partment. If you look in other countries that have separate departments of health and education they are generally countries where they have a national administration of programs in those areas, not countries like ours where we maintain the primary responsibility should rest close to the people in the State and local governments, and the Federal function should be one of financial equalization through the grants-inaid technique and through over-all planning and coordination. We think that there would be a positive danger in setting up professional departments at the Federal level to take on a character similar to a local school board or a local board of health or a local board of public welfare, all of which are dealing with the actual administration of professional services to individuals.

We think it is much more important that the top level of administration should be concerned with problems of fiscal policy, grant-inaid functions, relationships between the States and the Federal Government, and broad planning.

We have been very pleased, and I speak now from the point of State administering agencies, with the efforts that have been made in the Federal Security Agency to work out some sort of rational policy in the grant-in-aid area. We have been interested in the bill that this committee has just reported for a temporary Commission on Intergovernmental Relations, because it shows a concern with that same area of fiscal policy between the Federal Government and the States. But in addition to that, we see very positive advantages in having these very closely related functions in the same department.

I would like to mention just one area with which we have been particularly concerned lately, namely, the administration of medical care for the needy. That has traditionally been a welfare function. function going back to the poor laws, and yet we see developing in an evolutionary way a greater assumption of responsibility in the health departments. We have tried in our association to advance that evolution on a cooperative and not a competitive basis. We have a joint committee with the American Public Health Association, and also participate in the Interassociation Committee on Health, in which the AMA and other professional health organizations are members. They also have taken note of this interrelationship in the administration of medical care to the needy. The Federal Security Agency, through its constituent units, is trying to work out a policy there which will be positive and advance the joint concern, rather than competitive.

There are many other places that you could cite. For one thing now that the bureau administration is tending to be set up on a professional or functional basis, that is by health, welfare, education and so on, the problem of different age groups in the population cuts right across. You have got the Children's Bureau dealing with one of them, and you have the whole concern with problems of the aged and aging which cuts through all of these bureaus. There is a very real job for top coordination in those common denominators other than the purely functional.

I would say in conclusion that we wonder sometimes why there is so little really active promotion of this idea of a Cabinet department. I think one reason for it is that when you deal with a limited group in your population, like your farmers, they feel that the Agriculture Department is their spokesman and the Labor Department is the

spokesman for the organized labor and other labor groups, and similarly with commerce, but when you come to this area, you are dealing with the needs and aspirations of all of the people. It seems sometimes that the more diffused the interest, the more complete the interest, the less direct expression it receives. Yet it seems to us quite logical that Congress, which is elected to represent those general interests, should recognize them in this way by agreeing to let this plan go through.

The CHAIRMAN. Your statement may be printed in full in the record, your prepared statement.

(The statement referred to follows:)

TESTIMONY OF ELIZABETH WICKENDEN, WASHINGTON REPRESENTATIVE, AMERICAN PUBLIC WELFARE ASSOCIATION

My name is Elizabeth Wickenden and I am Washington representative of the American Public Welfare Association. This organization, composed of State and local public welfare departments and individuals engaged in public welfare at all levels of government, wishes to express its support for Reorganization Plan No. 27, 1950, to constitute the Federal Security Agency a Department of Health, Education, and Security. We wish, therefore, to express opposition to Senate Resolution 302 proposing that the Senate disapprove the plan.

It is our sincere hope that the Congress will this year agree to this long overdue recognition in the Federal Government for these fields of service that contribute so directly to the well-being of individuals and families. Proposals for such a department has been put forward for over 25 years, going all the way back to the Harding administration, and have been sincerely supported by those who feel such a move would contribute not only to a more effective Federal leadership and cooperative relationship with the States and professions in these fields but would also be a mark of recognition and prestige for this positive aspect of governmental responsibility that would be warmly received by people everywhere.

This particular plan seems to us to be well conceived to achieve the advantages of departmental status for these closely related fields of health, education, and welfare at the same time safeguarding their separate professional integrity and administration at the operating level. We are glad to see specific recognition given to the professional character of those important career positions in the Federal service of Surgeon General of the United States Public Health Service, Commissioner of Education, and Commissioner of Social Security. We have never felt that professional leadership in these important fields should be placed on the level of political appointment.

On the other hand we support the concept, embodied in plan No. 27, that these increasingly important areas of governmental responsibility should be jointly represented at the top level of governmental management and policy formulation in the President's Cabinet. There are two principal reasons on which our support for a combined department is based.

