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insurance has been in practice for a number of years that the fee-forservice plan creates a great deal of paper work and leads to abuse by doctor and patient.

Summarily, the National Medical Association wishes to express its commendation to the men who have been responsible in formulating this bill since it believes that only through the establishment of a sound national health program can the health of the nation be definitely improved.

The CHAIRMAN. Thank you, Doctor. Any questions, gentlemen! Senator DONNELL. I would like to ask a few, Mr. Chairman.

Doctor, early in your testimony you state that the National Medical Association, and I quote:

bases its support primarily on the fact that this bill is an expression of the democratic principle that an attempt will be made to give the most to the greatest number of individuals and

It is what is after "and" I call your attention to particularly—

because it is in conformity with the general-welfare clause in our Constitution whereby the Federal Government assumes the responsibility to see to it that the welfare of every individual in the Nation will be adequately safeguarded.

Dr. ROBINSON. I will ask Dr. Cornelli to answer that for you. Senator DONNELL. Let me ask a few questions before he answers, please. What is your name, please?

Dr. CORNELLI. Paul B. Cornelli.

Senator DONNELL. Paul B. Cornelli. What is your profession! Dr. CORNELLI. I am a physician.

Senator DONNELL. Are you a lawyer?

Dr. CORNELLI. No, sir.

Senator DONNELL. Dr. Robinson, may I ask you who is responsible for the insertion in your statement of that language which I have quoted, namely:

it is in conformity with the general-welfare clause in our Constitution whereby the Federal Government assumes the responsibility to see to it that the welfare of every individual in the Nation will be adequately safeguarded.

Dr. ROBINSON. I am.

Senator DONNELL. Then why, may I inquire, is it that you prefer not to answer the question?

Dr. ROBINSON. I have a little throat trouble. I have read the statement; and Dr. Cornelli has been here before as our representative in congressional legislation.

Senator DONNELL. It is because of your throat?

Dr. ROBINSON. Yes, sir.

Senator DONNELL. Dr. Cornelli, have you studied this question as to the effect of the general-welfare clause of the Constitution?

Dr. CORNELLI. I would say, Mr. Senator, that it is an accepted fart. I believe that many of the services which have been developed in this country through the United States Public Health Service have bee developed on the basis of the general-welfare clause. If you will let me follow this through

Senator DONNELL. Surely.

Dr. CORNELLI. Namely, that the Government can use tax funds for the improvement of the health and welfare of the Nation. For instance, the venereal-disease law, which was passed in 1938, and the

Cancer Act, 1937 or 1938, allocated millions of dollars on the basis that it could do this to improve the general welfare and health of the Nation. I think that is an accepted fact.

Senator DONNELL. Doctor, the specific question I had in mind was, and I think I put it to you: as to whether or not you have examined into the question as to whether or not the statement in our Constitution is one whereby

the Federal Government assumes the responsibility to see to it that the welfare of every individual in the Nation will be adequately safeguarded—

is a sound construction of the so-called general-welfare clause of the Constitution? Have you looked into that?

Dr. CORNELLI. I did maybe about 15 years or so ago, when I was working for my doctorate in public health. I have not checked the meticulousness of the statement as expressed in the memorandum here, but I believe that that expression is the attitude or feeling in this country in terms of the general-welfare clause.

Senator DONNELL. To what clause in the Constitution do you refer to as the "general-welfare clause"?

Dr. CORNELLI. I do not have the Constitution here.

Senator DONNELL. Is it section 8 of article I, which reads:

The Congress shall have power to lay and collect taxes, duties, imposts and excises, to pay the debts and provide for the common defense and general welfare of the United States; but all duties, imposts and excises shall be uniform throughout the United States.

Dr. CORNELLI. That is the statement which we used in the formation of this memorandum.

Senator PEPPER. Senator, maybe he would also wish to call attention to the fact that in the preamble to the Constitution, as one of the objectives in the formation of the Government there is reference to the general welfare.

Senator DONNELL. I have no objection to mentioning that. However, the distinguished Senator well knows that the Supreme Court of the United States stated distinctly that the preamble confers no legislative power whatsoever. That is the distinct holding of the Supreme Court.

