Page images




New York 10, N. Y., June 20, 1946. Senator JAMES E. MURRAY, Chairman, Senate Education and Labor Committee,

Senate Office Building, Washington, D. C. DEAR SIR: The League of Women Shoppers testified on April 24 in support of the Wagner-Murray-Dingell bill (S. 1606). We still feel that the aims of S. 1318 will best be served by the passage of S. 1606. However, in the absence of a program of complete medical care, the league wishes to support S. 1318 and urges its passage insofar as it provides for adequate maternal and child care.

The League of Women Shoppers should like to see a provision made in S. 1318 for the publication of the opinions and reports of the advisory committees in order that the public may know what advice the State health agency has deemed practicable and what suggestions it has overridden.

The league assumes that a national health-insurance program will be established very soon and feels that provisions should be made to integrate the program established by this bill with the broad insurance program. Yours sincerely,


(Mrs. David Jacobs), Chairman, Health and Education Committee.



New York 22, N. Y., April 10, 1946. Senator CLAUDE PEPPER, Senate Committee on Education and Labor,

Senate Office Building, Washington, D. C. DEAB SENATOR PEPPER : The Women's City Club of New York, composed of outstanding leaders of the community and members of the various professions and fields of business has for years been deeply concerned about the inadequacies of the Nation's maternal and child-welfare services.

We believe the passage of S. 1318, the Maternal and Child Welfare Act of 1945, introduced by Senator Pepper, would go a long way toward providing complete and high-quality health and welfare services for our children, and we feel the need for such legislation is so urgent that we urge it be given early favorable consideration.

If S. 1606, the maternal-health bill introduced by Senators Wagner, Murray, and Dingell, is to be reported on first, we urge that the provisions of S. 1318 be included in it as they are more specific with regard to maternal- and child-health services and facilities and include essential child welfare services which are not mentioned in S. 1606.

We are particularly pleased to note that S. 1318 makes no provision for a “means test,” to which we are unalterably opposed in this connection. All our children should have good medical care as a basic right, regardless of income. Respectfully yours,

(Mrs. Alfred Winslow Jones.)



New York 16, N. Y., April 2, 1946. Senator CL 1UDE PEPPER, Senate Committee on Education and Labor,

Senate Office Building, Washington, D. C. DEAR SENATOR PEPPER: The executive committee of the Girls' Friendly Society, U. S. A., has endorsed S. 1318, the Maternal and Child Welfare Act of 1945, for the following reasons:

1. As a church organization, concerned with children and young people, we recognize health as a fundamental asset for character development.

2. From our experience, we realize how many mothers and children are denied this because of the lack of adequate services and facilities.

3. In a democratic country, we believe the government should assume as its responsibility making such services available to all mothers and children.

We urge that the Senate Committee on Education and Labor, in its hearings on S. 1606, give consideration to these points and reports the bill favorably. We also urge that title I, section B, of this bill (S. 1606) be strengthened by the inclusion of the more specific provisions in regard to services and facilities, services to crippled children, and standards for professional personnel, as provided in S. 1318. Sincerely yours,

FRANCES P ARNOLD, Program Adviser.


LINCOLN, NEBR., June 24, 1946. Senator CLAUDE PEPPER,

Senate Office Building, Washington, D. C.: Cornhusker No. 799, Brotherhood of Railway Carmen of America. Heartily endorse the maternal and child-health service bill, S.1318. It is the opinion of our members that such a program as provided for in S. 1318 is of vital necessity and urge its immediate adoption. Sincerely,


Recording Secretary.




In the Maternal and Child Welfare Act the members of this committee are considering one phase of a very important but long-neglected problem—the national health and welfare of America. This in turn is part of a still larger problem-the total security of the American people and their protection against misfortune over which they have no control.

We of the Congress of Industrial Organizations had hoped that with the end of the war we could turn our attention to these problems and together with other citizens and the Members of Congress work out programs for advancing the well-being of all the people. Our representatives have testified before numerous congressional hearings urging passage of legislation for a national health program, for a hospital-construction program, and for improvements in all aspects of our social-security system. Progress on these bills has been disappointingly slow, and we now face the prospect that Congress will adjourn without having acted on any of these vital measures.

Not only have we taken no forward steps in the field of social legislation since the end of the war, but we are actually moving backward and losing some of the gains we made during the war years in various emergency programs which are now being terminated. Nowhere is this more true than in the field of maternal and child-welfare services.

