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EXHIBIT 15

THE UNIVERSITY OF ROCHESTER,

STRONG MEMORIAL HOSPITAL,

Rochester, N. Y., June 20, 1946. Senator CLAUDE PEPPER, Chairman, Subcommittee on Wartime Health and Education,

United States Senate, Washington, D. C. DEAR SENATOR PEPPER: I am appreciative of the opportunity to express my views on the maternal and child-welfare bill, 1318, which has been drafted for the purpose of improving the health and welfare of the children and mothers of this country. I am entirely in sympathy with your objective and approve of the general purpose of the bill.

As I see it, the bill is designed to encourage the individual States, through watching grants and outright allotments, to develop new, or expand existing, maternal and child-health and welfare services. The system of allotments will undoubtedly increase the volume and raise the standards of care in the poorer States. In addition, the shifting of a substantial portion of the cost of existing programs from State and local revenues to general Federal revenues will tend to increase the quantity of service in the wealthier States, even though they will bear a proportionately greater share of the total cost than they now do.

The most important and controversial part of the bill is the provision relating to eligibility for service under titles I and II. It is not clear whether the car. ticipating States are to be permitted, required, or forbidden to apply a means test. If a means test is to be permissive or required, this bill should be classified as a general public-health and welfare measure and the question of any change in the present economic scheme of medical care should not enter into the discussion. In my opinion, the application of a means test should be permissive with the individual States, thus permitting experimentation and the development of local programs in accordance with local wishes. In any event, this point should be made entirely clear by amending the language of S. 1318.

The adequacy of the amounts appropriated depends upon the employment of a means test. If such test is to be forbidden, or if it is to be permissive with the States, the appropriation would seem to be insufficient.

The benefits of title I seem so comprehensive that it is questionable whether title II is needed, since the benefits of the latter are or could be included in title I. Under titles I and II only 10 percent of the available funds are to be allotted on a matching basis. Although the desirability of increasing the quality and quantity of care in the poorer States is appreciated, it would seem that relatively more money should be allotted on a matching basis, and that specific limits should be placed on the amount any one State may receive as an outright allotment.

Although the Chief of the Children's Bureau is required to consult a conference of State officials, and an advisory committee which he names, before formulating general policies, he has a free hand in making policies and rules and regulations. I believe it would be better if there were some separation of powers, and if a more independent status were accorded the Federal advisory committees. This might be accomplished by having a board appointed by the Secretary of Labor (or Federal Security Administrator, as the case may be) which would have the power of enacting rules and regulations consistent with law, upon the request of the Chief of the Children's Bureau.

The adoption of S. 1318 would at once present an administrative problem of great magnitude, further complicated by the fact that many States would be found to have insufficient numbers of physicians, dentists, and nurses to meet the demands for service. It is suggested that a reasonable approach to this vast problem would be to cover initially a smaller segment of the population--perhaps children under 8 years of age, who make up about 10 percent of the population. When a satisfactory administrative system had been worked out on this modest scale, the age limit could be progressively raised as warranted by available personnel and facilities. Yours very truly,

BASIL C. MACLEAN, M. D.

EXHIBIT 16

THE MEDICAL SOCIETY OF THE STATE OF PENNSYLVANIA,
COMMITTEE ON PUBLIC HEALTH LEGISLATION,

Pittsburgh 22, Pa., June 18, 1946.
Hon. JOSEPH F. GUFFEY,
Senate Office Building,

Washington, D. C. DEAR SIR: It has come to our notice that there will be a hearing before the Senate Committee on Education and Labor on Saturday, June 22, on S. 1318, maternal and child-welfare bill, of which you are a cosponsor.

The house of delegates of the Medical Society of the State of Pennsylvania last October passed a resolution opposing this bill for the following reasons:

1. This bill is unnecessary because these services could be provided for through the original Social Security Act plus its amendments and supplements, publichealth-service law, and appropriation bills, also by the Wagner-Murray. Dingell bills, S. 1050, S. 1606, and S. 2143.

2. We can see no reason for providing services by the Federal Government for those plenty able to pay for themselves.

3. This bill is too comprehensive because it will take care of all the mothers and children up to 18 years of age in the United States through Federal tax funds.

We, therefore, suggest that this bill be held in committee until hearings are complete on all the bills which have medical-care and health provisions in them, and then assemble the testimony and try to evolve something more practical and more along the lines of a democratic form of government. Sincerely yours,

C. L. PALMER, Chairman.

EXHIBIT 17

[Telegram]

FORT WORTH, TEX., June 19, 1946. Hon. JAMES E. MURRAY, Chairman, Committee on Education and Labor,

United States Senate, Washington, D. C. The State Medical Association of Texas with a membership of 4,764 physicians will appreciate your courtesy in making this part of the official record in the forthcoming hearing on Senate bill 1318. Through action of its house of delegates the State Medical Association of Texas has officially gone on record as opposing this bill. We opposed the so-called Pepper bill for the following reasons : The bill seeks to place a great percentage of the physicians in the United States and in Texas under the control of a Federal bureau in Washington. Doctors, so far as child and maternal care are concerned, would be regimented and the relationship between physician and patient disrupted by Federal intervention. Children are designated as persons under 21 years of age, which we think is absurd since this exceeds the military age. According to the provisions of this bill any mother and child may submit to Federal medicine regardless of their financial circumstances. Many mothers will wish to employ their own physicians and pay for medical care. There should be local rather than Federal determination of need. We believe that every community should see that its indigent sick are afforded full and free medical care. The proposed bill calls for tremendous and indefinite Federal taxation. We believe it is contrary to the public welfare, and definitely and dangerously detrimental to public health. By direction of President C. C. Cody.

