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seminated. We have prepared a pamphlet giving all the known knowledge as to multiple sclerosis and how to possibly diagnose it and present it to all the physicians we could in the country. I think that we distributed somewhere between 30,000 and 40,000 copies free to the medical profession.

The CHAIRMAN. Can that be made available to the committee?
Mr. OWEN. I will be pleased to make it all available to the committee.

We have concentrated on research, and the 31 research projects are either completed or under way in such institutions as Harvard, Columbia Neurological Center, Boston University, Miami University, and all over the country.

The amount of money that we have raised and how we have spent it for salaries and so forth are in my statement.

We believe that there are about 250,000 people in the United States, as near as we can estimate, who are afflicted with the disease. That really means 250,000 families that are under the crippling and disabling effects of this disease because very shortly the patient becomes so that practically all the members of the family have to look after the patient.

One of our great troubles is there are no hospitals to take care of these people. By and large, most of the hospitals will refuse to take the patient. They cannot do anything for him. After they get him in they cannot get him out. He is apt to become just a permanent resident there as a load on a hospital that already cannot meet operating expenses for its regular patients.

There are very few hospitals that take chronic diseases. In New York we will say there are about two, and just recently we had a very tragic case of a woman who had a boy who was a cripple. She wanted to get him in a hospital. She found a hospital in Brooklyn and found out that they had a waiting list for 5 years, and in Peoria, N. Y., where they will take such cases, they had a waiting list for 21/2 years. She had to take care of her son and herself. That is not a unique case. It is quite a common thing.

On the question of the economic burden arising from this situation, of course it is very difficult to say. When you have a disabled boy in that age group, not only is he no longer a working member of society, but his family are not able to do the work that they were able to do before. He is a burden on doctors. He is a burden on food. He is a burden on transportation. He is a burden on the whole body of society. He is a burden on his friends because they give a lot of thought and care to him. The figures must be very large, and much larger, I think, per patient, than any other known type of disease because this being a progressive chronic disease, you have somebody for 30 or 40 years that is just a burden on himself, his friends, his family, and society in general.

Mr. WILLIAMS. Is there any pain connected with it?
Mr. Owen. Not very much.

Dr. TRAEGER. In the last stages, yes, considerable pain; not in the early stages.

Mr. Owen. Here is the thing that got me interested in this. The daughter of one of my clients had the disease badly. She got to where her knees were pulled up into her stomach and her heels into her buttocks and there was considerable pain or soreness from that. She could not lie in bed in a comfortable position on account of that and had to be operated on so her legs could be straightened out so she could lie in bed flat.

I have seen several cases where the poor person was absolutely flat on the back, could not turn right or left, could not move an arm, and was not only in psychological pain but considerable physical pain as the result of that situation.

I mentioned what we have done in the way of education. I mentioned what we have done in the way of research. It is totally inadequate. I think Dr. Traeger mentioned this morning what could be done in the way of research if we had the funds available for it.

A query: Does the creation of the National Institute of Neurological Diseases and Blindness and the appropriations for it in any way diminish private effort? Answer: Absolutely no; it only increases it. The efforts of this society and all of its organizations that go

ahead and in a voluntary way try to find results have been multiplied, and our program for research, for aid, our program in every way contemplates our going ahead with all the speed we can.

Of course, we are confronted, as all these other agencies are, with the impact of the income tax on our private citizens and the great difficulty of raising money. Our particular agency is confronted with another difficulty that does not confront heart or cancer, and that is, they were first in the field and have captured the popular imagination, and we coming along at a later date find it more difficult raise money from people who have their interests devoted to these other-and properly devoted—to these other diseases.

Mr. Heselton raised a question this morning: Where does the money come from? If this body will bear with me a minute, I would like to talk about taxes. What I have to say is not in any way political, critical, or anything.

Fundamentally, of course, an income tax is a consumption tax. I theoretically, am a taxpayer because I have apparently a substantial gross income, and I am the conduit of relief from which money flows from some source into the Federal Treasury. I am not really the taxpayer.

