The most recent action of the American Federation of Labor in this respect was taken by our 72d convention, meeting in St. Louis, Mo., September 21-25, 1953. A declaration unanimously passed by that convention stated, in part: The need for a greater number of hospitals, doctors, and other trained medical personnel, clinics and other medical-care facilities, and for a more satisfactory method of financing the cost of medical care is urgent, and becomes more urgent every day (Official Proceedings, 72d convention, AFL, p. 641). The convention also adopted the report of the executive council, which included in its recommendations: Continuance and expansion of the Hill-Burton hospital-construction program, including the construction of health centers. (Ibid., p. 310.) It is in no sense a detraction from the achievements of the present program to point out that it falls short of meeting the total need, both quantitatively and qualitatively. Speaking to the qualitative point, it is apparent that with the very progress that has been made with respect to general hospital bed construction, the specialized needs with respect to facilities for chronie disease, nursing homes, diagnostic and treatment centers for ambulatory patients, and rehabilitation facilities have fallen behind. Special appropriations whose authorization is contemplated in this bill for surveying these needs and making grants to the States and localities are designed to meet these deficiencies. I recall that the very inception of the program grew out of a com prehensive plan for the establishment of a network of integrated facili ties, including the fully equipped urban centers, the teaching hospitals, and what might be described as the feeder facilities, which would include the health centers and clinics where no attempt would be made to provide all of the specialized services necessary in the larger centers. The program has, in part, met that need, but in one sense our whole health facility construction program has gotten out of balance. The construction of the type of specialized facility that is contemplated in this measure will help to restore this balance. Many of the members of this committee have also over the years expressed an interest in the amount of funds available for the entire program. While I am aware that appropriations as such do not fall within the area of your responsibility as a committee, I cannot refrain from expressing our concern over what appears to us as an insufficient amount of funds scheduled for the entire program for the coming fiscal year. In this connection, I am speaking to the quantitative shortcomings of the present program. The original surveys made by the States following the enactment of the Hill-Burton Act indicated that there was a shortage of approxmately 900.000 hospital beds in the entire country. That was 7 years ago. While under the program about 105,000 beds have been added, our population has grown in that time by more than 18 million people. I am informed that current State surveys indicate total need of nearly 2 million beds, with a deficiency of at least 800,000. So we are barely keeping pace with our expanding needs. The $60 million authorization for the specialized projects contemplated in the bill now before you, together with the additional million for research and survey, appears sufficient to get this parti u lar program underway. However, it is with deep concern that we note the reference in the budget proposed for fiscal year 1955 to an amount of only $50 million for the continuation of the basic HillBurton program. This, as you know, represents a reduction of $15 million from the amount authorized for the current fiscal year. In fact, only in the year 1950 was the full $150 million authorized in the original act appropriated. While there may have been some justification in reducing the appropriations during the height of the Korean conflict, when there was a shortage of both manpower and materials, it does seem particularly inappropriate at the present time, in view of the backlog of accumulated needs and in view of threatened unemployment in the building and construction trades, that the amount appropriated for this program should be reduced to the lowest point in its history-to an amount representing one-third of the annual appropriation authorized in 1946. The construction of facilities both of the type contemplated in S. 2758 and of that authorized in the original act represent the most useful types of public works projects. We are aware of the fact that the construction of the specialized facilities for chronic disease hospitals, nursing homes, and other treatment centers and facilities would make possible a number of significant economies in providing services to these classes of patients. I would like to point out, however, that the problem of meeting the costs of medical care by individuals is still with us. It will still be with us in the event this bill is enacted into law. I am sure you are aware that its enactment will take us into an area of need where the provisions of presently existing insurance programs are the least adequate. This is not an argument against the bill. It is to point out once again that there remains the necessity to undertake overall comprehensive planning to meet the essential health needs of the Nation. Good as these proposals are, they