First we are strong supporters for the principle that the primary responsibility in these areas so closely affecting individual human well-being belongs in those units of government closest to the people, namely the States and local governments. We have therefore held to the concept that in the fields of health, education, and public welfare (social insurance presents a somewhat different and special problem) the role of the Federal Government should be one of administering grants-in-aid and over-all planning in terms of strictly national relationships (to the economy, national defense, population problems, basic standards, pooling of information, etc.) rather than the actual rendering of service to individuals.

We feel it is not only not valid to compare Federal activities in the fields of health, education, and welfare to those of a local board of health, school board, or board of public welfare, but that there are positive dangers in such comparisons. We have never advocated a Federal department corresponding to a State department of public welfare, but to take the much-discussed proposal for a Federal Department of Health, we would fear that such a separate department with full Cabinet rank might not be satisfied with the present grant-in-aid, research, and relatively limited functions of the Public Health Service and might begin to aspire to a program of direct Federal health services to individuals. It is the nature of practicing physicians, educators, and social workers to want to put their professional knowledge directly at the service of individuals. Federal

officials in these fields have had to learn to apply their knowledge in the area of policy and administration and to restrain their impulse to the direct practice of their profession. This is a very special talent in which professional skill and affiliation is only one part.

There are many positive advantages, moreover, to a combined department embracing these major grant-in-aid programs. We in the State welfare departments have welcomed the efforts of the Federal Security Agency in recent years to move toward a rationalization of the fiscal and administrative relationships between that Agency and the States. Many welfare departments, for example, administer programs in which the Federal aid comes from the Bureau of Public Assistance, the Children's Bureau, and the Office of Vocational Rehabilitation. It is a great contribution to economy and efficiency if Federal requirements and procedures relating to these programs can be simplified and coordinated before they reach the States. The fact that the Senate on the recommendation of this committee has just passed a resolution proposing a Temporary Commission on Intergovernmental Relations shows a keen awareness of the growing significance of the grant-in-aid as a governmental device and the importance of evolving consistent policies in its application to these fields.

In addition to the general interrelatedness of Federal grant-in-aid policies there are innumerable examples of specific areas where the relationship between the fields of health, education, and welfare is so close as to defy a sharp division and require the closest degree of cooperation. I would like to mention one of those in which we have an immediate concern as a practical example.

This is the problem of medical care for the needy. Traditionally, going back to the poor laws, medical care for the needy has been a part of the welfare responsibility. In most States and localities welfare departments are still providing whatever medical care is made available on a means-test basis. H. R. 6000, the social-security amendments just passed by the Senate, broadened to some extent their base of operations in this field. Yet we in welfare recognize the obvious fact that this is a health as well as a welfare function. In Maryland the health department has assumed full responsibility, with the help and the encouragement of the welfare department for this function. Not only have we set up a joint committee with the corresponding organization for public health, the American Public Health Association, to work in a cooperative way on this problem but we have followed with interest the efforts of the Federal Security Agency, through a committee composed of representatives of all the constituent agencies concerned with medical care, to evolve a consistent and forward-looking policy. The Interassociation Committee on Health, made up of the American Medical Association, American Hospital Association, American Dental Association, American Nurses' Association, American Public Health Association, and American Public Welfare Association has likewise adopted a statement of common policy and objective which recognizes the fact that both health and welfare are involved in the evolutionary development of this recognized public responsibility.

There are many other examples which could be cited. Now that our administrative bureaus are tending to be organized more along professional and functional lines there is a very real need for coordination and planning where other common denominators of interst, as for example age, are involved. The work on problems of children and the increased attention to problems of aging are good cases in point.

We feel that acceptance of Reorganization Plan No. 27 will best serve the interests of those whom these professional programs serve and will at the same time protect the professional integrity of their administration.

We feel it is consistent with the American tradition governing the division of responsibilities between the Federal, State, and local governments and will in no way endanger the primary responsibility of the latter in the operation of health, education, and welfare programs. At the same time it will assure a voice at the highest level of government for those aspirations of people throughout the land that our knowledge, our resources, and our skill should be used to achieve a better life for everyone. The CHAIRMAN. May I ask if I understand you correctly; you oppose the creation of separate departments?

Miss WICKENDEN. Yes, we favor Reorganization Plan No. 27, and we think that that would be the most desirable thing.

The CHAIRMAN. Would you oppose if there were eliminated from the plan of reorganization the inclusion of health and education and suppose they are taken care of some other way? Would you then oppose the creation of a Department of Welfare?

Miss WICKENDEN. Oh, no, we would not oppose it, but we think it would be much better if they were all in one department.

The CHAIRMAN. Thank you very much.

Miss WICKENDEN. Thank you, Mr. Chairman.

The CHAIRMAN. The next witness is Mr. Weitzer.

