to circulate false statements to try to defeat the health-insurance provisions of the bill. It is collecting money under the false pretext that contributions to it "should be deductible" from income taxes by individuals who contribute. As a member of the House Ways and Means Committee responsible for drafting our tax laws, I believe that the National Physicians Committee's statement to this effect is deliberately misleading and any such deduction is a violation of existing law which should be investigated by the Treasury Department. The A. M. A. and the National Physicians Committee have the right to oppose this bill or any bill, to make its views known, and to spend as much money as they want to try to defeat this bill. But it should be clear that the American Medical Association in the field of medical economics does not come into the court of public opinion with clean hands. The American Medical Association's attempt to kill voluntary health insurance plans was finally stopped by the United States Supreme Court only after the A. M. A. was convicted of engaging in illegal activities in restraint of trade under the Sherman anti-trust law. The false information which the A. M. A. circulated against the British health-insurance system has been repudiated by the secretary |