leave unmet the important problems of aid for medical education and aid in establishing local publichealth units. And the question of how the patients are to meet the cost of the services and facilities made available by the construction program remains largely unanswered. We support this program as one link in a chain of defense against disease. We hope the Congress will forge the other links without delay. May I again, Mr. Chairman, express to you and the members of this subcommittee the appreciation of the American Federation of Labor for the opportunity of presenting our views on these important proposals. Senator PURTELL. I want to thank you, Mr. Biemiller, for coming here and giving us the advantage of knowing your views and the views of the association that you represent. The testimony this morning concludes our schedule of witnesses on the President's health recommendations and proposals. The record, however, will be left open for 10 days, during which time admissible testimony may be filed and included in the record. These particular hearings are, therefore, concluded and the subcommittee will stand in recess until further call by the chairman. 46293-54-pt. 3-25 (By direction of the chairman, the following is made a part of the record:) Hon. WILLIAM A. PURTELL, DEARBORN, MICH., April 25, 1954. Chairman, Subcommittee on Health of Senate Public Welfare Committee, Senate Office Building. MY DEAR SENATOR PURTELL: I am writing to express my views on the pr posed Health Service Prepayment-Plan Reinsurance Act, H. R. 8356 and S. 3114, which are now under study by the appropriate committees of the Congress. I have been personally interested in the development of voluntary health prepayment plans for many years as a member of the American Hospital Asso ciation's original hospital service plan commission, later the Blue Cross Cou mission. I have been directly associated with the development of the B Cross movement in the United States and Canada since its inception; I was closely associated with the Philadelphia Blue Cross plan, and I am at present a member of the board of trustees of the Michigan Blue Cross plan. I believe that it is necessary and desirable for government at local, State, and Federal levels actively to encourage the extension of voluntary heath insurance. I have not understood, for example, why the Federal Government has not long ago made it possible for Federal employees to participate in Bi Cross and other voluntary health-insurance plans by extending the advantages of payroll deduction for this purpose as private industry has done for many years. I believe that the Federal Government should take the initiative in helping the States to develop methods for the coverage of certain segments of the population, such as the aged and the low-income groups, many of whom cannot afford to purchase adequate protection, but who could pay part of the cost of such protection. The continued solvency of our voluntary hospital system and the maintenance of quality of care combine to demand a solution to these problems. I have reviewed the proposed Health Service Prepayment Plan Reinsurance Act and I have read some of the testimony which has been presented to the Congress in connection with it. I do not pretend to be an expert on insurance matters and particularly not on reinsurance; I am, therefore, not qua (fi d to judge the technical aspects of the bill. It does seem to me, however, that the bill should help to induce both nonprofit plans and commercial insurance companies to more widespread experimentation in this field. The announced objectives of the administration and the stated purposes of the bill lead me to believe that the Congress would be well advised to take this first step to encourage the voluntary plans to widen the scope of their benefits and their area of coverage. As one who has been interested in the development and one who has bee interested in the operation of the Hill-Burton bill, it would appear to me that the Congress would be well advised to protect the Secretary of Health, Elaz tion, and Welfare and the insurance carriers by giving the proposed Advis Council some authority to approve regulations and standards. I make th suggestion for amendment which I believe would strengthen the bill and we draw support for it from some who might fear that the present word:2 concentrates too much power in one individual. Very truly yours, HENRY FORD HOSPITAL, ROBIN C. BUERKI, M. D. Executive Director, Detroit, Mich Hon. GEORGE MALONE, Senate Office Building, Washington, D. C.: This message is sent with deepest concern to protest the passage of Senate bill 3114. It is felt that it is not necessary for the Government to get into the operation of the insurance business through the reinsurance program. The high expense of Government in meeting its necessary functions renders performan of expensive and unnecessary functions inadvisible at this time. This reinstr ance proposal should be carefully reconsidered because it is not necessary at this time to meet the public need. I am sure that the American tradition of freedom of choice and the freedom of enterprise would be greatly endangered by the Government's entry into the health and accident insurance field. DALE P. SCHAUMBURG. Senator GEORGE MALONE, Senate Office Building, Washington, D. ('; Request you investigate and work to