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Dr. FURSTENBERG. I will have to go back to my wartime experience because I have been out of Public Health Service now for 4 years. There were officers in the Public Health Service assigned to other agencies at the request of the latter. These officers were almost lost within the administration of the other agencies and they could not easily relate their problems to the Public Health Service. They were merely on loan and were working in poor administrative framework. There were also agencies duplicating specialized functions in health and education. There was also competition in interpreting to the States. Several agencies might have individuals assigned to a similar program, reduplicating efforts, though sometimes strengthening the program, but more often ending in competition with each other for the right to interpret programs to the various States. This it seems to me could be corrected by a more coordinated administration rather than, as an example, having each agency have its own health-education service.

Senator SCHOEPPEL. Your thought there would be for the elimination of duplication of effort and expense?


Senator SCHOEPPEL. I notice that you indicate that integration of these many activities as provided for in plan 27 would eliminate waste and inefficiency and would improve the morale of workers?


Senator SCHOEPPEL. Do you not feel that the morale of the people who are subjected to this, a lot of it double-barreled and triple-barreled duplication, their morale might be at a pretty low ebb too? Are not these departments responsible for the rendering of a great public service and they are to be taken into consideration, are they not Doctor?

Dr. FURSTENBERG. I would agree with you, Senator. I was thinking specifically of Government workers who thought it rather silly to have two agencies working in the same area to do a service which could be done perhaps more effectively by one and not confusing, indeed, as you point out, the recipients of this service.

Senator SCHOEPPEL. I agree with you that duplication is bad but do you not feel that there is a responsibility on these respective department heads who are charged with the responsibility of operating the departments to prevent some of this duplication? Just good common sense administration would preclude that happening too much. Dr. FURSTENBERG. I certainly would not take issue with you on that, Senator.

Senator SCHOEPPEL. That is all.

The CHAIRMAN. Thank you very much, Dr. Furstenberg.
Dr. FURSTENBERG. Thank you, sir.

The CHAIRMAN. Mr. Nelson H. Cruikshank?


Mr. Cruikshank, you have a prepared statement?

Mr. CRUIKSHANK. Yes, sir.

The CHAIRMAN. You may either read it or submit it for the record.

Mr. CRUIKSHANK. It is very short, Mr. Chairman, and I will read it and if I may I would like to add certain comments.

The CHAIRMAN. You may proceed.

Mr. CRUIKSHANK. Mr. Chairman and members of the committee, my name is Nelson H. Cruikshank and I am director of the socialinsurance activities of the American Federation of Labor. I am appearing before your committee at the direction of Mr. William Green, president of the American Federation of Labor, to present the views of that organization in support of the President's Reorganization Plan No. 27 of 1950 and in opposition to Senate Resolution 302. On behalf of my organization, I wish to express appreciation for the opportunity to present briefly our position on this subject.

The activities of the Federal Government in the broad field of human welfare, which encompasses the fields of health, education, and economic security, have gradually expanded over the period of the last several decades. For many years these developing activities were carried on in an uncoordinated manner without any central direction. Soon after the enactment of the Social Security Act of 1935, which greatly expanded the responsibilities and functions of the Government in this area, the Federal Security Agency was established by Executive order. This Agency now exceeds several of the existing Cabinet departments in personnel and volume of expenditure. The far-flung interests and the size of this Agency, while they may be a cause of concern to some, indicate to the common people of this country the interest on the part of their Government in the welfare of its citizens. By this I do not mean that working people expect the Federal Government to provide for their every need. They do believe, however, that it is appropriate for an agency of Government to implement the American ideal that each individual should have an equal chance in the effort to make his own way and to provide for the needs of himself and his family.

This, Mr. Chairman, is very essential to the historic and traditional purpose of our organization. We believe in the fullest individual effort but we think that people in the race for the prizes of life should start out as nearly as possible from the same point and without a handicap, without a handicap inherent to the accident or place of his birth, the area, the economic situation and locality in which he is born in regard to educational opportunities or with regard to health, but, once being provided with an equal chance, then be given the utmost in freedom to make the most of that opportunity.

