STATEMENT OF JOSEPH H. LOUCHHEIM, REPRESENTING THE COMMITTEE FOR THE NATION'S HEALTH

Mr. LOUCHHEIM. Mr. Chairman, realizing that you wish to get away at 12 o'clock, I am sure, sir, that I shall be finished by that time. The CHAIRMAN. You have no prepared statement, have you?

Mr. LOUCHHEIM. On behalf of the Committee for the Nation's Health I wish to present our critical views of S. 140 and concurrently our comments on the proposal embodied in S. 712. We should like, at the outset, to underline the observation that has already been made before this committee—namely, that it is not usual for such organizations as ours to be greatly concerned over legislation dealing only with the structure of government or legislation effecting mere details of Federal administration.

Our main focus is on program legislation and more particularly we are interested in legislation leading to the development of a wellrounded national health program. But we are therefore inevitably concerned with national policies that do now or may in the future effect such a development.

Our interest in the legislation before this committee does not stem from anxiety over detail nor does it rest on any objection to the stated purposes of the legislation. We agree with one major underlying purpose, namely, coordination and Cabinet status of the Federal functions dealing with health, education, and security. On the other hand, we firmly disapprove of certain provisions in S. 140.

We are in accord with the need for top-ranking status of the Federal agency administering programs that directly affect the vitality of the Nation's most precious resource-its people. The health, education, and security of the American people are paramount and accordingly, we support the expressed intention to strengthen Federal participation in these fields. We also believe that health education and security are closely related. Many of these programs are interdependent, therefore a close working relationship is needed at the Federal level in the planning and administration of programs covering health, public welfare, social security, and education.

We feel that the prestige of Cabinet status would carry forward the progress already made under Reorganization Plan No. 2 enacted last year. The 1946 reorganization plan brought together in the Federal Security Agency the major activities in these fields and placed in the Administrator what seems to us to be adequate authority to bring about such further coordination and integration as may be necessary. Senator Aiken's proposal-S. 712-would simply establish the Agency as a department of Government and give Cabinet status to the department head.

S. 140, on the other hand, is not a measure that would merely elevate the status of the Federal Security Agency. The implications of its major provisions are far-reaching and are such as to raise serious objections. I will state these objectionable provisions briefly. The measure, if enacted, would prevent the Secretary from working out the most effective organization of the newly created Department by freezing the organization into three compartments, i. e., the Divisions of Health, Education, and Security; and by enumerating certain bureaus and other units which must be allocated to each

division-sections 5 (a) and 6 (b). Instead of promoting closer relationships, this provision would tend to emphasize separatism in functions. On the other side, it ties together other programs that should not be married by statute; for example, Public Assistance and Social Insurance. The Secretary of the Department should have discretion as to whether or how far these different though related activities should be in separate divisions.

We object strenuously to the specification in the bill that the three divisions be under the immediate supervision of three Under Secretaries who are required to be qualified specialists in the fields of health, education, or security, respectively, rather than persons experienced in broad determinations of public policy. This requirement runs counter to an accepted principle in American Government and confuses the role of public policy making with functional administration by career officers of government. Under Secretaries are political officers, like the Cabinet members under whom they serve. They are appointed by and hold office to represent the policies of an elected administration. To prescribe by statute that Secretaries or Under Secretaries be specialists mistakes their function. Such officers should represent the interests of the general public for whom certain health, educational, and social services are maintained, rather than represent the professional groups that render these services.

In the health field, the basic decisions of policy will involve the economic, social, and administrative aspects of medicine much more than the techniques of diagnosis, treatment, and prevention of disease, in which physicians are trained. The proposed bill would subordinate the Surgeon General of the Public Health Service, a career officer, under a politically appointed physician.

The sponsors of S. 140 have indicated in their testimony that these provisions represent a compromise with those who would hold out for three separate departments of government-each headed by a qualified specialist. To us this represents a yielding to an undesirable type of pressure politics. In the health field, this represents the aim of the American Medical Association to obtain control over the administration of the health functions of government.

We urge that your committee not compromise the general welfare of the American people by catering to groups who would promote their own power interests.

Finally, we base our objections to S. 140 on the fact that it is likely to impose definite national policies by indirection. In specifying that the "independence and autonomy" of State and private agencies must be preserved and protected without putting equal emphasis on national standards in the expenditure of Federal funds, S. 140 invites continuous pressures from special-interest groups.

Senator MCCLELLAN. Pardon me just a moment. I understood that the preceding witness very much approved that section in S. 140. You are opposing it?

Mr. LOUCHHEIM. That is correct, sir.

The bill prescribes that the Department's objectives shall be "carried out to the fullest possible extent through State and local agencies, public and voluntary." Such agencies must be "preserved and protected" to "to the highest possible degree." With this policy in mind, the bill also prescribes advisory committees and their functions in detail (secs. 3 and 5 (b).)

How far would this laudable objective take us in the direction of the actual administration of federally supported programs by private agencies? Certainly the present wording of the bill invites great pressures from these sources, in health, educational and welfare fields. If Congress wants to have programs which are supported from 50 to 100 percent by Federal funds administered by State and local governments, or by private agencies, without national standard, then Congress should make the decision explicitly. The present wording of the bill invites pressure politics by indirect methods, and is likely to arouse tensions if not conflict.