Senator PEPPER. I was just wondering whether you wished to pursue this technical inquiry, because obviously these men are not the profound students of the Constitution that you are, and if you do not doubt the power of Congress to pass this bill, their opinion, I dare say, on the question of the constitutionality and effect on the general-welfare clause in the Constitution would not be particularly pertinent to this inquiry.

Senator DONNELL. Senator, the only reason I asked the question is that Dr. Robinson has come before us as the head of a great national medical association making a statement that this bill is in conformity with the general-welfare clause in the Constitution, and defines that as one whereby—

the Federal Government assumes the responsibility to see to it that the welfare of every individual in the Nation will be adequately safeguarded.

Senator PEPPER. Maybe the doctor intended to say, as, for example, "I believe that the Government should do that."

Dr. ROBINSON. Yes.

Senator PEPPER. It seems to me, since it has not done it so far, maybe he meant to assume the passage of this bill, in which case the Government would to a large extent do that.

Senator DONNELL. I wanted to find, Mr. Chairman and gentlemen of the committee, the basis for this construction of the general-welfare clause as being one under which the

Federal Government assumes the responsibility to see to it that the welfare of every individual in the Nation will be adequately safeguarded.

I shall not pursue the inquiry with these two gentlemen, save only in compliance with the Senator's mention of the preamble, to read the preamble. I think it is only fair that it be read.

Dr. CORNELLI. I would like to direct a question to the Senator.
Senator DONNELL. Surely.

Dr. CORNELLI. Do you not believe that in our Nation the Federai Government, in most of the legislation which has had to do with the health and welfare and security of the Nation, in terms of individuals, that legislators by and large have assumed that the Federal Government has this responsibility? They may not have construed it in the specific sense I have stated, but I believe in back of the minds of all well-thinking legislators that is the true attitude of mind.

Senator DONNELL. Since you ask the question, I will answer t itematically, that by the general-welfare clause or a combination of clauses, that

the Federal Government assumes the responsibility to see to it that the welfare of every individual in the Nation will be adequately safeguarded.

And since he has asked the question I would like to say three things. First, that the preamble reads as follows:

We the People of the United States, in order to form a more perfect Unko i establish justice, insure domestic tranquility, provide for the common defence. promote the general welfare, and secure the blessings of liberty to ourselves and our posterity, do ordain and establish this Constitution for the United States & America.

Second, that in the case of Dore v. U. S. (195 U. S. 140), and Jack v. Massachusetts (197 U. S. 22), it is held that no power is derived from the preamble of the Constitution save only the source of taxation Senator PEPPER. What was the date of that case, Senator?

Senator DONNELL. The Jackson case was 1905, Jackson against Massachusetts. The Dore case, 1904. Neither of those cases have been overruled or modified so far as I am informed.

Senator PEPPER. Have you followed those cases down through Shephard's Citations?

Senator DONNELL. No, sir; I have not. I think it is well understood, Senator Pepper, and I think the Senator will not challenge this state- : ment, that it is well understood among lawyers that this is a correct statement of law, and that no power to enact any statute is derived from the preamble to the Constitution.

Senator PEPPER. Would you check that in Shepard's Citations! Senator DONNELL. I would be glad to do it, and put into the record! whatever I find, and I undertake to state here what is the law.

Senator PEPPER. There has been a good deal of change in the Cot-i stitution since 1905.

Senator DONNELL. I might add, Mr. Chairman, that the book from which I read of the Constitution of the United States of America

put out by the United States Government Printing Office, in 1936, pursuant to Senate Concurrent Resolution No. 35, adopted May 14, 1936, which is 31 years after 1905; and I make the statement without qualification or restriction that the law is, in my best judgment, as is stated, and that we shall find it so. But I shall be glad to check it and put into the record what I find.

The CHAIRMAN. Gentlemen, it seems to me that this is a highly technical point and I do not think it would be fair to ask laymen to pass on these technical matters. I assume that we will have sessions of our committee, at which time we will go into these constitutional problems very extensively.

Senator DONNELL. I think so, Mr. Chairman.

The CHAIRMAN. I have great respect for the learning and ability of the Senator, and I am sure he will be very helpful to us at that time in working it out, but I do not believe we should question laymen on it.