To the working people of this country it has long appeared as incongruous that the agency responsible for the direction of these programs which affect them most directly and in such vital matters as health, the education of their children, and the underwriting of their economic security should not be afforded an equal status with departments of the Federal Government concerned with business affairs, labor matters, national defense, agriculture and others represented in the Cabinet.

President Green expressed the position of the American Federation of Labor in this respect in a letter addressed to the honorable chairman of this Senate committee when plan No. 1 of 1949 was under consideration. I quote from President Green's letter of July 1, 1949:

* * * The American Federation of Labor has always insisted that equality of opportunity in education, a high standard of health for all, and assurance of

some protection against the unpredictable hazards of insecurity are essential to the maintenance of the American system of free enterprise and free institutions. Enlightened management also has come to accept this view, the validity of which becomes increasingly evident as our industrial society becomes more and more complex.

These are the objectives of the Federal Security Agency which would be administered by the proposed Department of Welfare.

That of course was with reference to last year.

They are far too vital, too important to the preservation of our way of life, to relegate them any longer to a secondary rank in the Government.

While, as indicated in this letter, we supported the plan proposed last year, in our opinion the plan which is now under consideration represents certain improvements over the 1949 plan. First, it guarantees that the identity of the Public Health Service, the Social Security Administration, and the Office of Education be preserved. Under the provisions of the plan there is no danger, therefore, that any of these very important and vital functions might be merged with other organizations. These functions are so vital to the interests of the people of this country that a strong argument could actually be made for elevating each of them to Cabinet status, except that the Cabinet itself would then be out of balance.

I understand, Mr. Chairman, that that argument has been made. There is validity to it and it is very understandable that people who devote their life to the work of the medical profession should feel that there should be a department of Cabinet rank devoted just to that. It is also understandable that those in the educational field should feel that their work is so important that there should be a Secretary of Education and I suppose that it is a credit to the sincerity of those people, they would not be devoting their lives to that kind of thing if they did not think it was important. It is only natural to expect that they should argue for a Cabinet position for each of those specialized and very important interests. However, as I have stated, if you should provide a Cabinet post for each of them, important as they are, the Cabinet would be somewhat out of balance and would itself become perhaps an unwieldly body.

What the structure provided under this plan does, therefore, is to provide Cabinet status to each of these three major functions through one Secretary and, at the same time, preserve the identity of each. In effect this plan can be viewed as a parallel to the organization of the National Military Establishment, with the Secretary of Defense a member of the Cabinet and the Secretaries of the Army, Navy, and Air Force reporting to him. The proposed Department of Health, Education, and Security would be in a very real sense our Department of Internal Defense as it would be the Department responsible for the activities of the Government which are designed to protect our way of life against the destructive attacks of ill health, inadequate educational opportunities, and economic insecurity. Never has there been a time in our history when it was more important that our internal defenses against these enemies be secured.

In our opinion the plan further provides for the highest quality of governmental administration by assuring that professional powers and authority will continue to be in the hands of competent professional persons. This is accomplished by the specific provision that the offices of the Surgeon General of the Public Health Service, Com

missioner of Education, and Commissioner of Social Security are all to be filled by Presidential appointment, with the advice and consent of the Senate, and that each such official is to meet the professional qualifications required by the post.

Mr. Chairman, since this question has come up I think it may be important to emphasize two things, one, that each nominee for one of these important posts could only be appointed with the approval of the Senate. Conceivably it could be as has been suggested a sanitary engineer or dentist but the Senate would certainly fulfill its obligations to see that in the specific case of the nominee before them his professional qualifications were adequate to the post.

The CHAIRMAN. May I interrupt there to make this suggestion. True, the Senate would confirm but if in adopting a plan, a reorganization plan which actually becomes law the Congress authorizes the appointment of a sanitary engineer as head of the medical department then it certainly would not be in good taste to reject a man for no other reason.

Mr. CRUIKSHANK. Not for no other reason but it would be for the reasons which certainly would be developed.

The CHAIRMAN. Therefore, someone who may entertain the view— I am not saying that I do that he should be a medical man of professional standing then has valid objection to this plan which would permit the appointment of a sanitary engineer as was suggested here.