STATE MEDICAL ASSOCIATION OF TEXAS,
HOLMAN TAYLOR, Secretary.

EXHIBIT 18

UTAH STATE MEDICAL ASSOCIATION,

Salt Lake City 1, Utah, June 17, 1946. Hon. Senator CLAUDE PEPPER,

Senate Office Building, Washington, D. C. DEAR SENATOR PEPPER : At the meeting of the house of delegates of the Utah State Medical Association subsequent to the announcement of the Pepper bin 1318 last fall and in discussions of the bill by the members of the council of the Utah State Medical Association, they have voted to oppose this legislation.

We have always been opposed to this type of legislation. We feel that it is a definite step by Government bureaus to interfere between the doctor and his patient. We can see no reason why this type of legislation should be enacted any more so than that of Senate bill 1606, to which we are also opposed. Yours very truly,

Ray T. WOOLSEY, M. D., President.

EXHIBIT 19

CHARLOTTE 2, N. C., June 21, 1946. Hon. CLAUDE PEPPER,

United States Senate, Washington, D. C. DEAR SENATOR PEPPER: This is to advise that I have carefully studied proposed bill 1318 and voted approval of it in conference at a recent meeting of the National Committee on Children and Youth. Further, as a practicing orthopedic surgeon in the State of North Carolina with 10 years' field experience in State-wide operation of the social-security program for crippled children I do personally approve the proposed measure. Benefits to be expected from this new general welfare act seem to me to be a wholesome enlargement and expansion of a program already proved to be of untold value to the people, as so constructively administered by the Children's Bureau through individual State agencies.

My own feeling is that the unselfish people of the United States desire that the benefits of such legislation be made available to those who deserve and need the character of services proposed in the act. With kind personal regards, I am Sincerely yours,

O. L. MILLER, M. D.

EXHIBIT 20

WASHINGTON SPASTIC CHILDREN'S SOCIETY,

Seattle 11, Wash., June 22, 1946. Senator CLAUDE PEPPER,

Senate Office Building, Washington, D. C. DEAR SENATOR PEPPER: I have your telegram dated June 17, 1946, and I hope that this letter will reach you by June 26, as you asked.

Mr. Boyack, our State president, asked me to write the statement, as I am chairman of the publicity committee for our State-wide program.

The Washington Spastic Children's Society was organized in Seattle in April 1945, and we completed our organization on a State-wide basis on May 25, 1946.

Our State officers are

President.—Mr. M. W. Boyack, Seattle, in the insurance business, and the father of a spastic child.

Vice president.--Mr. F. L. Graybill, Spokane, legal adviser of the farm credit bank, also the father of a spastic child.

Secretary.Mrs. Phyllis M. Corrison, Seattle, secretary to the president of a labor union, and mother of a spastic.

Treasurer.-Mr. Helmer Kastner, Seattle, purchasing department, Boeing Aircraft Co.

а

Board of Trustees.—Three-year term : H. J. Wyckoff, M. D., outstanding ortho pedic physician and surgeon, our chief medical advisor; Harold Faulkner, Wenatchee, physiotherapist; Atley 0. Nelson, Jr., Seattle, inspection department, Boeing Aircraft Co., himself a spastic. Two-year term: Mr. W. A. Heath, Tacoma, superintendent of Tacoma General Hospital; Mr. William C. Quick, Yakima, United States Army buying officer, also the father of a spastic child ; Mrs. Rachel A. Collings, Bremerton, head of physiotherapy department at Roosevelt Hospital, Bremerton. One-year term : Miss Evelyne Hayes, Wenatchee, businesswoman; Mrs. H. Whittenbecher, Spokane, housewife and the mother of a spastic; Mr. Clarence Rogers, Walla Walla, principal of a grade school, and the father of a spastic.

The Washington Spastic Children's Society is incorporated as a nonprofit corporation in the State of Washington.

The preceding paragraph indicates that we have tried to get well-rounded State-wide groups to represent the individuals in the State of Washington who are afflicted with cerebral palsy (a more correct term than spastic paralysis).

The main project of the society in the coming year will be the drive for legislation to establish an educational program for spastics in the State of Washington. We hope to get this bill through the 1947 session of the legislature.

There has not been a complete survey of the extent of the spastic problem in the State of Washington, but from what has been found in other States there should be from 2,000 to 2,500 spastics in Washington.

We know that at least 70 percent of spastics are capable of being educated. The educational program of the spastic is costly, however, because he must have a coordinated program-physiotherapy, academic education, and speech training.