I remember an experience of mine, years ago in a trial, a very able lawyer for the Defense involved one of my witnesses in a technical discussion of mineralogy. My witness, just an ordinary miner, but as a result of the cross examination the miner was induced to qualify as a sort of expert and the lawyer made him appear at a disadvantage. I do not think it is fair to bring up a technical discussion on a constitutional question with a layman. I think it could be regarded as something irrelevant to the general statement.

Senator DONNELL. Mr. Chairman, in response I may say that I should not have pursued this further, but Dr. Cornelli himself requested permission to ask me a question, which I attempted to answer. In the second place, I present also this fact: That when a witness presents himself to this committee, as the doctor has, very courteously and interestingly, and states in his testimony on behalf of the National Medical Association that this bill is

in conformity with the general welfare clause in our Constitution whereby the Federal Government assumes the responsibility to see to it that the welfare of every individual in the Nation will be adequately safeguarded.

I think it is highly appropriate at least to note in the record the contrary view.

I shall be very brief with respect to the third matter to which I call your attention, and that is this: That the following is quoted from a portion of a paragraph appearing at 127 of this book, published in 1936 by the United States Printing Office:

The phrase, "to provide for the general welfare"-This portion is quoted from the case of the United States v. Butler, 297 U. S., at page 64 or thereabouts, issued in 1936. The opinion was:

"The view that the clause grants power to provide for the general welfare, independently of the taxing power, has never been authoritatively answered." Mr. Justice Story points out that if it were adopted, "it is obvious that under color of the generality of the words, to 'provide for the common defence and general welfare,' the Government of the United States is, in reality, a government of general and unlimited powers, notwithstanding the subsequent enumeration of specific powers. The true construction undoubtedly is that the only thing granted is the power to tax for the purpose of providing funds for payment of the Nation's debts and making provision for the general welfare."

I simply want to challenge the statement, Mr. Chairman, that under the general welfare clause the Federal Government assumes the responsibility to see to it that the welfare of every individual in the Nation

will be adequately safeguarded; and I close by calling specific attention to the provisions of amendment 10 of the Constitution, which reads:

The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the Sates repectively, or to the people.

The CHAIRMAN. Senator, my understanding is that Public Law 410, which provides the Public Health Service, has been upheld by the Supreme Court. Particularly titles 2 and 3 were upheld by the Supreme Court on the right to levy taxes and expend them for the 1 public welfare.

Senator DONNELL. Well, I think you are familiar with the point raised on the floor of the Senate with respect to S. 191, and later with the school-lunch bill.

The CHAIRMAN. Yes.

Senator DONNELL. In which I am not attacking the power givet.. but I think there is a limitation on the power to tax, and there is no decision of the Supreme Court of the United States, so far as I know, which says that the Federal Government assumes the responsibility! to see to it that the welfare of every individual in the Nation will b adequately safeguarded. I do not think it is the law, and I think it i should be challenged clearly and distinctly in the record at this time. The CHAIRMAN. We will take that matter up later on. Senator DONNELL. That is all I desire to say, sir.

The CHAIRMAN. The next witness will be Dr. Harold T. Low.

STATEMENT OF DR. HAROLD T. LOW, PRESIDENT, ASSOCIATION OF AMERICAN PHYSICIANS AND SURGEONS

The CHAIRMAN. Dr. Low, will you state your full name, and the association which you represent?

Dr. Low. My name is Dr. Harold T. Low, of Pueblo, Colo.

The CHAIRMAN. You are president of the Association of Americar Physicians and Surgeons?

Dr. Low. Yes, sir.

The CHAIRMAN. Will you explain what that association is, wher it was created, and give us its membership?

Dr. Low. If I may say, sir; the first paragraph or two of ou prepared statement will take care of that.

The CHAIRMAN. You may proceed, then.

Dr. Low. In addition, may I say that I have practiced medicine fr 36 years and am still actively engaged therein.

I am president-elect of the south central branch of the America Neurological Society.

Mr. Chairman, I want to thank you for the invitation which you extended the association to appear here and to give our view on th legislation.

The CHAIRMAN. We are glad to have you here.

THE ASSOCIATION OF AMERICAN PHYSICIANS AND SURGEONS

The Association of American Physicians and Surgeons was organize a little more than 2 years ago. In this short time, it has gained fa: reaching and rapid acceptance, having members in every State of the

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