I have been a practicing physician in Seattle for close to 25 years. I regret that I am unable to identify myself, as retributive measures in one form or another would surely be my lot. I am a member of the King County Medical Society and of its Medical Service Bureau administering prepaid care. It may be of assistance to your committee to elicit from Dr. Jared answers to some of the following points: 1. Is it true that under the Seattle system patients do not have freedom of choice of physician? Less than 50 percent of the medical profession of Seattle participate; this figure includes nonmembers of the medical society. 2. Is it true that every obstacle is thrown in a newcomer's way to keep him from participating, by simply finding reasons for keeping him out of the Medical Society? 3. Is it true that the physicians at present receive $1.80 per office call, and that this figure has been reached only after 15 years, during which period the calls were paid for beginning with 80 cents, then $1, then $1.20, etc., until the present fee was reached, and that $2 per call is the maximum fee he can reach? 4. Is it true that funds were built up over the period of years the prepaid system has been in existence by withholding from physicians, by means of payment of the above low fees, and through legal "hocus pocus," the funds were utilized for the securing of the Doctors Hospital, which had been initiated by Federal grant, but is now in the sole custody of the clique running it? Is it true that while this clique permits patients under the prepaid system to be hospitalized there, withholds privileges from some of the doctors who participate in the plan, and thus again limits choice of physician even amongst those who do participate and that after the money was withheld from these physicians and utilized to secure this hospital? * * * 5. Is it true that any member of the medical society is considered moral and ethical no matter how much he mulcts the patient, while that same member must receive authority for surgery and other expensive care when that is furnished by the prepaid system? Is it true that the doctor does not have wings, and will by nature push private enterprise in medicine, in which the individual has no way of knowing whether he is being hurt or bettered, to the maximum, as long as the patient has any money left to spend? Yours respectfully, A DOCTOR ASHAMED OF DOCTORS, Practicing M. D. in Seattle. Subsequently the chairman submitted the following supplementary list of organizations which have indicated their endorsement of S. 1606: Alameda County Council, CIO. Amalgamated Meat Cutters and Butcher Workmen of North America. American Association of Social Workers, Milwaukee Chapter. American Epilepsy League, Inc. American Labor Party-PAC, New York County. American Labor Party, Bayside Club. American Slave Congress. American Veterans Committee Auxiliary, Philadelphia Area. American Veterans Committee, Brenner Wiener Chapter, New York. Atlanta Federation of Trades, Georgia. Association for Childhood Education. Blackman Lake Local, Washington State Pension Union. Boot and Shoe Workers Union, St. Louis, Mo. Brownsville Neighborhood Council, New York. Calumet Joint Labor Council, Illinois. Carpenters' District Council of St. Louis. Central Labor Union, Louisville, Ky. Central Trades and Labor Council, Edwardsville, Ill. Central Trade and Labor Council, Parkersburg, W. Va. Chicago Action Council. Chi Eta Phi Sorority, Washington, D. C. Children's Aid Society of Pennsylvania. Church Federation of Los Angeles. Citizens Political Action Committee of Queens, N. Y. Community Club Health Committee, Brooklyn, N. Y. Council for Community Action, New York. Contra Costa County Central Labor Council. Contra Costa County CIO Council. Cooperative Trades and Labor Council, Hamilton, Ohio. Current Issues Committee, Brooklyn, N. Y. Dubuque Trades and Labor Congress, Iowa. Duluth CIO Womens' Auxiliary. Eau Claire Industrial Union Council, Wisconsin. Farmers Educational and Cooperative Union, Casselton, N. Dak. Federation of Glass, Ceramic and Silica Sand Workers, CIO. Fort Wayne Federation of Labor, Indiana.. Fraternal Order of Eagles, Bellaire, Ohio. Girls' Friendly Society of the U. S. A. Greater Buffalo Industrial Union Council, CIO. Kenosha Trades and Labor Council, Wisconsin. Illinois State Federation of Labor. Independent Citizens Committee of the Arts, Sciences and Professions, Inc. Independent Citizens Committee of the Arts, Sciences and Professions, Radio, Stage and Screen Division. Independent Voters Committee of Garden Bay Manor, N. Y. Industrial Union Council CIO, Norristown, Pa. Industrial Union of Marine and Shipbuilding Workers of America, CIO. International Brotherhood of Boilermakers, Iron Ship Builders and Helpers of America, Great Falls, Mont. International Brotherhood Electrical Workers, Kalamazoo, Mich. International Brotherhood of Paper Makers. International Federation of Architects, Engineers, Chemists and Technicians, Washington, D. C. International Federation of Architects, Engineers, Chemists and Technicians, Philadelphia, Pa. International Ladies Garment Workers' Union, Hazelton, Pa. International Photo-Engravers Union of North America. International Typographical Union. International Union of Mine, Mill and Smelter Workers, CIO, Fayetteville, N. Y. International Workers Order, Lodge 4266, Chicago, Ill. Julius Rosenwald Fund. Jewish Community Council of Springfield, Mass. Lake County Central Labor