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and say

Those of us who have made a careful study of this plan can look at this plan and I think point out that it conforms in most details with S. 140, the Taft-Fulbright bill. If anything S. 140 and this plan, I think, have about 99 percent in common, in terms of a projected program.

Therefore, I think it is fair enough for me to make the statement that the Federal control of education is not involved in this program. True enough, any Commissioner of Education would have to be approved by the Senate before he could become a part of that set-up, and he would be responsible directly to the Secretary on a direct channel level rather than going through any other phase of the contemplated Cabinet set-up.

And when we talk about Federal control of education, you know as well as we do that the time has come in this country where the Federal Government has been providing services which cannot possibly be met on a local or State level, the necessary expenditures for additional public education or additional public school teachers' salaries, or what have you. And there are a number of bills before the Congress today on that score. I do not think we ought to shut our eyes

because

you

have an independent Board of Education somewhere off in the corner that that is going to be a solution to the problem. I think that Congress does have a responsibility, and it should have a hand in determining the policy. If I know the Congress' record in that respect, it has been a pretty good one, in reference to the kind of appropriations it has made. The only regret I have is that no bill has been passed during this past session thus far which would make it possible to have better schools and larger salaries for our teachers.

I am merely touching on some of the areas covered by the witness who testified for the State school office, and I would like to point this out: That there are 14 Central States which recently went on record in favor of this plan and they too are composed of educators. The field of education, contrary to the common belief, is not all one-sided against this plan. I think Dr. Zook can talk for my money at any point, any time, because I consider him to be among the best educators.

Senator Ives. I did not assume that they were opposed to it. Dr. Zook appeared here for the plan.

Mr. SCHIFF. As far as the NEA is concerned here in this set-up, you will find their top-level officers, some of whom I know and have talked to personally, would go for this plan in a big way.

Senator Ives. But you would construe an action of the NEA in supporting a board that is now proposed and forming a resolution before them to be unfavorable where this plan is concerned?

Mr. SCHIFF. No. If I may say so, I would say that, for this reason, Mr. Chairman. I recall the statement of Dr. Clark, who talked for the American Social Hygiene Association. In his case he said “We will want a Department of Health.” True enough. But that does not mean to say we are against plan No. 27. And he came out in favor of plan No. 27 at the hearings before the House. And I have an idea that the NEA crowd very definitely, if they saw they could not get a Department of Education, would go for this, because they, along with the other educators, would have

something very definite to say with reference to the make-up of that Department. I think the educators who testify against this plan make a very serious mistake when they shut themselves off from the rest of the American public. They cannot afford to do it in their own interests. When they want support for their program from social-welfare groups and from the public-health groups and from the civic and fraternal groups they will realize they too are part of the American public.

I think it would behoove the State school officers' group to think that problem through twice before definitely coming out against the plan.

Finally, and I point this out to you because I know you are in a hurry, I just have had occasion to talk to our chapters all over the country. I have wired to them and written to them. This is our

. No. 1 legislative program, and they have been in touch with the educators on local levels and the health people on local levels, and I think the letters that have come in to our office and other offices, as I have been told, would indicate that the American public wants this plan and has waited many, many years for this thing finally to come before the Senate in the form it now is, in order that it may receive the approval of the Senate. And I certainly hope it will receive not only your personal endorsement, but that of the Senate as well. Thank

you, Senator. I appreciate having had the opportunity to be heard.

Senator Ives. Thank you, Mr. Schiff, it has been a pleasure to have you.

We will recess at this time until 10 o'clock tomorrow morning.

(Whereupon, at 3:55 p. m. the committee was recessed, to reconvene at 10 a. m., Friday, July 7, 1950.)

REORGANIZATION PLAN NO. 27 OF 1950

FRIDAY, JULY 7, 1950

UNITED STATES SENATE,
COMMITTEE ON EXPENDITURES IN THE

EXECUTIVE DEPARTMENTS,

Washington, D. C. The committee met, pursuant to recess, at 10 a. m., in room 357, Senate Office Building, Senator John L. McClellan, chairman, presiding.

Present: Senators McClellan, Humphrey, Mundt, Smith of Maine, and Schoeppel.

The CHAIRMAN. The committee will come to order.

