which I take it is the Social Security Act and the provisions of sections 207 and 208 of such Act shall be applicable this title in the same manner and to the same extent as they are applicab to title II of the Social Security Act, as amended with the provision here about the certification of payments and assignments of moneys. Subdivision (f) of section 205 of the Social Security Act, which I have before me, reads as follows, on page 14: No person so subpenaed or ordered shall be excused from attending and testifying or from producing books, records, correspondence, documents, or other evidence on the ground that the testimony or evidence required of him my tend to incriminate him or subject him to a penalty or forfeiture; but no persc shall be prosecuted or subjected to any penalty or forfeiture for, or on account of, any transaction, matter, or thing concerning which he is compelled, after having claimed his privilege against self-incrimination, to testify or produce evidence, except that such person so testifying shall not be exempt from prosec tion and punishment for perjury committed in so testifying. Doctor, I understand from this section (f) that I have read to you: that is, 205 (f) of the Social Security Act, that a person coming I a proceeding there cannot be excused from testifying on the grout i that the testimony or evidence required of him may tend to incrim nate him. I understand also that subdivision (b) of section 207 of S. 16. that the provisions of this subdivision (f) that I have read from the Social Security Act, are applicable to S. 1606. The point I am getting at is this, and I would like to have your judgment on this, do you understand that in view of those facts it wou be possible for a practitioner to be brought in before this appeal body. set up by the Surgeon General, not a court, but some appeal body, ar: could be required to testify we will say, on a matter involving SOLL: criminal offense, like abortion, if I may mention that, and that the practitioner would be compelled to testify under the terms of the two sections read together, the only right that he would have woul be that in testifying he would be able to claim his privilege agains self-incrimination; in other words, his testimony could not be us. against him in a criminal proceeding, but could be required to divul all of those facts involving crime, and my question is, do you so understand the application of those two sections, one to the other? Dr. GETTING. Well, Senator, first of all, I would like to explain the: I am a physician and not a lawyer, and I have found, in all instance where there is cross-reference between one act or another, that eve on going to the attorney general's office for an opinion-that is t State attorney general-I have not always been able to obtain a f: mal opinion which he could assure me would stand in court. And in the past, when we have been subpenaed and required · bring certain testimony into court, we have been instructed that wh we can be subpenaed and we may have to bring those records into cou we are not obliged to divulge them to a lawer of either party, exc.: upon the express order of the judge, in which case we have to. I think that in all fairness I would have to say that, in my opini this matter of privileged information, as to how it shall be handle. is not clear in my mind and it would have to be clarified before th became a law if we were to effectively administer it. Senator DONNELL. I have not given it very great amount of thought myself, but the point, I think, is one that is of high importance, and certainly should be considered. As I understand it, just very briefly to recapitulate, the Surgeon General can set up these appeal bodies. I do not recall any particular qualifications that are required by way of legal knowledge on the part of the appeal bodies. And the provisions of 205 (f) of the Social Security Act seem to be incorporated by reference in S. 1606, which, I think, would justify, at least tentatively, the inference that a physician coming before this appeal body could be required to testify to anything that they might ask about, subject only to the protection that what he said could not be used against him in a criminal proceeding. I submit that not as any dogmatic or final statement, but as a point that I think should be considered very carefully. And I judge from your response you think that study should be given to it, too, before the measure should be enacted into law. Am I correct? Dr. GETTING. Yes, sir. I would even go further than that. In my opinion, and that of the association, the delegation of authority to the Surgeon General of hearing appeals, or to his representatives, on matters of this type is in error. Senator DONNELL. I may say, Doctor, if I may interrupt, in fairness to the draftsman of the act, it is provided that such powers and duties; that is to say, of the Surgeon General, are subject to the limitations and rights of judicial review, contained in section 205 of the Social Security Act, but he does have the right, as I have indicated, to establish what the act terms necessary and sufficient appeal bodies, just as I have indicated. Dr. GETTING. The reason I say they are in error is this: That the Surgeon General should not be responsible for the operation of this program except on a national level. On a local level it should be under the jurisdiction of either a local department of health or State department of health. Then the State department of health, over the local department of health, should be the appeal body. And they should not be in the form of quasi-judicial hearings, but in the form of fair review, with appeal to the courts. A hearing, in the language of some of the State laws, means a quasi-judicial procedure with crossexamination and with all of the prerogatives of a formal quasi-judicial hearing. They are extremely time consuming. They would be an administrative block in that it would increase the cost of administration. And all you really want is to make sure that either the physician or the hospital or the patient has a fair review of his case. Then if counsel, on the part of the plaintiff, feels that he has not had a fair review, he can appeal to the court. If the State administers it, it will be the State court; if it is federally administered, it would be the Federal court. Senator DONNELL. I think I should add, in fairness, that while there are no qualifications that I now observe which are required of these appeal bodies or their members, there are two provisos in section 207 which I had not observed and which I think should be incorporated in the record, namely, Provided, That with respect to any complaint or dispute involving matters or questions of professional practice or conduct the hearing body shall contain competent and disinterested professional representation: Provided further, That with respect to any complaint or dispute involving only matters or questions of professional practice