Paradoxical as it may seem, the war emergency forced us to pay greater attention to the needs of mothers and children than we have so far seen fit to provide for them in the postwar period. It is shocking to think that we are willing to protect the health of mothers and infants only when the husband and father is serving in the uniform of his country, as was done under the emergency maternal- and infant-care program; or that we are willing to provide funds for day-care centers for children of working mothers only when the demand of war industry made necessary the mobilization of all the available labor supply, as was done under the Lanham Act.

It is shocking, but nonetheless true, that these programs are coming to an end. The child of a veteran, for example, now receives such medical care as he can afford from the available facilities in his community. The child of a woman forced to work because of the death of her husband on the battlefield now receives such daytime care as is provided by the local community unaided by Federal funds. The gallant struggle of the working mothers of the District of Columbia to maintain adequate day-care facilities for their children is only one example of the need and desire for the continuation of this type of program.

The bill now before your committee sets forth three main objectives—adequate medical care for all mothers and children; adequate attention to the special needs of crippled children ; and the provision of child-welfare services for all children. Before discussing these separate parts of the Maternal and Child Welfare Act, I want to remind this committee of the interest that the members of the Congress of Industrial Organizations have in the general welfare of children. They are mothers and fathers themselves. Their trade-union membership is in itself an evidence of their struggle to obtain a better standard of living for their children even more than for themselves. Higher wages mean better food and clothing for their children and with them better health. Higher wages mean a better chance to pay the doctor's bills when a child falls sick. But few of our members are financially able to provide the long-range medical care that every child needs if remediable defects are to be discovered and corercted. No individual worker can obtain hospital care or laboratory tests for his children in areas where hospitals and laboratories do not exist. Only through Federal legislation can the workers of this country see their children get the medical care they want for them.

The bills which your committee is considering would provide the three types of services I mentioned earlier by means of grants-in-aid to the States partly on a matching basis and partly on the basis of the State's needs. Each State is left free to work out its own program in accordance with certain standards set forth in the bill. These standards would assure that all mothers and children would receive the services provided without discrimination of any kind, and provide certain safeguards as to the quality of the services, their relation to a total State program, the methods of payment for services rendered, freedom of choice on the part of doctors and patients, and adequate appeals machinery.

Provision is made for State advisory councils composed not only of members of the professions and agencies administering the services called for in the legislation but also of persons representing the public and hence the recipients of these services. This is a principle we have wholeheartedly endorsed in previous testimony on related social-security programs. We feel very strongly that local participation in the development of such programs is the only way to make them living, vital parts of a community plan for better living.

Turning now to title I of the bill, maternal and child health services, we believe that eventually the health problems of mothers and children can best be solved as part of an over-all national health insurance program such as that embodied in the national health bill now before other committees of the House and Senate. We are happy to note that the chairman of this committee and Senator Pepper have proposed a preamble to this section of the bill declaring it to be the policy of Congress that the special services provided for the health of mothers and children shall form a part of any national health program authorized by Congress. We are reluctantly coming to the conclusion that the chances are waning for prompt passage of a national health program and that the most we can expect from this session of Congress is some provision for the health of the children who are our future citizens. Should the national health insurance program be adopted at some future date, progress would have been made under the Maternal and Child Welfare Act in advancing the health of one section of the population, and provision would have been made for caring for the health of mothers and childen whose economic status made them ineligible for coverage under health insurance.

Certain amendments have been proposed to this bill to which we lend our support, particularly the designation of sperifir sums to he authorized for the second year of the program in the amounts of $75,000,000 for health services and $40,000,000 for services to crippled children. We also approve specifying research as a function of State agencies, more specific provisions for the progressive development of State-wide programs so that the next 10 years will see the establishment of all the services enumerated in the bill, more specific provisions for development, use, and purchase of care from health centers, hospitals and clinics, and provision for payments on a fee-for-service basis in addition to the other methods now set forth in the bill.

Certainly few people can quarrel with the principle that the health of our mothers and children is a matter of national concern. Your committee has heard expert witnesses testify as to the number of deaths in infancy and childhood, the incidence of disease among children. The lack of trained personnel and adequate facilities in certain sections of the country, notably rural areas, is a well-documented fact. And the drain on our resources through lack of adequate medical attention to defects discovered in childhood is a matter of public knowledge through the findings of selective service.

We therefore hope to see the Congress take speedy action on the provision in this bill for the health of mothers and children as a start at least toward the eventual goal of health care for everyone.

I am sure the members of this committee need no urging to support Title II, Services to Crippled Children. From the wealth of testimony which you have heard on the special problems of the physically handicapped, it is readily apparent that the sooner handicapped children can receive early diagnosis and treatment, together with special educational and training services, the greater the possibility of their becoming well-adjusted, useful citizens, able to make their full contribution to the whole of society. The services that would be provided in this title of the bill are a far cry from charity but rather represent one of the wisest investments for the future that the citizens of this country could possibly make.