After reading your bill, S. 1318, it would seem that Federal funds might be available to aid a State program if it were passed. The fact the Federal funds would be available might encourage the various States to enact legislation to promote child-welfare programs.

In closing I should like to state that my personal experiences show how necessary it is that spastics receive an education. I have the advantages of a college education, and I have met several spastics who would be as well off as I am, if they had had the opportunities that I have had.

When we consider the training program for spastics, we find that we receive best results when we start with the preschool-age child.

I am enclosing a few newspaper editorials and articles from the Seattle papers.
Thank you for your interest in our program.
Sincerely,

ATLEY 0. NELSON, Jr.

SPASTIO PARALYSIS VICTIMS

(By Atley 0. Nelson, Jr., Director, Washington Spastic Children's Society)

A year ago this month the Washington Spastic Children's Society was started in Seattle. On May 25 it will hold its first State-wide convention at the New Washington Hotel.

During its year of existence the society has organized local units in Spokane, Everett, Bremerton, Aberdeen, Yakima, and Vancouver. It has already done much to bring about the time when those afflicted with cerebral palsy (more commonly known as spastic paralysis) can receive the training and education that will enable them to take their places in the world.

Perhaps I am more conscious of the absolute need of help for these people, because I am a spastic myself. It happens that I have been able to overcome my handicap to a large extent.

As I consider my past experiences it becomes clear that it was the intelligent decisions of my mother as to what was best for me that contributed most to the improvement in my condition during childhood.

During most of my younger years no one understood what was wrong with me, and most people believed I should be content to live a “rocking chair" existence. But not my mother.

Until I was 15 years old we lived in Boulder, Colo. Boulder is located so you can be right in the mountains after a 15- or 20-minute walk. From early spring until late summer our family spent much time in the mountains. I was allowed to climb over the rocks and get around as best I could.

A large part of my boyhood was spent on my uncle's farm and I was allowed to do anything I wanted to in the way of roughing it. I was expected to do as much for myself as I could. There were many tasks, such as gathering eggs, that I had as my chores. I feel it was this rugged life in the mountains and on the farm that did a lot to teach me to control my muscles.

I was not allowed to go to school until I was 9 years old. Even then the public schools would not take me. However, by this time I had become so demanding in my desire to go to school that my mother had to do something. After some persuasion the sister superior of a private Catholic school consented to take me on a 2-month trial. The result was, I attended that school through the sixth grade (in 5 years).

Then my family moved to Aberdeen, Wash. My mother decided I was ready to attend public school. She took me to see Mr. Everett Shimmin, principal of the Aberdeen Junior High School. He encouraged me to enter as a regular student, and I completed my high-school education in Aberdeen public schools. Then I attended the Grays Harbor Junior College for 2 years before entering the University of Colorado, where I received my bachelor-of-arts degree with a major in zoology in 1939.

Since my graduation from colle I have been quite successful in many ways. For 2 years I was employed by the State department of fisheries as a research biologist. I left my State job to take a position with the Boeing Aircraft Co. in the inspection department. I have been at Boeing's for almost 4 years.

Whatever success I have had I feel I owe a great deal to the many people who have given me a chance to prove what I could do. The first job I had was in a furniture store while I was still in high school. The fact that there was a man who had enough faith that I could be a successful errand boy will always remain one of my pleasant memories.

During my second year at the Grays Harbor Junior College I had charge of the college book store, and I made more money for the store than anyone in previous years. I shall always be grateful to Dr. Lewis Tidball, who was the dean of the junior college, for that opportunity.

While it is true I have been able to overcome most of my handicaps, I am sure much of my improvement would have come sooner, and perhaps it would have been complete, if the present methods of treating cerebral palsy had been known when I was a child. I refer to the kind of treatment given in the class now being conducted in the Warren Avenue School.

It is known cerebral palsy is caused by an injury to the area of the brain that controls motor-muscular activity. The condition may be very slight or it may affect all the muscle groups of the body.

It has been found a coordinated program of physiotherapy, academic education, and speech training is the most efficient method of treating persons thus afflicted. It has also been found this method of treatment is most effective when started with preschool-age children.

It has been my pleasure to be active in the program of the Washington Spastic Children's Society for 8 months. One of the society's main projects is to work for State legislation that will set up the necessary schools for the estimated 2,000 to 2,500 children afflicted with cerebral palsy in this State.

Education of these children should be our first consideration because it is known at least 70 percent have normal to above-normal intelligence.

In our program of public education on this subject it is most important to stress the intelligence of spastics. Because of the difficulty spastics have in expressing themselves, they are often mistaken for feeble-minded individuals.

In recent months I have come to know a number of persons afflicted with cerebral palsy. Many are about my own age (32). If they had had the many advantages and opportunities that I have had, they would be as well off as I am. I intend to do all I can to help the spastic children now growing up to be given the same chance that I was.

AiD FOR SPASTICS AN URGENT NEED

(From the Seattle Post-Intelligencer, Saturday, May 25, 1946)

Few causes are worthier of public support than that of the Washington Spastic Children's Society, which is holding its first annual convention in Seattle today.

This is an organization made up largely of parents of children afflicted with cerebral palsy, more popularly known as spastic paralysis—a condition caused

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