or conduct the hearing body shall consist exclusively of such professional persons. There are those two provisos, and to that extent my statement about the absence of any provision for qualifications is in error and should be modified. I think that is all I want to ask, and I thank you very much, sir. The CHAIRMAN. I thank you, Doctor. Your recommendations and views as expressed here will, of course, be given very careful study. Dr. GETTING. May I state that either I or any officers or members of the association would be glad to be of any assistance to the committee at any time in any matters dealing with this type of legi-lation. Senator DONNELL. Your letterhead just gives Boston, Mass., as your address. Is there any further address? Dr. GETTING. Care of the State Hospital. The CHAIRMAN. Thank you, Doctor. These views that you have expressed here are the views of your organization? Dr. GETTING. That is correct. The CHAIRMAN. And do you approve of every recommendation tl. 1: you have made here personally? Dr. GETTING. Personally, I do, because the way this statement was made, letters were sent out to all of the States, and their criticism was then compiled by me personally, and the matter of the statement was then summarized and the complete meeting of the association passed upon it. The CHAIRMAN. Thank you again, Doctor. This will conclude the meeting today. We will meet tomorrow morning at 10 o'clock. (Thereupon, at 3:35 p. m., Thursday, April 18, 1946, the committee recessed to reconvene Friday, April 19, 1946, at 10 a. m.) NATIONAL HEALTH PROGRAM FRIDAY, APRIL 19, 1946 UNITED STATES SENATE, COMMITTEE ON EDUCATION AND LABOR, Washington, D. C. The committee met at 10 a. m., pursuant to adjournment, the Honorable James E. Murray (chairman) presiding. Present: Senators Murray, Aiken, and Donnell. The CHAIRMAN. The committee will come to order, please. Yesterday we had on the witness stand Dr. Low, representing the Association of American Physicians and Surgeons. I wish, in connection with his testimony, to insert in the record some literature from that organization, in which the organization states its position. In this literature we find the following statement: The Association of American Physicians and Surgeons is an organization of physicians who contract and agree not to participate in systems of State medicine; therefore, when a majority of the physicians of the Nation become members of the AAPS, systems of State medicine cannot be operated. The best available legal advice concurs with the validity and legality of the actions proposed by this line of reasoning. Opinions of the legal counsel of the association have been made available to attorneys of medical organizations throughout the Nation, and there have been no disagreements with the first objective of the AAPS to so organize ethical physicians that they may determine and enforce the conditions under which they will or will not give their services. (The document referred to is as follows:) Now, DOCTOR, IT'S YOUR MOVE! BUT YOU MUST ACT QUICKLY! Thursday, May 24, 1945, was "S. R. Day" (start of regimentation) for American system of the private practice of medicine. On that day Senator Wagner, (New York) and Representative Dingell (Michigan) introduced their new, modified social-security bill, which includes compulsory health insurance; and which, regardless of "fancy" wording, if passed by Congress, will destroy the freedom of American medicine. There is one way that you can guarantee your right to the private practice of medicine and stop bureaucratic encroachments on your profession: Join the Association of American Physicians and Surgeons and thereby contract and agree with your colleagues throughout the Nation that you will not participate in schemes of political medicine. Systems of regimented medicine cannot operate without the participation of a substantial majority of physicians. When a majority have joined A. A. P. S., as it now appears they will, there can be no bureaucratic control of American medicine. It's your move, doctor! The forces of political medicine have made another move-an entering wedge into the future of the medical profession. Not until a majority of physicians have enrolled under the banner of AAPS will they be safe from further, deeper inroads into their professional security. It isn't too late, if you act now! An application blank will be found on the back of this folder. Sign it today! Mail it today! Add your strength to the thousands and thousands of physicians throughout the Nation who have determined to remain free. ASSOCIATION OF AMERICAN PHYSICIANS AND SURGEONS. H. W. DETRICK, M. D., Secretary. Turn to pages 2 and 3 for an analysis and interpretation of some of the regi menting features of the new Wagner-Murray-Dingell bill. Also you will find the answers to any questions you may have regarding the Association of American Physcians and Surgeons. This folder is being sent to all eligible physicians including members of AAPS, for their information. AAPS IS NOT A UNION The AAPS is not a "union," as the term is ordinarily understood today. A labor union employs the strike to gain its objectives, whereas members of the AAPS are "employed" by their patients, against whom they will never "strike" The AAPS is not an organization to deal with the present employers of its members. On the contrary, it is strongly organized to protect its members from the uninvited intrusion of a usurping, would-be employer-a State or Federal burea Physicians need no union under the present American system of medical prac tice; the AAPS is established to protect and preserve that system as against a system of political medicine under which practitioners would need a union, as State and Federal employees. Act today in the interests of your priceless American heritage of freedom for yourself and your patients. Sign this application-mail it today. AAPS permanent headquarters are now located at 11 South La Salle Street Chicago 3, Ill. I agree to abide by the articles of incorporation, by-laws, and lawful orders and rulings of the Association of American Physicians and Surgeons, Inc. I further agree that my membership shall ipso facto terminate if and when I violate any lawful rule, regulation, or by-law of this Association. Except for members of the armed forces, interns and students, dues ($1000 annually) must accompany application. HERE ARE FACTS OF THE NEW WAGNER-MURRAY-DINGELL BILL It proposes this (TITLE 2-NATIONAL SOCIAL INSURANCE SYSTEM) Introduced into Congress May 24, 1945 The bill provides for the Surgeon General, under the supervision of the Federal Security Administrator, to administer the act, after "consultation” with Advisory Council. The 16 members of the Council are appointed by the Surgeon General with the approval of the Federal Security Administrator. Membership of the Council "shall include medical and other professional rep resentatives and public representatives in such proportions as are likely to |