Union, Gary, Ind. Los Angeles Newspaper Guild, CIO. Michigan Citizens Committee. Midwest Independent Citizens Committee of Arts, Sciences and Professions. Muskegon Federation of Teachers, Michigan. National Association of Colored Women. National Association of Telephone Equipment Workers. National Federation of Telephone Workers. National Lawyers Guild, Baltimore City Chapter. National Society for Crippled Children and Adults, Inc. New York Association of Teachers of Biological Sciences. Oil Workers Union, Martinez, Calif. Oil Workers International Union, Sapulpa, Okla. Philadelphia Citizens Political Action Committee. Pioneer Women's Organization, Los Angeles, Calif. Pioneer Women's Organization, Detroit, Mich. Plywood, Box Shook and Door Council, Olympia, Wash. Pontiac Industrial Unions Council, Michigan. Portsmouth Lodge, No. 441, International Association of Machinists, Virginia. Public Affairs Committee of Oxford, Ohio. Railway Mail Association, Women's Auxiliary, Jackson Heights, New York. Retail Clerks International Protective Association. Retail, Wholesale and Chair Store Food Employees Union, Local 338, New York. Rockaway Youth Forum, Rockaway Park, N. Y. Roma Citizen Club, Inc., Plains, Pa. Russian-American Citizens Club, Inc., New Haven, Conn. Sauk County Federation of Labor, Wisconsin. Screen Story Analysts' Guild, Hollywood, Calif. Seattle Municipal Employees' Local No. 57, Washington. State, County and Municipal Workers of America, CIO, Local 2, Chicago, Ill. St. Louis Newspaper Guild, Missouri. St. Joseph Central Labor Council, Missouri. Stove Mounters' International Union of North America, Kalamazoo, Mich. St. Paul CIO Council, Minnesota. Student Christian Movement in New England, Boston, Mass. Trades and Labor Assembly, Ogden, Utah. Trades and Labor Assembly, Sioux Falls, S. Dak. Trades and Labor Council, East Liverpool, Ohio. United Automobile Workers, AFL, Milwaukee, Wis. Union Settlement, New York. United Electrical, Radio, and Machine Workers of America, Local 286, Fitchburg, Mass. United Electrical, Radio, and Machine Workers of America, Local 237, Bridgeport, Conn. United Electrical, Radio, and Machine Workers of America, Local 1131, Milwaukee, Wis. United Hatters, Cap, and Millinery Workers International Union. United Office and Professional Workers of America, Local 102, Detroit, Mich. United Office and Professional Workers of America, Local 178, Los Angeles, Calif. United Packing House Workers of America, Local No. 11, Boston, Mass. United Public Workers of America, Local 1, New York. United Retail and Wholesale Employees of America, Local 189, Reading, Pa. United Rubber Workers of America, Local 2, Akron, Ohio. United Steel Workers of America. United Steelworkers, Local 1443, St. Louis, Mo. United Textile Workers of America. United Trades and Labor Council, Pittsburg, Kans. Urban League of Greater New York, Inc. Utility Workers Union of America, CIO. Virginia State Federation of Labor. Wholesale and Warehouse Workers Union, Local 65, New York. Young Women's Christian Association, Buffalo, N. Y. STATEMENTS ON S. 2143 AMERICAN HOSPITAL ASSOCIATION, Hon. JAMES E. MURRAY, Chairman, Committee on Education and Labor, United States Senate, Washington, D. C. DEAR MR. MURRAY: In answer to your request we are pleased to submit comments on Senate bill 2143, which was introduced by Senator Taft on May 3, 1946. While we speak for the American Hospital Association, we must point out that this opinion is informal, since our council on Government relations has not had opportunity to study this bill in order to establish the official position of the American Hospital Association with regard to it. However, the American Hospital Association has frequently stated its general recommendations with respect to national legislation affecting the further development of hospital and medical care. In previous appearances before your committee and before other congressional committees we have set forth certain fundamental principles which we believe should be followed by the Federal Government in its excellent purposes of making such care more widely available. These broad recommendations have been formulated by hospital leaders on the basis of practical administrative experience in providing hospital care to the citizens of the various communities throughout the Nation. From these recommendations it is possible for us to judge what the opinion of hospital people throughout the country would be with regard to any proposed legislation in the field of health and it is on that basis that our present comments are made. We have been impressed with the general approach of Senate bill 2143, to the problem of indigent care. The American Hospital Association has officially favored a program of Federal aid to the States to assist in making hospital and medical care available to those who cannot pay for it. We recognize that this indigent group is a minority of the population. It has been pointed out that probably more than 75 percent of our people are self-supporting and independent and prefer to remain so. Therefore, it seems inappropriate to set-up a complete Federal system of medical and hospital care for the whole American people. Most of them, we believe, do not want such a system and would resent the interference of government in such personal matters. To the average American wage earner, Blue Cross plans and various other methods of prepayment for hospital and medical care have special appeal. The amazing