We will resume hearings on Senate Resolution 302, which resolution proposed to disapprove Reorganization Plan No. 27 of 1950. Our first witness this morning is Dr. Louis H. Bauer, of the American Medical Association. Will you come up, please, Doctor.

The Chairman also wishes to announce before we begin that it is our purpose to close these hearings today. Some 10 or 11 witnesses are scheduled to testify. We do not want to preclude anyone from an opportunity to fully present his views but we shall ask the witnesses to help us to expedite the hearing as much as possible.

Very well, Dr. Bauer.

STATEMENT OF DR. LOUIS H. BAUER, CHAIRMAN OF THE BOARD

OF TRUSTEES OF THE AMERICAN MEDICAL ASSOCIATION, NEW YORK, N. Y.

Dr. BAUER. Thank you, Mr. Chairman.
The CHAIRMAN. Do you have a prepared statement, Doctor?
Dr. BAUER. Yes, Senator, I do.

The CHAIRMAN. Do you prefer to read it, or would you like to insert it in the record and comment upon it?

Dr. BAUER. I think, Senator, in view of what you have said that it will not be necessary to read the entire statement.

The CHAIRMAN. You may read such parts of it as you desire and the other parts that you do not read may be incorporated in the record. The full statement may be printed, and you can read and comment upon such parts of it as you desire.

Dr. BAUER. Yes, sir. First, may I say that I am speaking as chairman of the board of trustees of the American Medical Association, and by specific direction of that board. I will submit the statement I have prepared for the record.

The CHAIRMAN. Very well.

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(The statement referred to follows:) STATEMENT OF DR. Louis H. BAUER, ON BEHALF OF THE AMERICAN MEDICAL

ASSOCIATION I am Dr. Louis H. Bauer, of Hempstead, N. Y., and I speak today i'n favor of Senate Resolution No. 302 and in opposition to Reorganization Plan No. 27. I am speaking in my capacity as chairman of the board of trustees of the American Medical Association, which has a membership of approximately 146,000 physicians, and by specific direction of that board.

The plan now being considered by your committee would establish a Department of Health, Education, and Security which will be an executive department. To this newly created department would be transferred all functions of the existing Federal Security Agency. In effect, therefore, the plan would give departmental status to that Agency.

Within recent years, this represents the fourth time we of the medical profession have presented to the Congress our judgment as to the inadvisability of creating an executive department in which would be associated or combined health, educational, and welfare functions. In the first session of the Eightieth Congress, hearings were held on two bills by the Senate Committee on Expenditures in the Executive Departments: S. 140, a bill to create an executive department of the Government to be known as the Department of Health, Education, and Security; and S. 712, a bill constituting the Federal Security Agency a Department of Health, Education, and Security. These bills died with the final adjournment Eightieth Congress.

In 1949, we expressed similar dissatisfaction with the President's Reorganization Plan No. 1 submitted to the Eight-first Congress (H. Doc. No. 222 on June 22, 1949), which proposed that the name of the Federal Security Agency be changed to the "Department of Welfare," and that this Department be constituted an executive department. More recently we appeared, on June 19 of this year, before the House Committee on Expenditures in the Executive Departments in opposition to Reorganization Plan No. 27, the plan that is now being considered by your committee.

Essentially there is no important difference between the proposals suggested by the legislation introduced in the Eightieth Congress, the contents of the President's Reorganization Plan No. 1 submitted to the Eighty-first Congress, and the current Reorganization Plan No. 27. They all would combine in an executive department functions relating to health, eduction and welfare, or social security. Such a combination, in our judgment, would not advance adequate and proper Federal programs to stimulate improvement in the health of the citizens of our country. On the contrary, such a combination would tend to subordinate health problems to those related to other aspects of our national welfare. Such a subordination would be extremely unfortunate.

As has been on other occasions brought to the attention of the Congress, the medical profession of the United States has formulated a 12-point program for the advancement of medicine and public health. The very first point of this program suggests the creation of a Federal Department of Health of Cabinet status with a secretary who is a doctor of medicine, and the coordination and integration of all Federal health activities in this Department, except for the medical services of the Armed Forces and the Veterans' Administration. This point in our program reflects a position that medicine has expressed for many, many years. Since 1875 the association has advocated a Federal Department of Health with a secretary who is a physician in charge. The present activities of the Federal Government in relation to matters of health present a confusing, uncoordinated, and uneconomical picture. Various agencies concerned with health are distributed in many Government departments. It would be in the interest of efficiency and economy to have them coordinated under one head, to avoid duplication of effort, diversion of activity, and unnecessary waste of money.

