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We, therefore, urge favorable action this year on the measures we have recommended.

(The resolution of the CIO is as follows:)


Resolution adopted by the 15th Constitutional Convention of the Congress of

Industrial Organizations, November 1953 The health of our members and their families and the health of the Nation are basic concerns of the CIO. Repeatedly we have sought to alert the American public, the l'nited States Congress, and the organizations of professional people who have primary responsibilities in the fields of health care to the scandalous failure to meet the health needs of our Nation's families.

A tremendous gap exists between present health services and those which we have the technical know-how to provide. The best we can furnish is the only acceptable standard by which the the adequacy of our health services can be measured.

We have made thoughtful recommendations for the solution of this great problem. We have supported legislation designed to bring medical facilities and personnel to adequate levels and to provide comprehensive medical care for all Americans through a system of national health insurance. Across thousands of bargaining tables we have negotiated health-insurance plans and reduced the health cost burden for many of our members. We have made headway in obtaining improvements in the benefits and administration of the nonprofit voluntary cooperative health-care plans, such as the Blue ('ross hospitalization plans. But in all of these efforts we have only begun to solve the problemadequate health care remains as a great challenge to our Nation.

Since our last convention a group of distinguished citizens appointed to the President's Commission on the Health Seeds of the Nation by President Truman reported its findings and recommendations on Building America's Health. This fre-volume report confirms our grave fears regarding the availability and adequacy of medical facilities and care. The report forthrightly underscores the shortage and maldistribution of doctors, nurses, dentists, and hospitals; the plight of our medical and dental schools; the inefficient organization of doctors'

and hospital service : discriminatory practices which curtail availability of hosMapital and medical care, as well as opportunities for professional training for mem

bers of minority groups; the inadequacy of medical research; and our failure to develop socially sensible ways to finance medical facilities and medical care.

With the Commission's comprehensive and courageous report of the present status of the Nation's health before us, the need for social action is evident. All of the Commission's majority recommendations are perfectly consistent with the promises of the present administration as stated in the 1952 platform of the Republican Party

l'nfortunately, the s3d Congress has slashed appropriations for many vital health services, and long-established services, such as hospitals for seamen, are threatened: Now therefore, be it

Resolred, That the CIO recognizes that the me lical goal of the American jemple_comprehensive health service of high quality available to all people mually-requires a national health program, based on national health instiranice, designed to provide high quality medical services, facilities and personnel in expanding quantity and with appropriate organization and distribution.

Such & program must provide greatly expanded Federal assistance to schools of dentistry and me licine, for nursing and medical technician training, for construction of new hospital and health center buildings and facilities, for student scholarships, and for research.

It must include a system of prepaid health protection which will provide all America's families with a rounded program of preventive care, prompt access to services for the diagnosis and treatment of sickness and disease, and comprehensive rehabilitative services for the disabled. Such a program must expand Federal aid to State and local public health programs It must continue and extend high-quality medical care for such groups as seamen and veterans.

We urge our affiliates to coutinue to support State and local legislation to improre health services.

We favor the development and expansion of voluntary, comprehensive prepayment bealth plans, and deplore the drive of the insurance companies to

introduce deductible programs which discourage the early and prompt resort hve of to needed treatinent

We urge affiliates to continue to work for increased consumer representation 2010 on the boards of voluntary health insurance plans and other organizations providing medical services and thus to help in providing the leadership and constructive thinking necessary for the attaining of our health goals.

We reaffirm our support of the committee for the Nation's health. Senator PURTELL. Thank you, Mrs. Ellickson. I want to state now, and I state for the information of the other witnesses who appear here this morning, the absence of my colleagues on both sides of this committee is not due to any lack of interest in your testimony or the testimony given by others here this morning

La It is simply that we are so pressed for time that others find it necessary to be at other meetings or are officially absent.

However, I can assure you that your testimony will be presented to them, and read by them, and studied very carefully.

I want to thank you very much for appearing here, Mrs. Ellick-on. Mrs. ELLICKSON. Thank you.

Senator PURTELL. Is it your desire now that we have Mr. James Brindle, acting director of the UAW social department, speak now!

Mrs. ELLICKSON. We would rather have Dr. Morris Brand, Mr. Chairman. Senator PURTELL. All right. Any way you wish it. Is Mr. Brindle

:3 to appear?

