Mrs. BERNHARD. It wouldn't affect us as an agency at all. Senator FERGUSON. Would it affect some of those agencies that you work through? Mrs. BERNHARD. It would affect many agencies in different States. It would affect all State departments of welfare and health and education. Senator FERGUSON. Going back to the statement that Senator O'Conor asked you about: Are you fearful that if you do not acquire what you are advocating, that it would affect those agencies? Mrs. BERNHARD. Well, perhaps I can put it the other way around. If it is written into the bill that the voluntary agencies must receive a sort of priority, I think that it would affect the work of the department when it is set up. Senator THYE. What do you mean by "priority"? Do you mean they would recognize an agency such as your agency in seeking advice relative to the type of a program to be supported and carried on by the Department? Mrs. BERNHARD. It really has no bearing on our agencies, but I do see how it would work in the various States where there are both private and public programs and where if it is set up in the Federal bill that the new department must concentrate on using the voluntary agency; it more or less gives a priority to the existing pattern and doesn't leave any leeway for changing the pattern of administration as best suits the need at that time. What I would like to see would be flexibility in this bill, rather than spelling it out and making it inflexible. Senator FERGUSON. Do you think this present bill would freeze the situation? Mrs. BERNHARD. I think S. 140 would freeze the situation. Senator FERGUSON. And no new agencies could be developed who would desire to come in? Mrs. BERNHARD. I am not so concerned about new agencies as how the present agencies and the present needs would be met. The CHAIRMAN. Do you think it would freeze things worse than thev are frozen at present under the Federal Security Agency? Mrs. BERNHARD. I think we made a distinct step forward in having the Federal Security Agency, and I would like to see the pattern of being able to shape the policies continued rather than to freeze either at the present level or as it was previously. I think S. 140 would tend to divide it and compartmentalize it, while S. 712 would leave leeway of administrative action and make it a flexible tool in the hands of the Secretary. The CHAIRMAN. S. 712 would leave the same degree of flexibility which there is at present in the Department? Mrs. BARNHARD. That is right. The CHAIRMAN. You may proceed. Mrs. BERNHARD. From my experience as a member of the New York Board of Social Welfare and of the boards of several voluntary agencies I know that agencies which assist indiivduals through health and welfare programs supported in a large degree by Federal funds must be required to meet specified Federal standards. For these reasons the National Child Labor Committee is opposed to S. 140 and supports S. 712 which would establish a Department of Health, Education, and Security by the direct step of conferring this. status on the Federal Security Agency without sacrificing to that status the freedom to organize and administer its program which it has had as an agency and which it will need as a department. The CHAIRMAN. Are there any questions of Mrs. Bernhard at this time? The next witness was to have been Dr. Ernst P. Boas, chairman of the Physicians Forum, Inc., New York City. I understand Dr. Boas is not present, but that a representative of the Physicians Forum is present. Is that correct? Is there any representative of the physicians forum present? (No response.) (The following statement was submitted to the committee by Dr. Anna-Tulman Rand, chairman of the Physicians Forum, Inc., which was incorporated in the hearing:) STATEMENT ON THE FULBRIGHT-TAFT BILL (S. 140), BY THE PHYSICIANS The Physicians Forum appreciates the opportunity to present its views on S. 140 designed to create an executive department of the Government to be known as the Department of Health, Education, and Security. This statement is authorized by our executive committee and council. We are a national organization of physicians, all of whom are members of the American Medical Association or the National Medical Association. We are concerned primarily with the problems of devising and supporting methods which will make the best possible medical care available to all the people. Any measure which changes and reorganizes those governmental agencies now vested with administration and policy in the fields of health and welfare is one with which we are concerned. We approve the general principle of reorganization and consolidation of those Federal agencies dealing with the functions of health, education and security begun last year. We believe that these functions of Government are so vital that they merit creation of a Cabinet department. Despite this, S. 140 contains so many objectionable provisions that it cannot receive our endorsement. Sections 5 (a) and 6 (b) of the bill severely restrict the Secretary from establishing the most effective organization of the department by freezing the organization into three divisions. This is inadvisable, particularly at a time when the scope and functions of these departments are continually increasing. We believe it is administratively unsound to provide by law that the Food and Drug Administration must be administered by the Health Division or that the welfare functions must be administered by the Division of Security. The Children's Bureau is responsible for important