Several suggestions have been made to provide a remedy for this situation. The President in the early part of the Eighty-first Congress recommended, as I have previously indicated, a Department of Welfare to which would be transferred at least the major functions of the Federal Government in the fields of health, education, and welfare. Prior to that time it was suggested to the Congress that a Department of Education, Health, and Welfare be created to which would be transferred all functions now exercised by the Federal Security Agency. It has been suggested too, that all health functions of the Federal Government be combined in an independent health agency. And in addition there has been proposed legislation introduced in prior sessions of the Congress that a department be created to have sole and exclusive jurisdiction over the proper health functions of the Federal Government.

At the recently concluded meeting of the American Medical Association, held in San Francisco, our house of delegates expressed its firm conviction that Reorganization Plan No. 27 will not promote the health of the people, will not effectuate the recommendations of American medicine toward that end. In this statement I wish to summarize as briefly as I can the reasons that prompted the recent action of the house of delegates.

In the first place, the designation “Reorganization Plan” No. 27 is a complete misnomer. The plan does not reorganize anything. It merely elevates to an executive department status an existing agency of the Federal Government, with all of its inadequacies.

The plan does not suggest what economies it will effect. In submitting the plan to the Congress, the President stated that it is not practicable at this time to estimate the savings that will accrue from this plan.' An estimate was not "practicable” because the plan will not effect any savings.

The health of the people is sufficiently important to justify the creation of an executive department that would devote its sole attention to the promotion of health programs or, if in the wisdom of the Congress the creation of such a department is not expedient at the present time, the establishment of an independent agency to consider health problems divorced from those relating to education and welfare. The Hoover Commission did recommend an independent health agency under which would be assembled all Federal activities concerned with health. Plan No. 27 is therefore in conflict with the recommendations of that Commission.

An estimated small fraction (as of March 1, 1950, 4.36 percent of the population is engaged in agriculture and there is a separate Department of Agriculture. An estimated 34.6 percent of the population is engaged in commerce and labor and there are separate Departments of Commerce and Labor. On the other hand, 100 percent of the population is vitally concerned with matters of health and that fact would seem to be of sufficient importance to warrant very serious consideration by the Congress of the establishment of a separate and independent department or agency to deal with health matters.

While the house of delegates of the American Medical Association, as I intimated before, has repeatedly urged that a National Department of Health be established, recognition has been given to the dangers incident to the mingling in one department of functions relating to health and to other matters, including welfare. At a special meeting held in 1937 at a time when the reorganization of governmental activities in the executive departments was under consideration, the board of trustees prepared a statement expressing the opinion that “health activities of the Government, except those concerned with the Military, Establishments, should not be subservient to any departmental interests.” This action of the board of trustees was approved by the house of delegates at its meeting in Atlantic City in June 1937.

Reorganization Plan No. 27, if permitted to become effective, might well serve to bring about such subserviency. The President stated in submitting Reorganization Plan No. 27, “The Surgeon General and the Commissioner of Education retain all of the statutory authority, and duties now vested in them. The Public Health Service and the Office of Education remain intact as statutory entities with statutory functions.” Yet I respectfully invite your attention to the fact that the plan provides for a Secretary of Health, Education, and Security. His top associates are an Under Secretary, an Assistant Secretary, and an Administrative Assistant Secretary. All of these will be over the Surgeon General although the plan provides that the Surgeon General may report directly to the Secretary. There is no provision that any of the new positions shall be filled by a physicianin fact, the plan goes so far as to provide that the Surgeon General need not be appointed from the regular corps of the United States Public Health Service, nor is there anything in the proposed plan which would guarantee that even he would be a physician.

The association is deeply concerned that the quality of medical and hospital care be kept at the highest possible level, that nothing in the administration of Federal or other programs should be crystalized along lines that do not keep uppermost the importance of high quality standards.

With regard to the statement by the President that "adoption of this plan will not in any way interfere with further adjustments in the functions of the new Department, either by statute or reorganization plan,” may I say that we have

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