STATEMENT

OF BERNARD WEITZER, NATIONAL LEGISLATIVE REPRESENTATIVE, JEWISH WAR VETERANS OF THE UNITED STATES OF AMERICA

Mr. WEITZER. Mr. Chairman, on behalf of the Jewish War Veterans of the United States of America, I want to express our appreciation for this opportunity to present to your committee our approval and support of Reorganization Plan No. 27 of 1950 and our opposition to Senate Resolution No. 302.

I am appearing here by mandate of our national executive committee in their meeting June 24 at the Commodore Hotel, New York City. This is in harmony with the preamble to our constitution from which I quote the following excerpts of our purposes: "To foster and perpetuate true Americanism-to cooperate with and support existing educational institutions to instill love of country and flag and to promote sound minds and bodies in our members and our youth." These purposes were written when our organization was founded in 1896 by men who fought in the War Between the States. and we continue to adhere firmly to these purposes.

We believe that Reorganization Plan No. 27 of 1950 will help to carry out those purposes.

In this reorganization plan, it is provided that the activities of the Federal Government in respect to health, education, and security be given the dignity and the prestige of a Presidential Cabinet department. It is well that this be done, for these activities deal with the conservation and the development of our most important resources our human resources. These are the true foundations of America's greatness and of its strength. From these resources we draw products of our industry and our farms and all the good things of life which the United States enjoys beyond any other country on the face of the globe. Even more important, the freedom in which we live is based on these human resources.

Furthermore, defense of our freedom, defense of our country and of all the things we hold dear are inextricably interlaced with the activities of the proposed Department of Health, Education, and Security. Likewise, the qualifications, the potentialities, and the well-being of our labor force are similarly interlaced with the activities of the proposed Department. How could it be otherwise when productive efforts of human beings are so dependent upon their health, education, and their sense of security? I am sure that with your own imagination you can extend these tie-ups to practically every field of activity which is now represented in the President's Cabinet. In fact, the activities of the proposed Department are an essential ingredient of the recipe for making better and more secure citizens. Therefore, it is vital that the head of these activities should sit regularly with the other members of the President's Cabinet in their Cabinet meetings for that interchange of ideas and advice which go to make our country what it is.

Moneywise, too, the activities encompassed in Reorganization Plan No. 27 are of major importance. About 1% billion dollars are being collected annually in old-age and survivors insurance taxes and about 600 million dollars are paid out annually on that account. There are also about $12,000,000,000 in accumulated funds. In other programs authorized by the Congress some $800,000,000 are paid out annually for grants-in-aid. Thus these activities have quite an effect on our Federal fiscal policies. This is a further reason why there should be a Secretary of Health, Education, and Security to sit in the President's Cabinet.

It is clear that the scope, the size, and the importance of these activities justify Cabinet representation. Though these activities have developed greatly during the past 15 years, the idea of Cabinet representation is not new. There has been talk about it for some 30 years under five different Presidents. The Hoover Commission in its report has recommended such a Cabinet office although not in the precise terms of Reorganization Plan No. 27.

However, our organization is in accord with the deviation from the Hoover Commission's recommendations for a United Medical Administration. That recommendation would gut and disrupt the Veterans' Administration, which has been so helpful in seeing to it that veterans receive as expeditiously as possible the many benefits which Congress has voted for veterans. In other respects, Reorganization Plan 27 does not differ too much from the Hoover Commission's recommendations. In fact, most of the differences are there to meet objections made by Senators to Reorganization Plan No. 1 of 1949. In any event, such differences do not go to the heart of the issue, as we see it, the desirability and the need for giving the Federal Security Agency Cabinet status as the Department of Health, Education, and Security.

To conclude, health, education, and security are now so big and important, so vital in our national economy, so closely related to the problems of other Cabinet departments that the activities embraced by reorganization proposal No. 27 should be represented by its head in the President's Cabinet. These activities are no longer a sideshow. They belong in the main tent.

Thank you for the opportunity to appear before you.

Now, Mr. Chairman, I want to make a few comments on some of the things that have been said this morning if I have time, largely with reference to the use of words. There was some reference to the violation of the Hoover committee recommendations, and I guess from the standpoint of pure English that is perfectly all right, but it seems to me there is a connotation that what the Hoover Commission has recommended is something of a form of law or sacrosanct and not subject to change. I do not see that in that respect at all. Another word, the use of "welfare" attitude as though that is something sinister. To me the old-fashioned sense of the word "welfare," as it is used in the Constitution of the United States is one of the objectives of our Government. I think of it in terms of the well-being of the people, and it seems to me that there is nothing sinister or wrong about that.

There was a good deal of talk this morning about the political direction of these activities as opposed to professional direction. Well, I have seen all kinds of professional direction in a great variety of industries, and I have watched it in the Government, and I think that