Question. What about the last two proposals? Answer. The fourth step in the procedure, under the Wagner-Murray-Dingel bills would establish authority and the machinery for the Federal Governmes: to provide "prepaid personal health service benefits." Question. What is meant by "personal health service benefits"? Answer. The term "personal health service benefits" includes general medic benefits, special medical benefits, general dental benefits, special dental benefits home nursing benefits, laboratory benefits, and hospitalization benefits (es 214, p. 65). Question. For whom will these services be provided? Answer. For all Social Security beneficiaries and their dependents ( 201, p. 35). In addition to this, provision can be made for the inclusion other persons or groups not now covered under the provisions of the Socia Security Act (sec. 209, p. 55). Question. For how many people would such service be available? Answer. Approximately 110,000,000 people under existing laws-presumat; under the new proposal, 130,000,000 people. Question. How much would the providing of such services cost? Answer. President Truman, in his message, stated that the providing of the medical care outlined in his proposals would approximate 4 percent of wage The term "wages" means the income of both employed persons and self-employe individuals up to $3,600 per year (sec. 217, p. 72). On the basis of all previe estimates, this would approximate $4,000,000,000 annually. Question. How would such comprehensive services be made available? Answer. The bill states "The Surgeon General of the Public Health Servi shall perform the duty imposed upon him by this act under the supervision a...! direction of the Federal Security Administrator" (sec. 203, pp. 35 and 36) a "the Surgeon General is hereby authorized and directed to take all necessary and practical steps to arrange for the availability of benefits' (lines 10, 11, 1 p. 36). Question. Would the Surgeon General have full control of the expenditure of this $4,000,000,000 without outside interference? Answer. The Surgeon General, with the approval of the Federal Secur Administrator, is authorized and instructed to provide medical care, dental care laboratory care, nursing care, and hospitalization for all of these people Tie act reads: "The Surgeon General is hereby authorized and directed to take 1 necessary and practical steps to arrange for the availablity of the benefits" (sub. B. p 36). * *.* Question. Is the Surgeon General required to establish an Advisory Counc” Answer. Yes. The bills would establish a National Advisory Council. It would consist » the Surgeon General, as Chairman, and 16 members. The Surgeon Gener with the approval of the Federal Security Administrator, appoints the 16 m= bers (sec. 204, pp. 41 and 42). Question. What are the functions of the Advisory Council? Answer. The Advisory Council shall advise the Surgeon General (line 18. p. 47Question. What else is it authorized to do? Answer. The Advisory Council shall: (1) Hold at least two meetings each year (line 18, p. 42). (2) Receive compensation at a rate not to exceed $25 per day for time spent in attending meetings and time devoted to official business (line 5, p. 431. (3) Establish special advisory, technical, regional or local committees er commissions (subsec. C, p. 44). Question. What would be the functions of these committees appointed by the National Advisory Council? Answer. With reference to the functions of these committees, the act reads "to advise upon general or special questions," et cetera. Their function is r advise (line 21, p. 44). Question. Is the Surgeon General to appoint any other committees? Answer. Yes-The act reads: "Except with respect to States or local areas for which other arrangements have been made, the Surgeon General shall appodr local area committees to aid in the administration of this title” (line 12, p. In Question. What are the functions and authority of these local area 'mittees? Answer. They are given authority to do one thing-"make reports." The reads: "Such committees are hereby authorized to make annual and speci reports with recommendations, if any, to local area officers and to the Surgeon General through his State or regional officers" (lines 6, 7, and 8, p. 40). Question. What other authority has the Surgeon General? Answer. The Surgeon General, with the approval of and under the direction of the Federal Security Administrator has, among other responsibilities, authority to: (1) Hire doctors, specialists, dentists, nurses, laboratory technicians, and establish rates of pay (sec. C-pp. 36 and 37). (2) Establish fee schedules for physicians' and dentists' services (subsec. Gp. 48). (3) Fix the qualifications for specialists. The act reads: "Specialist or consultant services shall be those designated by the Surgeon General" (subsec. Cp. 45). (4) Determine the number of individuals for whom any doctor or dentist may provide service (subsec. J-p. 50). (5) Determine what hospitals or clinics may provide service for patients and under what conditions (subsec. B-p. 52). (6) Negotiate or renegotiate contracts or agreements with representatives of public agencies, nonprofit groups, and individuals, for the purpose of providing full medical benefits to all Social Security beneficiaries and their dependents (subsec. C-p. 36). (7) Make reports to Congress (line 16—p. 41). Question. Would such a system allow the patient free choice of physician? Answer. The patient would only have choice of a physician from those who agreed to work under the plan and on condition that the Surgeon General has not so limited that physician's practice as to preclude the acceptance of more patients. Question. Could such a system be introduced in the United States and still allow for physicians to maintain private practice? Answer. If all of the provisions of this proposed legislation were put into operation, the process would destroy the private practice of medicine in the United States. Question. Why do doctors so relentlessly and vigorously oppose these measures? Answer. Because in every instance where the Government has interfered in the distribution of medical care, it has resulted in: (1) A