Mr. CRUIKSHANK. I am not sure it would. However, your comment leads me to the second point which I think is a very important one and that is that the plan does not alter any existing law or requirement. If the present Surgeon General can be a sanitary engineer and as such head the major health agency of the Federal Government then there is nothing in the plan that alters that.

The CHAIRMAN. That would be ture. Is that correct?

Mr. CRUIKSHANK. In my opinion it is. When you were talking to the witness who just preceded me I referred to page 5 of the official copy of the plan and I note there these words:

The Surgeon General may be appointed from the commissioned Regular Corps of the Public Health Service, and if so appointed (1) he shall not cease to be a member of such corps by reason of his appointment as Surgeon General, and (2) provisions of law applicable to the heretofore existing office of Surgeon General of the Public Health Service, including those with respect to pay and allowances, shall be applicable to him.

I think the important phrase is "provisions of law applicable to the heretofore existing office of surgeon general" shall continue. I think that is an important thing that is at the heart of this whole plan; that the plan does not alter any existing law with regard to these appointments. If there is something wrong with that law, if, for example, there is something wrong about permitting a sanitary engineer to be Surgeon General, a matter on which I am not commenting now one way or the other, if there is something wrong with that it is wrong in the present set-up and would not be altered by the plan. If it is right as it is, it would not be altered by the plan. I think it is an important consideration about the whole plan that it does not alter existing law about these vital functions of government. It simply elevates them to cabinet status.

The CHAIRMAN. I am not sure what the present qualifications for Surgeon General are. I think it well that we inquire into that and

have some advice on it. (See letter from Federal Security Agency, p. 137.) You may be correct in what you say that the present law might authorize the appointment.

Mr. CRUIKSHANK. I am not sure either, Mr. Chairman. The question never came to my mind.

The CHAIRMAN. I was under that impression and I may be wrong. Mr. CRUIKSHANK. In any event, the plan does not alter that or does not prevent the Congress from taking whatever action would be necessary; that is, if this plan were adopted it would not freeze anything that is right or wrong.

The CHAIRMAN. I understand.

Mr. CRUIKSHANK. While the substantive elements of each program are thus carefully preserved, the plan provides that, in the interest of efficiency and economy, the so-called housekeeping functions of the three major branches of the Department are to be consolidated.

It is for these reasons that this plan appears to us to be a well considered and timely measure. We therefore respectfully urge this committee to recommend that the plan be permitted to go into operation under the terms of the Reorganization Act of 1949 and accordingly to oppose the adoption of Senate Resolution 302.

The CHAIRMAN. Any questions?

Senator HUMPHREY. The question I was about to ask is the question which I think Mr. Cruikshank very ably answered with reference to the existing qualifications for Surgeon General. As I understand it, it is your belief that it does not in any way alter the existing law?

Mr. CRUIKSHANK. I think, Senator, it is stated right in the plan itself that it does not.

Senator HUMPHREY. I was not able to be here when other persons testified with reference to their observations on this. I think it is interesting to note, however, that we found no objection when recently the President appointed a new Secretary of the Army who did not happen to be a general. He appointed a man who was Director of the Budget and used to be in the Post Office Department, a most able man and one in whom I have the greatest confidence. I refer to Frank Pace.

When it comes to the national defense of this country, the very heart of our liberties, we do not say that the Secretary of the Navy ought to be an admiral or that the Secretary of the Army ought to be a general or the Secretary of the Air Force be an Air Corps man. What we expect is a good administrator and someone who can understand policy. I think that the record is quite clear that it does not always bode well for sound medical administration to have a doctor in charge of a hospital or a medical department. I think we have found in some instances that there are men who are most capable and yet are not doctors; that is my personal opinion from sad experience. Mr. CRUIKSHANK. Many directors of hospitals and trustees of hospitals are laymen of course, however, not interfering in the medical professional aspects. I think that is most important and I agree with you heartily that what this post would require would be the specialized skill of an administrator.

Senator HUMPHREY. Take for example a university, we do not always appoint great educators to be presidents of universities, we appoint administrators.

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