The creation of a Cabinet department can be achieved most simply by transferring the functions and powers of the Federal Security Agency to a new department, as is proposed in S. 712. S. 712 contains no undesirable provisions. It raises none of the controversial issues that we foresee from S. 140. It leaves internal administrative reorganization to the Secretary, as is the customary procedure in other departments of government. Since the legal problem of creating a Cabinet department is so simple, we are obliged to conclude that the restrictive features of S. 140 are its primary purpose and that its ostensible objective is merely a sugar coating to make its bad features palatable.

Accordingly, the committe for the Nation's health wishes to have recorded its opposition to S. 140. If the Congress sees fit to enact legislation creating a new department having within its scope the administration of health, education and security programs, we urge the passage of S. 712.

Senator MCCLELLAN. Will you state just how this committee for the Nation's health is composed, whom it represents?

Mr. LOUCHHEIM. Yes, sir. The committee for the Nation's health was organized under the laws of New York State as a membership nonprofit organization, and received its charter on March 1, 1946. Its purpose is to

Senator MCCLELLAN. That is a new organization, isn't it?

Mr. LOUCHHEIM. It is 13 months old, sir.

Senator MCCLELLAN. Organized for the purpose of sponsoring this sort of legislation?

Mr. LOUCHHEIM. National health legislation, backing the President's national health program, sir.

Senator MCCLELLAN. How many members have you?

Mr. LOUCHHEIM. We have at the present time approximately 3,000 members.

Senator MCCLELLAN. In New York?

Mr. LOUCHHEIM. They are in 47 of the 48 States, sir.

Senator THYE. Whom do they represent? What types of organizations are included?

Mr. LOUCHHEIM. Members are not representatives of organizations. They are individual members that back our program.

Senator THYE. From what walks of life do most of your members come?

Mr. LOUCHHEIM. Some of them are part of the medical profession. Some of them are other professional people, such as economists, social workers. Some of them are businessmen. Some of them are school teachers. All walks of life, sir.

Senator MCCLELLAN. Out of the total population of the Nation, then, you have 3,000 members?

Mr. LOUCHHEIM. Yes, Senator, but I should like to point out to you that this organization does not believe that its primary purpose is a mass membership. What we are is an organization with one purpose; namely, that of pressing for national health insurance and national health legislation, and we believe that we are a focal point, and we endeavor to advise and assist other organizations that have similar aims.

Senator MCCLELLAN. I can understand their sincere belief in the virtue of their objectives and all of that, but I was just trying to ascertain what real influence or consideration should be given on the basis of dealing with 140,000,000 people when you represent a new organization that you believe in that is composed of about 3,000 members.

The CHAIRMAN. Does this letterhead of yours list the names of your executive committee?

Mr. LOUCHHEIM. I don't know which letterhead you have, sir. The CHAIRMAN. Does it represent prominent members of the association?

Mr. LOUCHHEIM. I should be glad to read to you both our honorary chairmen, our board of directors

The CHAIRMAN. This list of names is your vice chairmen.
Mr. LOUCHHEIM. Honorary vice chairmen, sir.

The CHAIRMAN. Will you read those.

Mr. LOUCHHEIM. Our board of directors consists of 20 individuals: Dr, Channing Frothingham, of Boston; Carl C. Lang, of New York, who is a banker and vice president of the Continental Bank & Trust Co.; Michael M. Davis, Ph. D., of New York; Thomas Addis, M. D., of San Francisco; Barry Bingham, of Louisville, Ky., editor and publisher of the Louisville Courier Journal; Ernst P. Boas, M. D., New York; Morris Llewellyn Cooke, Washington; John J. Corson, Washington; Mrs. Gardner Cowles, of Des Moines, Iowa; Albert W. Dent, New Orleans, president of Dillard University; Abe Fortas, Washington attorney; Clinton Golden, Pittsburgh-the CIO; Mary Dublin Keyserling, of Washington; Mrs. Albert D. Lasker, of New York; John V. Lawrence, M. D., of St. Louis, Mo.; Mrs. Dorothy Norman, of New York; V. Henry Rothschild, New York, attorney and secretary; Anna M. Rosenberg, of New York; Dr. R. M. Walls—a dentist of Bethlehem, Pa.; and Matthew Woll, second vice president of the AFL.

Senator HOEY. What method do you adopt to get the views of your members or board of directors on a bill like this?

Mr. LOUCHHEIM. Our board of directors meets twice a year. We have an executive committee which meets approximately once every 6 weeks. The executive committee set up a subcommittee which is a legislative committee given authority to take action on legislation within the scope of our committee.

Senator HOEY. And this represents the views of the legislative committee?

Mr. LOUCHHEIM. Which met on February 13 of this year, prior to the time that Senator Aiken's bill was introduced.

The CHAIRMAN. According to your letterhead, your chairman is Channing Frothingham, M. D. Your honorary vice chairmen : Jonathan Daniels-from your State, Senator-Russell Davenport, Jo Davidson, William Green, Bishop Francis J. McConnell, Philip Murray, Bishop G. Bromley Oxnam, Mrs. Franklin D. Roosevelt, David Sarnoff, and Gerard Swope.

Is that correct?

Mr. LOUCHHEIM. That is correct, sir.

The CHAIRMAN. Any further questions?

Since there are no further questions, we thank you for your appearance here this morning.

The hearings will now be recessed until Thursday morning at 10:30 a. m., and there will be four or five witnesses to appear before the committee at that time. The order has not been definitely determined as to how the witnesses shall appear because we are trying to adapt the hearings to the convenience of the witnesses as far as it is possible to do so.

(Whereupon, at 11:55 a. m., the committee adjourned until 10:30 a. m., Thursday, March 20, 1947.)