serious deterioration in the quality of medical care. (2) It has destroyed the initiative and the incentives of the individual doctor. (3) It has robbed the medical profession of its independence and its selfrespect. Question. What about medical education and medical research? Answer. "The Surgeon General is authorized and directed to administer grants-in-aid to nonprofit institutions and agencies engaging in research or undergraduate or postgraduate professional education" (sec. 213-p. 63). Question. How much money would be available for this purpose under the proposed legislation? Answer. For the year 1946-$10,000,000. For the calendar year 1947$15,000,000. For each calendar year thereafter, 2 percent of the amount expended for benefits under the proposed legislation. Question. How much would this 2 percent total? Answer. It is estimated that this 2 percent would approximate $80,000,000 annually. Question. Would the Surgeon General have full authority to expend or alloeate this research-educational fund? Answer. Yes. The Surgeon General is supposed to consult his advisory council. However, the advisory council has no authority. The act reads: "the Surgeon General is hereby authorized and directer to administer grants-inaid * *" (lines 23 and 24-p. 63). The Surgeon General would have authority to expend the sums regardless of the advice of the advisory council. Question. What would it cost a wage earner to secure medical service under such a plan? Answer. No provision for pay-roll tax deductions is made under the new bills. Question. Why was the bill introduced without some provision for a special tax to meet the cost? Answer. It has been stated on good authority that no provision was made for pay-roll tax deductions in order that the bill might be referred to the friendly Committee on Education and Labor in the Senate rather than the Finance Com mittee and to the friendly Interstate and Foreign Commerce Committee In the House rather than the Ways and Means Committee which must deal with all matters affecting taxation. Question. How will funds be collected to pay this cost? Answer. It is anticipated that the bill will be amended to provide for pay-roll deductions of wage earners and deductions from the income of the self-employed up to $3,600 per year. In his message President Truman stated, "a broad program of prepayment for medical care would need total amounts approximately equal to 4 percent of such earnings." Question. If the amendments provided for pay-roll deductions of 4 percent from the pay envelope of the employee, what would the service cost him each year? Answer. If the annual earnings were $1,000 the cost would be $40. If the annual earnings were $2,000, the cost would be $80. If the annual earnings were $3,000, the cost would be $120. If the annual earnings were $3,600, the cost would be $144. Question. If two or more people in the family were employed, would the de duction be made from the income of each one? Answer. Yes. If there are two workers earning approximately equal incomes, the cost would be doubled. If there were three workers earning approxmately equal incomes, the cost would be multiplied by three. Question. Actually, is this socialized medicine as it was defined by President Truman? Answer. Yes. In his message, President Truman said: "Socialized medicine means that all doctors work as employees of Government." The President's proposals anticipate: (1) The Federal Government collecting a vast fund out of the earnings of workers of between 3 and 4 billion dollars annually. (2) Placing the expenditure of this vast sum in the hands of one man, Surgeon General (under the direction of the Federal Security Administrator who under the provisions of the Wagner-Murray-Dingell bills is instructed provide medical, dental, nursing and laboratory care and hospitalization for al people. He would hire doctors and establish rates of pay, etc. (See p. 15 of this booklet.) Yes, this would be "socialized medicine" in its most vicious and dangerous form. CONCLUSIONS The cards are now "face up on the table." The final "showdown" on political medicine is at hand. For all practical purposes, Title II-Prepaid Personal Health Service In ance of the May 24, 1945 Wagner-Murray-Dingell bills (S. 1050-H. R. $230 and Title II-Prepaid Personal Health Service Benefits of the November 19, 1945 Wagner-Murray-Dingell bills (S. 1606-H. R. 4730) are identical in intent. These are classical documents. A careful study reveals a remarkable admixture of unimportant verbiage and softening phrases intended to divert attention; or to deceive, combined with terse, decisive cold steel directives. These directives, with the authority provided, would establish the Federa Security Administrator as a medical dictator in the United States. He world be clothed with the power and saddled with the responsibility to provide medical, dental, nursing, and laboratory care and hospitalization for every man, woman, and child in this country. The Surgeon General of the Public Health Services designated as his administrative officer. The enactment of the bills into law would destroy the private practice of medicine in the United States. Practically it would make all expectant mothers, all mothers and all children to the age of 21 wards of the "State." Enactment. would place the expenditure of more than $4,000,000,000 annually in the hands of one man-the Surgeon General of the Public Health Service with the approval of the Federal Security Administrator. It would entail the most vicious and dangerous aspects of socialized medicine, It is estimated that 300,000 bureaucrats would be necessary to administer system. It would establish machinery for the political distribution of medical care. The concept is strictly totalitarian. The mechanisms, if adopted and placed in operation, would establish a core of collectivist control under which freed of enterprise in any form could not long survive. President Truman has gives these proposals his blessing. An unusual crisis of great peril is at hand. Every person-worker, merchant, doctor, lawyer, businessman-who desires to keep the deadening hand of politics out of the sick room should protest. All of those