The child-welfare services established by title III are a recognition of the fact that the health of children is closely related to their whole personal adjustment to society. Delinquent children are often found to have been suffering from undetected physical defects which have produced difficult personality problems. Family social problems are likewise the root cause of many health problems.

Here again, as in the provisions for health care, the problem is a much broader one than that of just the children involved. The welfare problems of the child in most instances cannot be divorced from the welfare problems of the entire family, and the expansion of the whole public-assistance program in our socialsecurity system represents the over-all approach to a problem which this legislation tackles only in part.

The needed coordination of health and welfare services for children with similar services for all our citizens can be more easily achieved under the President's proposed reorganization plan, which would group these functions of the Children's Bureau with those of the Federal Security Agency and eventually bring them under the proposed Department of Health and Welfare. This will allow a greater integration of the services to children administered by the Children's Bureau with those of the other health and welfare agencies of the Government.

The Congress of Industrial Organizations hopes, however, that in any final determination of the status of the Children's Bureau, it will have adequate policy. making authority to carry on its supervision of the administration of an over-all program for the health and well-being of America's children, as well as the functions of carrying on research and demonstration projects.

In conclusion, I want to repeat that while passage of this bill would represent an immense step forward in social progress, the Congress will not have discharged its responsibilities to the American people until similar programs have been established for all Americans.



Washington 1, D. C., June 21, 1946. Hon. CLAUDE PEPPER, Acting Chairman, Committee on Education and Labor,

United States Senate, Washington, D. O. DEAR SENATOR PEPPER: In response to to the request contained in your telegram of June 18, I am submitting the enclosed statement in support of Senate bill 1318 for inclusion in the record of hearings on this measure. Sincerely yours,

WM. GREEN, President, American Federation of Labor.



The American Federation of - Labor has been deeply concerned in developing national health provisions for the people of the United States. In 1943 we sponsored a bill to provide an adequate social insurance system including health insurance and we have endorsed the National Health Act (S. 1606) which would provide an adequate national health program built around the principle of contributory healih insurance. This measure would provide medical care for insured workers and their dependents and includes special provisions for maternal and child care. Based on the principle of contributory social insurancea principle which the American Federation of Labor has consistently supported this bill would assure medical care as a right paid for by the covered workers rather than making such care available on a charity basis.

The American Federation of Labor endorsed the wartime legislation under which the Children's Bureau in the United States Department of Labor administered the program of medical care for wives and infants of men in the armed forces. Prior to that we assisted in planning and securing legislative approval of the child services administered by the Children's Bureau under the Social Security Act.

The federation realizes that there are special aspects relating to the health of mothers and children that give the Nation a special responsibility for making adequate medical care available to them. We support every effort to develop a program that will meet these objectives.

On April 16, 1946, I presented to the Committee on Education and Labor of the Senate the position of the American Federation of Labor with respect to the National Health Act (S. 1606). In that statement I emphasized the interest of the federation in part B of title I of this bill which provides for increased grants to States for maternal and child health services, and said, "We feel that it is entirely appropriate that there be a special part for such a program as we recognize that society has a special responsibility to make real the right of all children to good health."

The principle which I then expressed is applicable to S. 1318 provided that such a program is wisely developed as a part of a comprehensive national health program.

That such comprehensive planning is contemplated is indicated by the amend. ments to the House version of this bill (H. R. 3922) offered by Senator Pepper in his testimony before the subcommittee of the House Committee on Labor on May 28 reading as follows:

"SEC. 2. The Congress finds, and experience has shown, especially during the war, that there is need for expansion of maternal and child-health and welfare services through aid to the States, and declares that immediate action by the Congress is required to meet these needs.

“It is further declared to be the policy of the Congress that the special services for the health of children and their mothers during maternity herein provided for should form a part of any national health program to be authorized by the Congress and should be coordinated with and fitted into any such program.”

I therefore urge on behalf of the American Federation of Labor the adoption of Senate bill 1318 as a part of a national health program based on the principle of contributory social insurance.



Washington 1, D.O., June 24, 1946. The Honorable CLAUDE PEPPER,

United States Senate, Washington 25, D. C. DEAR SENATOR PEPPER : Our statement in support of the maternal and child welfare act, S. 1318, addressed to the chairman of the Senate Committee on Education and Labor, is attached. May I ask you to please include it in the record of the hearings on this bill. Sincerely yours,

ELISABETH CHRISTMAN, Secretary-Treasurer.

« PreviousContinue »