health functions which may belong more properly in the Division of Health. It is unwise therefore to freeze it in the Division of Security. The requirement that the three Under Secretaries appointed by the President with the approval of the Senate must be specialists as, for example, the Under Secretary of Health, a physcian, is in our opinion, very unwise and mistakes their function. For example, the Under Secretary of Health is an administrative officer who will be called upon to make basic decisions of policy which will involve the economic, social, and administrative aspects of medicine rather than the techniques of diagnosis, treatment, and prevention of diseases in which physicians are trained. Limiting this position to physicians will withdraw from consideration the appointment of many qualified people who have had considerable experience in health administration. The Under Secretaries should represent the public for whom the various health, educational, and social services are maintained rather than the professional groups that render these services. The same practice should be permitted in this department as is followed in the War and Navy Departments where the Secretaries and the Assistants are not military men. We find other features of the bill objectionable, particularly section 5 (b) which prescribes the appointment of advisory committees to the Secretary. The fact that there is not provided representation for the beneficiaries of the services which the department will control is a serious omission. We believe that they have as much right to advise and be consulted as any individual or organization that dispenses these services. The provision that these advisory committees shall include persons most representative of voluntary organizations invites great pressure from these sources and by the wording of this bill creates the danger that federally supported programs may actually be administered by private agencies. These agencies do not always represent the desires of the public as a whole. Because of the above objections the Physicians Forum is opposed to S. 140. On the other hand, we do support S. 712 introduced by the chairman of this committee. That bill gives the Federal Security Agency Cabinet status by changing its name to the Department of Health, Education, and Security. This is the most logical means of creating such a department since most of the functions to be performed by this department are now performed by the Federal Security Agency. In this manner the objections we raise to S. 140 are removed and the Secretary is not restricted in his efforts to create the most efficient administration possible. The CHAIRMAN. Mrs. LaFell Dickinson, president of the General Federation of Women's Clubs is not here. Is there a representative of the General Federation of Women's Clubs here? (No response.) The CHAIRMAN. The hearing will be resumed Monday. The witnesses will be Dr. James R. Miller, member of the board of trustees of the American Medical Association, Hartford, Conn.; Dr. Roscoe Sensenich, chairman of the board of trustees of the American Medical Association, South Bend, Ind.; Dr. Reginald F. Atwater, executive secretary of the American Public Health Association, New York City; and Dr. V. A. Getting of the Association of State and Territorial Health Officers, Boston, Mass. I think they will be interesting witnesses. I hope as many members of the committee as possible may be present at 10:30 on Monday. The hearing is now recessed until 10: 30 Monday. (Whereupon, at 11:20 a. m., an adjournment was taken until 10:30 a. m., Monday, March 24, 1947.) DEPARTMENT OF HEALTH, EDUCATION, AND SECURITY MONDAY, MARCH 24, 1947 UNITED STATES SENATE, COMMITTEE ON EXPENDITURES IN THE EXECUTIVE DEPPARTMENTS, Washington, D. C. The committee met, pursuant to adjournment, at 10:30 a. m., in room 357, Senate Office Building, Senator George D. Aiken (chairman) presiding. Present: Senators Aiken (chairman), Ferguson, Bricker, Thye, McCarthy, Hoey, Robertson, and O'Conor. The CHAIRMAN. The hearing will come to order. Our first witness this morning on the continuation of the hearings on S. 140 and S. 712 is Dr. James R. Miller. I believe, Dr. Miller, you are a member of the board of trustees of the American Medical Association? STATEMENT OF DR. JAMES R. MILLER, HARTFORD, CONN., MEMBER, BOARD OF TRUSTEES, AMERICAN MEDICAL ASSOCIATION Dr. MILLER. Yes, Senator. The CHAIRMAN. Are you speaking for the American Medical Association this morning? Dr. MILLER. Yes, sir. The CHAIRMAN. How many members do you have on the board of trustees? Dr. MILLER. Nine members. The CHAIRMAN. Do those nine members determine the policies of the AMA? Dr. MILLER. The policies are determined by the house of delegates. The CHAIRMAN. How many members are there in the house of delegates? Dr. MILLER. 180 members-no; 176, I think. The CHAIRMAN. How many members does the American Medical Association have? Dr. MILLER. About 130,000. The CHAIRMAN. But the house of delegates determines the policies? Dr. MILLER. Yes, sir.. The CHAIRMAN. Now, will you proceed with your testimony? Dr. MILLER. Although no poll in regard to this particular bill has been taken of the membership, nevertheless I feel that the majority opinion of our memebrs-the vast majority-is in conformity with the statements that I shall make. The CHAIRMAN. I have received several letters indicating that the American Medical Association has requested their members to express their opinion on certain bills before the Congress. It is obvious |