really interested in preserving our American way of life should register definite and vigorous opposition with their Congressmen and Senators. Write to them-write or telegraph your protest-today. HEALTH SECURITY PROGRAM THE NATIONAL PHYSICIANS COMMITTEE FOR THE EXTENSION OF MEDICAL SERVICE The management committee has been instructed by the board of trustees to take all necessary steps designed to: (a) Encourage the medical profession to active participation in the development of plans and the more general use of existing facilities to provide for easy payment of insurance against unusual or prolonged illness; (b) Educate the people to the importance, nature and value of prepayment facilities (within the framework of principles approved by the medical profession), now available for meeting the costs of unusual illness; (c) Investigate conditions relating to and inform industry concerning the principles underlying sound participation with employees in prepayment plans for meeting the cost of unusual or prolonged illness and hospitalization; (d) Inform private insurance underwriters of the opportunity that is being offered through cooperation in Nation-wide efforts to provide group insurance policies for those needing or desiring insurance against the hazards of unusual illness; (e) Encourage the more generous use of Government funds administered at State and local levels to insure effective medical care for the indigent. (f) Eoncourage contributors and friends to a greater degree of participation in the efforts of the National Physicians Committee in this constructive program. The National Physicians Committee is utilizing to maxmum capacity its resources and organizational strength in ceaseless efforts to preserve in the United States our system of private enterprise to the end that: Doctors of medicine may retain, in the public interest, their personal independence their individual and collective integrity and effectiveness. Understanding of purpose is sought and cooperation is welcomed in the belief that joint efforts will result in the attainment of these objectives. NATIONAL PHYSICIANS' COMMITTEE FOR THE EXTENSION OF MEDICAL SERVICE A non political non profit organization devoted to 1. The task of securing the most widespread distribution of the most effective methods and equipment in medicine and surgery. 2. Familiarizing the public with the facts in connection with the values, the methods, and the achievements of American medicine. Maintained exclusively by voluntary contributions. Needing, for maximum effectiveness, the systematic organized support of all county and sectional medical societies, insurance underwriters, and interested units of business and industry. BOARD OF TRUSTEES Dr. Edward H. Cary, Chairman, Dallas. | Dr. Wingate M. Johnson, WinstonDr. William F. Braasch, Secretary, Rochester. Salem. Dr. Thomas A. McGoldrick, Brooklyn. Dr. George H. Coleman, Treasurer, Dr. Wm. R. Molony, Los Angeles. Dr. F. F. Borzell, Philadelphia. Dr. John H. Fitzgibbon, Portland. Dr. J. Milton Robb, Detroit. Dr. Edward H. Skinner, Kansas City. Dr. Leland S. McKittrick, Boston. health services through Federal aid; and Federal grants to States to provide medical care for the needy. The main bulk of the pamphlet is filled with an all-out attack on the b vital provision-the one establishing a national compulsory health insuran system giving virtually complete hospital and medical service, together with limited dental and nursing care, to all Americans who work for a living, and * their dependents. This is a fairly accurate statement. For the record, we want to mis it perfectly clear that the National Physicians' Committee for the Ex tension of Medical Service, at this time and at all times during r existence, has devoted its efforts toward extending better and better medical care to more and more people in the United States, and w vigorously work to achieve this better and better medical care for more and more people. The reasons for the National Physicians' Committee's approving the first three clauses of the Wagner-Murray-Dingell bill and opposi, a the compulsory health insurance provisions, are obvious and clear-cut ENDORSEMENT OF TITLE I Referring to part A of S. 1606, titled "Grants to States for Pub Health Service," page 1 of the bill, the medical profession and the pu lic, when it is explained, are in favor of steps to be taken to provi treatment and control of tuberculosis and venereal disease and extend ing the Public Health Services through grants-in-aid to States wit State control and local administrative authority. Part B of S. 1606, titled, "Grants to States for Maternal and Chil Health Services," page 13 of the bill; with minor amendments t section would become acceptable and would provide an effective mechanism for the achievement of very desirable objectives. PROPOSED AMENDMENTS TO TITLE I Over a long period of time, the medical profession has maintar that the activities of the Children's Bureau should be placed under :supervision of the Surgeon General of the Public Health Departm It is believed that this is not only a desirable but an almost nevessazi feature, leading to the coordination of various health activit throughout the United States. The second suggested change has to do with the centralizing of trat ing of health service personnel. It is not considered that this is a ciding factor. It is considered to be a desirable one, with the idea of imposing upon State agencies the responsibilities for training nat nal and child care personnel. The really vital and essential change can be accomplished by slight modification in subsection 8 of section 122, at the top of page 16. The paragraph should be altered to read as follows: Provide that as services and facilities are furnished under the plan, they be available to all mothers and all children in the State of locality who are able to pay for such services without hardship, and where such hardship is en firmed by the local unit of the State agency. It is obvious that such a change is fundamental. However, such s modification of section 8 would insure effective maternal and chile care for every mother and every child in this country. It would re |