The consumer of goods is the taxpayer. The fellow that buys a loaf of bread, he pays the tax of the fellow that sells him that loaf across the counter; he pays the tax of getting that loaf of bread over that counter; he pays the tax of the baking company and all the employees that baked the bread; he pays the tax for getting the flour to the baking company; he pays all the taxes all the way back to the farm because, unless he pays that tax and those fellows get reimbursed for their tax, they would not have enough left out of their income to live on. The taxpayer is the consumer. The income tax is a consumption tax. Now, the consumer, by and large, is just the average man. The man that drives a taxicab here is a consumer, and relative to his income against mine—and theoretically I am a taxpayer, but I am just a conduit-he consumes in bread and clothing and ordinary consumable things much more than I really, although my income may be several times his. So what? My point is that when that fund comes to the Federal Government out of the consumption by the average man of his food and his clothing and his shelter, and after the expenses of Government and other things are taken care of, you have a trust fund. That comes out of what that fellow could do in the way of taking care of his own health. What shall you do with that trust fund? Here I have come to something that is in reality a deep thought with me, and I want to say with a lot of my friends and associates I would rather spend that trust fund in taking care of these thousands and millions of our own people than I would in spending it all over the world in driblets in taking care of others that we do not know about. I would say that if you solved the problem of multiple sclerosis in the United States, you would be solving it for millions of people afflicted with multiple sclerosis all over the world. The disease is very prevalent in Europe.

You may not only solve multiple sclerosis; you may solve a lot of other kindred neurological diseases. Neurologists with the eminence of Dr. Bailey here pronounce multiple sclerosis as the outstanding neurological problem known to science today. You solve it and you may solve a lot of other things. That, in my judgment, is far more important in the world than anything else. It is of more importance to them, as well as to us, than to fritter our money away in a lot of foreign projects. That is not a criticism of anybody's foreign aid. It is my fundamental belief that we should take this money that comes out of this consumer and devote it to these neurological diseases.

Gentlemen, I thank you. The CHAIRMAN. I am very much interested in just what you said. You have indicated some thoughts somewhat similar to mine. It may be for the reason your thoughts and mine are running alike that I appreciate more what you said than otherwise would be the case.

There are some who are fearful that when you speak in the terms you have used here today you are approaching so-called socialized medicine. I am not one of those who scares so easily by merely raising the claim that any good you try to do is socialization. I have a very strong feeling there is an obligation on the part of the Government to be helpful to the people. This National Institute we have here set up for the purpose of studying these diseases is all part of the plans, as I interpret your remarks, and certainly no one charges that with being socialized medicine because it is something the Government is doing. I do detect, however, in the way you presented it, there might be some who would think of it in those terms, even though some of us might not think they would be justified in so doing.

Mr. Owen. Let us look things in the face and not at any time be scared by the bugaboo of aid. I do not think anybody could have grown up in a more conservative life than I or be more naturally hostile to Government taking over anything. I am very hostile. Î have been a Republican all my life. I would vote for the devil if he were a Republican; nevertheless, most of my partners are Democrats and they are all wonderful fellows and have as much patriotism and desire to do good for the country as anyone, so this is not Democrats or Republicans.

The CHAIRMAN. You say that many of your friends are Democrats! Mr. Owen. I say that a great many of my partners are.

The CHAIRMAN. I assume you speak of Wendell Willkie, who at one time was a Democrat.

Mr. Owen. At one time. He saw a little light of day, anyway.

There are realms of activity, such as the Neurological Institute, that are beyond the capacity of the ordinary individual, acting as an individual, or through his local organization, to cope with. In the first place, he cannot raise the money. He does not have the capacity to take it out of the private citizen who is rather indifferent to the problem. He does not see it. The average citizen does not see the problem that you gentlemen are seeing today. He is interested, as I am, in going to the ball game or having a ride on Sunday. He does not see the problem.. It requires expenditures, and so forth, on a much larger scale than can be relied upon from private citizens.

Now, we were in that realm in the investigation of nuclear fission and the atomic bomb. It never could have been done by private industry. It might have been done 50 or 100 years from now. It would require that the Government step in and take hold of the problem. I think some of these problems of public health have to be approached on that level.

Now, whether that goes to the question of giving every citizen his own medical care, that goes to a totally different thing. I know that medical care is getting to be so expensive, proper medical care, for the average man that very frequently he just cannot get it. Neither can he nor his friends. Nevertheless, he should have it. That is a totally different problem than the one that we are confronted with here.