Senator PURTELL. Do you want Dr. Brand to talk now!

Senator PURTELL. We are very happy to have you, Doctor. You have a prepared statement !



Senator PURTELL. Do you wish to have the statement put in the record and summarize it, or would you like to read the complete statement ?

Dr. Brand. I would like to read the complete statement.
Senator PURTELL. We are very glad to have you.

Dr. BRAND, Mr. Chairman and members of the committee. My name is Morris Brand, and I am appearing in behalf of the Congress of Industrial Organizations and the Amalgamated Clothing Workers of America, a CIO affiliate.

I am the medical director of the Sidney Hillman Health Center in New York City, where preventive, diagnostic, and curative medical services are provided to members of the New York joint board of the Men's and Boys' Clothing Workers, ACWA. Previous to this post tion I was the associate and for a time acting medical director of the Health Insurance Plan of Greater New York (HIP).

The CIO and ACWA wish to express their appreciation for being given the opportunity to present their comments and suggestions on health legislation which will affect in particular about three-quarters of a million ACWA union members and dependents, and in general this Nation's population of 160 million persons. With the happiness

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and welfare of so many at stake, it is not surprising that both organizations are anxious to present their points of view with the hope that Congress will stop the repetitious and costly surveys and start building for a healthier America.

On several occasions facts and statistics revealing the unmet health needs of the Nation have been collected, masticated, digested, absorbed, and assimilated. Among the many studies excellent and provocative information can be found in the reports of (1) the Committee on Costs of Medical Care, (2) the National Health Survey, (3) the selective-service rejections, (4) the 1951 report to the Senate's Committee on Labor and Public Welfare when Senator Lehman was chairman, and, most recently (5) the President's Commission on the Health Needs of the Nation. The health principles formulated by the Commission is as adequate

foundation as one can hope to find for the excellent recommendations which the Commission made in its report. These recommendations, if properly implemented and dovetailed with our medical profession's excellent and vast potential knowledge and skills, would raise our country's health to the highest degree possible.

Mr. Wolverton's speech before the House of Representatives on February 3 last on the introduction of H. R. 7700 and the bills S. 1153 and H. R. 3582, introduced, respectively, by Senators Ives and Flanders and Representative Javits, are manifestations that our administration and many of our Nation's legislators, regardless of their political affiliations, are aware of the urgent need for a wider distribution of modern medical services. Unfortunately, the proposed formulas are inadequate and weak. They do not permit a constructive approach to better health. The CIO and ACWA, therefore, maintain that the only way to create the health structures that will be functional, valuable, and have firmness, stability, and meaning for the 160 million people—and many more to come is to:

1. Establish a coordinated and integrated national health program for comprehensive medical and hospital services, including national health insurance.

2. Provide aid to professional schools through grants for training health personnel.

3. Provide aid in the building of hospitals and group medical practice clinics with a minimum of State and local matching funds.

4. Provide aid for the extension and expansion of State and local public health services.

5. Provide aid to maternal and child-health services and expansion of

program for the physically handicapped children. 6. Provide for the development of a mental-health program to improve our mental hospitals and for the training of psychiarists and other mental-health personnel.

7. Provide aid in the understanding and prevention of chronic diseases and increase the facilities and services for the chronically ill.

8. Extend rehabilitation services to provide aid for those who become disabled each year.

The recent curtailment of funds for health services, limited as they are, may mean financial economy for the moment. In the long run, however, these economies will prove costly because of their harmful impact on the health of our citizens. Our people's health must not be sold short for a handful of silver.

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S. 3114 (H. R. 8356 )

With regard to the companion bills, S. 3114 and H. R. 8336, the CIO and ACWA are impressed with the intent and purposes set forth in the preambles, but because there is no relationship between the preamble and the body contents, they disapprove both measures as wholly inadequate to serve any useful purpose.

The labor organizations are of the opinion that the reinsurance bills will not add to the health and well-being of this Nation because the health status can be improved only by a program of national health insurance which will provide comprehensive preventive, diagnostic, and curative medical and ancillary services in the home, office, and hospital to every individual in accordance with their needs. Heroic measures are needed to provide the American public with the modern medical knowledge and skills which can be provided by our excellent medical profession. To maintain the financial and other artificial barriers between the public and the profession is wasteful, both of the vast potential of American medicine and people's health resources

Both the CIO and ACWA are of the opinion that the proposed acts are so general in terms that it would place upon the Secretary responsibilities of a detailed analysis of each applicant for reinsurance coverage which would demand a large and costly administrative es tablishment. Furthermore, if many plans applied for coverage within a brief period of time, it would create a serious administrative handicap and give rise to additional criticism of governmental bureaucracy.