growth of Blue Cross in a comparatively short time to where it now covers more than one-seventh of our population is evidence that the American people prefer to be independent and self-sufficient. These plans now protect nearly 22 000,000 people. Over 7,000,000 of these have been added in the last 2 years. This indicates that its rate of growth is increasing. These figures do not include the many millions of persons who are protected by commercial insurance and other similar voluntary methods of prepayment of hospital care. The strong feature of the Blue Cross system is that it encourages the continuous growth of our voluntary system of medical and hospital care in this country. Under this system medical and hospital care have equalled the highest standards to be found anywhere in the world. It is our profound belief that the present high quality of medical and hospital care, in this country today has not come about because of any governmental determination to create it but because of the humanitarian incentives that are to be found only in a free people in a country free of governmental interference. We therefore concur in the broad aims of Senate bill 2143 to provide Federal aid to the States to assist in the care of those who are not able to provide such care for themselves. Modern hospital care has been developed over a long period of time to meet specific needs. It has been the experience in this country that wherever a need has arisen, the spontaneous efforts of the American people have been forthcoming to develop the answer to those needs. Thus the present system has been developed in orderly fashion, one step at a time, according to the needs which have arisen in the various areas throughout the country. We realize that in some areas the ability of the States to care for their needy people has not approached that of the country as a whole. It is our belief that medical and hospital care will make better progress if this orderly logical development is encouraged to continue. There are certain definite needs now for improvement of medical and hospital care in various areas of the country. These needs are twofold. The first need is for additional hospital facilities. S. 191, the Hospital Survey and Construction Act was developed in your committee to give Federal assistance to the States to determine where such additional hospital and health facilities are needed most, and to assist the States in beginning a program of construction to meet those needs. If S. 191 be enacted by the present session of Congress one great forward step in improving distribution of medical and hospital care will be well under way. The other area of immediate need is in making medical and hospital care available to the comparatively small group in our country who are financially unable to pay for it. Senate bill 2143 apparently makes a sincere effort to meet this need on this basis. To the extent to which Senate bill 2143 meets this need of this group of people we favor this legislation. You will recall that in our testimony on Senate bill 1606 we approved in general the aims of title I of this bill which endeavor to accomplish the same worth while purposes. We wish to direct attention to section 308 of Senate bill 2143 which we strongly favor. This would make it possible for Federal employees to participate in Blue Cross and other prepayment plans through pay-roll deductions. We think it is unfortunate that, so far, the largest employer in the country, the Federal Government, has refused to permit its employees to participate in Blue Cross plans through pay-roll deduction. We strongly favor legislation either in Senate bill 2143 or in separate legislation which would permit pay-roll deductions for Federal employees so that they may participate in this typically American method of self protection. In general we may say that the American Hospital Association favors the approach of Senate bill 2143 to the problem of national health. We believe that no group of people in this country is more conscious of the desirability of extending medical and hospital care than we are; and no one is more conscious of the apparent dangers of its development by means of complete Federal control. We are not able at this time to express an opinion on those administrative provisions in the bill. However, if this legislation should be seriously considered for prompt passage we would like to have an opportunity to give it thorough and intensive study and present to you our comments in greater detail at that time. We thank you for the opportunity of expressing to you the informal opinion of the American Hospital Association with regard to this important topic. Sincerely yours, JOHN H. HAYES, President-elect. THE ASSOCIATED WOMEN OF THE AMERICAN FARM BUREAU FEDERATION Chicago 2, Ill., June 4, 1946. Hon. JAMES E. MURRAY, Chairman Education and Labor Committee, DEAR SENATOR MURRAY: With further reference to our letter of May 24, the matter of the Taft, Smith, and Ball bill, S. 2143, was referred to the board of directors of the American Farm Bureau Federation, in session here last week. The board directed that the bill receive further study by the medical care committee before taking definite position. I would like to suggest that you keep in touch with our Washington representative, Mr. W. R. Ogg, who will advise you of later developments. Will you kindly include this letter in the record? Thanking you, I am. Sincerely yours, Mrs. CHAS W. SEWELL, |