defeat H. R. 8356, which is Senate bill 3114, which appears being railroaded through committees. Passage will regiment one branch of insurance, hamstring all State insurance commissions, be a step toward socialized medicine. Let's keep what State rights we still have. This request is solidly backed by Nevada State Insurance Agents' Associations. LAWRENCE P. STETCHER. Senator W. MALONE, Senate Office Building, Washington, D. C.: Definitely advise to kill Senate bill 3114. Does not accomplish what it was intended for. Definite step toward socialism for medical and insurance field. GRANATA AND LUCINI. RED LUCINI. LAS VEGAS, NEV. Senator GEORGE W. MALONE, Washington, D. C.: Believe Senate bill S. 3114 and House bill 8356 may be very detrimental to the insurance business and may have much wider aspects than appear on the surface. Please investigate these thoroughly, as general opinion here of insurance men is opposed. JAMES C. YOUNG. Senator GEFRGE W. MALONE, Senate Building, Washington, D. C. Regarding legislation S. 3114, definitely against public interests and detrimental to insurance industry. Would remove all State control of insurance. Please vote no. RAYMOND and WENDELL CUTLER, Hon. GEORGE W. MALONE, United States Senate, Washington, D. C. Understand S. 3114 has been introduced which will in effect put Government into insurance business. Know you realize that electorate in last election desired less, not more, socialization, so you are therefore urged to oppose this bill. M. WILLIAM DEUTSCH. Senator GEORGE W. MALONE, Senate Office Building, Washington, D. C. Nevada State Insurance Agents Association wishes to express strong opposition passage, S. 3114, accident and health reinsurance. It does not achieve purpose of improving public welfare, permits socialization of insurance, and takes control of insurance out of various States substituting Federal control. D. E. MATTSON, Secretary. Hon. GEORGE W. MALONE, Urge your careful study and opposition to Senate bill S. 3114 which sets up reinsurance plan under Federal control, as this plan takes away State control and regulation and is not necessary as it does not improve the health or benefit of the public. Firmly believe that the regulation of insurance can be handled better by States than from the Government level. J. V. CORICA LAS VEGAS, NEVADA. Hon. GEORGE W. MALONE, Senate Office Building, Washington, D. C. Request your serious consideration to opposing passage S. 3114. Bill will not accomplish objective of improving public health. Bill grants sufficient authority to Secretary of Health, Education, and Welfare, to enable Secretary to completely regulate insurance, control State insurance departments, and eventually result in socialization of medicine and insurance. Letter follows. PAUL A. HAMMEL, Insurance Commissioner, State of Nevada, Hon. GEORGE W. MALONE: I have just read over the summary of the insurance bills H. R. 8356 and S. 3114. It looks to me like this is an attempt to control the insurance business. The bill is supposed to provide reinsurance, but my company does not need re.nsurance and there is plenty of reinsurance available for those that do. The bill would place very broad regulatory power over all health and accident insurance in the United States with the Secretary of Health, Education, and Welfare This we do not want to happen. Please give this your attention and read this bill over carefully. Respectfully, LEON K. STANLEY CALAVADA DIVISION, Reno, Nev., April 17, 1954. Re S. 3114. Hon. GEORGE W. MALONE, Senate Office Building, Washington, D. C. DEAR SENATOR MALONE: We greatly appreciated your recent communication. Just at the moment there seems to be a rather serious problem in your bailiwick relative to the above-mentioned bill. In studying some of the conditions set forth in that item it appears to us this is a definite attempt on the part of a portion of the Federal Government to take over State's righs insofar as the several insurance departments of the States are concerned. It furthermore appears this is an attempt to set up a dictatorship under the Secretary of Health, Education, and Welfare, to tell insurance companies what prems they can charge, what benefits they can provide, etc.,all of which we definitely conclude would not be in the public interest. During the past several years different ideas have been suggested from Washington indicating an attempt by some factions back there to develop an overall Federal control of the insurance business in the United States. We are con fident you recognize that such an arrangement would wreck the finest business, in our estimation, that operates in the United States today in behalf of the popnistion. The immense growth of the health and accident protecton business during the past few years definitely shows many companies in this field are capable of handling any and all requirements of this nature and also that more and more people each year are protecting their families and themselves through this medium. Not only would the requirements of this bill enacted into law socialize the insurance business in the United States but it would also be a long step toward socialization of medicine, also. We sincerely hope you will exert your usual good energies in again preserving the right of the States in looking after their own business. Yours very truly, D. L. ACREA, Manager, |