The bills also lack specific standards and criteria for implementations to fulfill the intents and purposes set forth in the declaration

The proposed acts would extend reinsurance to private insurance carriers as well as nonprofit organizations. It is difficult to believe that any carrier would be interested in experimentation in fields which if unsuccessful would lead to a cost of 25 percent of the losses. Recent abrupt cancellation of various policies by commercial cartier is evidence of their ultraconservatism and fear of undue losses. Not. withstanding the Federal Government's willingness to pay 75 percent

Tö of the losses, stockholders are interested in successful dividends and not in unsuccessful costly experiments.

Those carriers which may be interested in additional services or wider coverage will of necessity have to establish a premium charse based on sound actuarial accounting. Otherwise, they would not, in accordance with the bill's provisions, be entitled to the rein-urate, To deliberately charge a low premium for the experimental period mav attract new buyers but it is obvious that they will not continue their subscriptions when the premium rates will be adjusted upward to meet the actual costs.

The labor organizations do not believe that the bill will find a means of providing coverage for retired persons, low-income groups, un employed, and those disabled by chronic illness, because such pers generally do not have the funds to purchase any insurance coverain

The bill provides for a National Advisory Council and speitas classifies only four members who shall be experienced in the adminis tration of health-service plans. It would serve the publie's interest in a fuller measure if labor and other consumer organizations would

be designated as consumer representatives, and of the 4 representatives mentioned above at least 1 should represent nonprofit hospitalservice plans and another nonprofit comprehensive medical-service plans.

The comment made by Mr. Edwin J. Faulkner on March 26 before the House Interstate and Foreign Commerce Committee when testifying on the reinsurance bills are worth repeating. He stated :

Government reinsurance of health-insurance plans would introduce no magic into the field of financing health-care costs. Reinsurance can distribute risks among insurers just as insurance distributes them among policyholders, but, no matter how far this distribution is carried, it must be sound to succeed. Reinsurance does not increase the ability of the insurer to sell protection to the unwilling buyer. Reinsurance does not reduce the cost of insurance. Reinsurance does not make insurance available to any class of risk or geographic area not now within the capabilities of voluntary insurers to reach.

To summarize briefly, the CIO and ACWA oppose the reinsurance bill because it will in no way begin to solve the health needs of the Nation.

However, the CIQ and ACWA take this opportunity to recommend for this committee's consideration the following suggestion for use of the $25 million for practical pilot studies:

Congress should appropriate the $25 million to be used as grants to nonprofit hospital and medical-care plans which, regardless of their present coverage, would agree to: (1) Provide comprehensive medical services in the homes, hospitals, and doctors' offices; (2) provide total hospital services in accordance with needs; (3) remove waiting periods, limitations against age, sex, race, and preexisting conditions; (4) eliminate deductible features; (5) broaden their underwriting rules to permit enrollment of individuals or individual families; (6) enroll the retired, unemployed, and those with low incomes who ordinarily cannot purchase existing voluntary insurance plans; (7) provide psychiatric treatment; and (8) add dental services and enter into many other areas which, because of the lack of sound actuarial information, have been considered unsound financially and, therefore, avoided.

Plans such as the health-insurance plan which provides a medicalservice program through 30 medical groups--the Permanente plan, the Blue Cross, and Blue Shield—should all be invited to participate in these pilot studies.

These experiments should be approved by a national advisory council and conducted by the United States Public Health Service for the Department of Health, Education, and Welfare. Controlled pilot studies should provide information which could be used to advantage many more times the value of the sum expended.

H. R. 7700

The ACWA agrees with the declaration of policy and purposes set forth in title VII of H. R. 7700 that-and I will now give several quotations

there is a serious need throughout the country for a greater number of hospitals and related medical facilities and services;

to simulate private lending institutions *** to loan funds by which medical centers, hospitals, clinics, and other medical facilities can be financed, built, and operated on a self-sustaining, self-liquidating basis;

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