The attack on these diseases, cerebral palsy, polio, cancer, heart disease, multiple sclerosis, must be by the Government as something affecting the entire body of citizens and the entire economy to supplement what we in our small way and with our best efforts can do in our voluntary organizations.

Mr. HELLER. As I understand it, therefore, you are advocating a plan of Government subsidy; is that correct?

Mr. Owen. I do not care whether you call it a subsidy or not. I am advocating the Government putting money in a neurological institute, and putting it into other institutes affecting other diseases where a great body of intelligent men can attack a national problem. We cannot raise enough money privately to do it.

Mr. HELLER. I agree with you.

The chairman mentioned that perhaps that might be called socialized medicine. As far as you are concerned, you do not care what name you call it?

Mr. OWEN. I do not care about the name.

Mr. HELLER. Suppose the argument is advanced that it is socialized medicine, would your position still be the same?

Mr. Owen. I would say get away from the name. They are all afraid of names. Get away from the name.

I will give you an example. Take roads. Roads originally were all privately built. They charged tolls for them. Well, after a while they discovered that the free movement of people, free transportation of people, was such an important social benefit to all of us that roads became a public thing and everybody could move over them without charge. Well, that is a very simple illustration. There are a lot of things that are of such importance to the entire social body and cannot be taken care of by private enterprise that, as a great cooperative society, we must take care of them through the Government.

Mr. HELLER. Is it your statement, Mr. Owen, that there are hardly any cures for the diseases we are discussing and that that is particularly true of the one to which you are addressing yourself?

Mr. OWEN. No cure.

Mr. HELLER. And do you say these diseases cannot be successfully attacked privately; that the Government must come in to spend the money to do the job; is that your testimony?

Mr. Owen. That is my testimony. We cannot raise enough money privately to handle this problem. We do the best we can, but we cannot raise enough money privately, and it is of such national importance that it must be tackled on a national scale.

Mr. HELLER. Yes.

Mr. Owen. I say you can attack it, because the money that the Government would put on it is the income tax that comes out of the fellow who buys a loaf of bread. It does not come out of me.

Mr. HELLER. And you doctors and you fine people here today would not care what you called it; socialism or socialized medicine or anything else? You say, "Give us the money to help us find cures for these diseases."

Mr. Owen. That is right. I don't know what they would say. I do not care. I do not think Dr. Bailey cares.

Mr. HELLER. I assume they take the same position.

May I ask a question of one of the doctors on the panel: Mr. Owen made the statement that the doctors fail to recognize the disease he just discussed and yet he very clearly and succinctly mentions the symptoms, enumerating double vision, staggering, tremors, weakness, bladder trouble, et cetera. What I cannot understand is that if you know the symptoms and you are able to analyze them so carefully and minutely, why can you not understand the problem and get at it and diagnose it?

Dr. TRAEGER. That is a good question and Mr. Owen suggested that that is true of the average doctor. It is not true of the average doctor alone; it is true of a good neurologist. The difficulty lies in the fact that these symptoms do not appear all at once.

You may have only one symptom. The patient may wake up one morning and be staggering a little bit. He might go to an orthopedic doctor. Or he may have trouble with his eyes and go to an eye doctor. Or he may have trouble with his bladder. I'wo or three days later that will clear up. Maybe 4 or 5 months later another symptom will come along.

The entire symptom picture, as you are familiar with it in pneumonia or polio, does not come at once. You may have one single symptom, and that may drag on for a long time.

Mr. HELLER. It is very progressive?

Dr. TRAEGER. It is very progressive, slow, variable, and goes up and down.

Mr. HELLER. It is alive and then dormant, and it takes a period of time! Is that your answer?

Dr. TRAEGER. That is right. There are some persons with multiple sclerosis who are really crippled and in 6 months are perfectly normal. Then there is nothing the matter, and then they get it again. The next time it is worse, and it goes on and on and on.

Mr. HELLER. In other words, if it is an injury to the brain, let us say, you can, as a result of the cells being killed, have a patient suffer a paralysis which may take 10 years before you recognize it as paralysis; is that what you mean?

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