Senator DONNELL. And these men are all members in the medical profession; that is correct, is it not? Dr. FOREMAN. I think it is. Senator DONNELL. Very largely they are actual practitioners; that is correct, is it not? Dr. FOREMAN. But not infallible. Senator DONNELL. None of us are infallible, but they are practicing physicians? Dr. FOREMAN. Yes. Senator DONNELL. And would have the opportunity, perhaps, to judge better than some of us not physicians as to the operation of this bill? Dr. FOREMAN. That I would not agree to. I think that the layman is much more in a position to say what is the best kind of service than the doctor. Senator DONNELL. I am talking about the financial effect on the doctors. Do you think that the doctor or the average layman is better qualified to judge the financial effect? Dr. FOREMAN. No; because I would not deny that certain experts would get less under this than they would at the present time. If they decided to stay out, they might continue to get as much, but I do feel that by and large the medical profession would be better compensated under this national health bill than it is at present. Senator DONNELL. Doctor, is it not a fact, or do you know, that regardless of whether this bill would better compensate them, that there is a very large segment of the medical practitioners in this country that regard this bill as unsound in principle even though it would give each man more money than he would get under present conditions; and that the opposition, at least in large part, is based on the principle of Government insurance compulsorily applied, regardless of the effect it may have had on the individual practitioner? Dr. FOREMAN. That is not a medical question. Dr. FOREMAN. I know that doctors have based objections to this on completely nonmedical grounds. Senator DONNELL. Yes. Dr. FOREMAN. They feel it is too much Federal control, but that is just as if doctors were opposed to income tax. Senator DONNELL. Is that not one of the important bases of the opposition of the American Medical Association, that they do not favor the federalization of control of the American Government of patients and doctors; is that not one of the important bases of the opposition? Dr. FOREMAN. I do not think it is; no. Senator DONNELL. You do not think it is. Dr. FOREMAN. No. There is no Federal control of the relation of doctor over patient in this bill. Senator DONNELL. I think we might disagree on that, but I shall not go into this point with you. Is there anything further, Senator Smith? Senator SMITH. No. Senator DONNELL. Thank you, doctor, for coming. Pardon me, I did not know Senator Aiken was here. Senator AIKEN. I had another committee hearing. THE PROBLEM OF THE SOUTH I was just wondering, Doctor Foreman, in the southern conditions. what progress has been made in the South in improving health and providing medical care in the last few years? Dr. FOREMAN. I think the greatest has been done through the supplemental work of the Farm Security Administration, Senator. And we have had a chance to get medical care on a much more basic plan than ever before, although even that is selective. Senator AIKEN. You say the syphilis mortality is above the national average; and the tuberculosis, influenza, and pneumonia rates are higher than elsewhere. How do the percentages of illness and death compare with what it was 10 or 20 years ago? Dr. FOREMAN. It is less, Senator, but it is still far higher than the rest of the country. Senator AIKEN. There is some improvement? Dr. FOREMAN. There is some improvement; yes. Senator AIKEN. What is that due to? You say the Farm Security Administration, in some cases. What other factors would tend toward improving health conditions in the South? Dr. FOREMAN. The Public Health Service, standard of public health, sanitary facilities, economic position of the people. Senator AIKEN. Higher earning power? Dr. FOREMAN. Higher earning power. Still we are the poorest part of the country; have the largest number of midwives; the greatest consumers of patent medicines. Senator AIKEN. The fewest doctors? Dr. FOREMAN. The fewest doctors, the fewest hospitals, the fewes nurses. And I do not believe that there is any real hope for getting good health conditions in the South except on a national basis, on the basis of Federal aid, through such a plan as this. Senator AIKEN. Or an increased earning capacity. Your shortage of doctors is due to the fact that people cannot afford doctors? Dr. FOREMAN. One of the factors in their not being able to afford it is that there is so much illness. I can supply the Senator with the amount of time lost by the workers of the South from the industrie of the South because of illness, which exceeds by far that of any other part of the country. The whole question of pellagra and malaria, and so forth, which are peculiar diseases to the South, have greatly impeded our econom development; and I would say definitely it is a national question. because one of our greatest exports in the South is uneducated peop whom we send constantly to the North and West out of the South. Senator AIKEN. Are they coming back from the North in anywhere near the same numbers as they went into the North? Dr. FOREMAN. As I remember the figures, the South had fewer returning veterans coming back to the South than any other part ‹ f the country. I think on the one hand it is dissatisfaction with the po conditions of the South, and on the other hand I think it is the econom opportunities that exist in the North, and there is a constant migration of people from the Southern States to the North; and I think that the whole country suffers when those people go to the North uneducated and unhealthy. You have to bear the burden of our unhealthy and uneducated people when they move north. Therefore it seems to m to be a national problem which should be met by the Congress of the United States. Senator DONNELL. Is there anything further, Senator Smith? [No response.] The committee will probably not meet in this room tomorrow. We will meet, however, at 10 o'clock tomorrow morning, and the location of the meeting will be announced in the Washington Post tomorrow morning. If there is nothing further, gentlemen, the meeting stands adjourned until tomorrow at 10 o'clock. (Whereupon, at 11:31 a. m., Wednesday, April 10, 1946, the committee adjourned to meet again at 10 a. m., Thursday, April 11, 1946.) NATIONAL HEALTH PROGRAM THURSDAY, APRIL 11, 1946 UNITED STATES SENATE, COMMITTEE ON EDUCATION AND LABOR, Washington, D. C. The committee met at 10 a. m., pursuant to adjournment, the Honorable James E. Murray (chairman) presiding. Present: Senators Murray, Johnston, Aiken, and Donnell. The first witness this morning is Mr. Harold L. Ickes, the executive chairman of the Independent Citizens Committee of the Arts, Sciences, and Professions. Mr. ICKES. I have a statement here and I am going to ask your indulgence to read it. I prefer to finish the statement before I am asked any questions, if that is agreeable. The CHAIRMAN. That will be very satisfactory. STATEMENT OF HAROLD L. ICKES, EXECUTIVE CHAIRMAN OF THE INDEPENDENT CITIZENS' COMMITTEE OF THE ARTS, SCIENCES, AND PROFESSIONS Mr. ICKES. Mr. Chairman and gentlemen, I am glad to have this opportunity to appear before this distinguished committee today in support of the purposes of the Wagner-Murray-Dingell bill. I do,. however, wish to warn you that I come here not as an expert in the field of public health, although I have had some experience in the problems of that field. CONSERVATION OF THE NATION'S HEALTH Most of my life has been devoted to conservation, generally the conservation of natural resources. Too many of the people of America too frequently think of our natural resources in terms of oil or coal, trees or land, or in terms of water power or national parks. Indubitably, these are natural resources and they are worth protecting and by and large in the last generation or two this country has done a good job of protecting them. But many of us have, in the past, tended too often to overlook the fact that the people of America are its greatest natural resource. Most of us take people for granted-except, of course, at election time. It does us no good to conserve our oil fields, to perfect new techniques for getting more miles out of a gallon of crude oil, to make new plastics out of the hydrocarbons of coal, to harness additional water power, to irrigate more arid lands or to prevent erosion if there are no people to enjoy the fruits of these advances, or if there 85907-46-pt. 1-26 393 |