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process when you want to establish better efficiency and operation in any enterprise to begin by creating positions of ability and people of ability at the administrative and executive level. It is through their advice, coordination, and control that you can accomplish those results.
Mr. RIEHLMAN. That is all at this time, Mr. Chairman.
Senator SMITH. We are trying to alternate between the House and the Senate and between the majority and minority parties, and at this time we will recognize Senator Humphrey.
Senator HUMPHREY. Mr. Dodge-
Senator HUMPHREY. Just to review the status of this plan, as compared to the 1950 plan, No. 27: First of all, as I see it, the plan of 1950 provided for the appointment of an Under Secretary and one Assistant Secretary for Health, Education, and Security.
Mr. DODGE. That is correct.
Senator HUMPHREY. This plan, as I understand it, provides for the appointment of an Under Secretary and two Assistant Secretaries. Mr. Dodge. That's right.
Senator HUMPHREY. Also, the plan of 1950 provided for a special or an administrative assistant to the Secretary of Health, Education, and Security.
My question is this: Does the plan of 1953 contemplate that one of the Assistant Secretaries prescribed therein will perform administrative functions, an administrative assistant for internal office management functions?
Mr. DODGE. Well, not specifically, Senator Humphrey. The form of the organization is slightly different in the establishment of the Under Secretary who will, what we call in business, be the operating manager and, in that sense, would be a higher ranking man to perform administrative-management services.
Senator HUMPHREY. Now, am I correct in this statement that both these plans, the 1950 plan and the 1953 proposal before us, contemplate the appointment by the President, with the advice and consent of the Senate, of the Surgeon General, Commissioner of Education,
Mr. DODGE. That's right.
Senator HUMPHREY. Both of these plans also provide that the functions which are presently prescribed under law will remain in the respective divisions or heads—the Surgeon General, the Commissioner of Education, and the Commissioner of Social Security ?
Mr. DODGE. That is correct.
Senator HUMPHREY. In other words, no reorganization plan can abolish functions?
Mr. DODGE. That is provided in the Reorganization Act.
Now, the point that I want to get to is with reference to this special assistant to the Secretary appointed by the President, with the consent of the Senate, from among persons who are recognized leaders in the medical field with wide nongovernmental experience. Without argu
ing the merits of that particular appointment, my question is this: Will this in any way conflict with the statutory authority of the Surgeon General?
I have before me a review of the responsibilities of the Surgeon. General and the Public Health Service. The Surgeon General's offica is to be continued under this plan, as is surely the Public Health Service, since it is provided by public law. Is there any conflict of jurisdiction between this special assistant to the Secretary and the responsibilities and duties of the Surgeon General? Mr. DODGE. I believe, Senator, if you refer to the plan in section 3Senator HUMPHREY. Yes.
Mr. DODGE. That he will advise the Secretary with respect to improvements in these plans.
Senator HUMPHREY. Well, now
Mr. DODGE. He is not an operating man in the sense that I think you mean.
Senator HUMPHREY. So, he is more or less a special adviser to the Secretary?
Mr. DODGE. Correct.
Senator HUMPHREY. Well, now, why don't we have a special adviser on education, Mr. Dodge ? The education of our people is as vital as is their health.
Mr. DODGE. I think I could rephrase your question, Senator: Isn't there an equally good reason for having a special assistant on education?
Senator HUMPIIREY, Correct, sir.
Mr. DODGE. I'd like to answer it this way: The problem of making adequate medical service available to all the American people is a serious one at the present time and one which the balance between private and governmental participation must be carefully worked out. For this reason, it was considered wise to make immediately available to the Secretary of the new department a top-level special assistant with a distinguished background in private medicine who could provide important advice in the recommendation and administration of the laws which are directed to establishing this balance.
In the field of education there is some difference. The balance is there, one between the Federal Government and the State and local governments, and here the plan recommends a committee of able representatives of these latter jurisdictions, and it was thought to be a more appropriate arrangement for providing advice in this area.
Senator HUMPHREY. Mr. Dodge, I accept that, as to the whole value of your statement, but let's be, as one of my distinguished colleagues said here a moment ago, extremely candid. Isn't the truth of the situation that the American Medical Association raised such a fuss at the time of the last two plans that this is a sop in an effort to placate the bitter opposition of the American Medical Association to reorganization plans that we had before us on other occasions?
Mr. Dodge. That I can't answer because I wasn't a participant in the others.
Senator HUMPHREY. Well, I base my question on this, Mr. Dodge: "There is no more critical problem facing the American people today than education. While the health of our people may be in difficult circumstances, considering the reports that we have heard, I have
never heard any more reports that were more alarming than the lack of school teachers, the lack of classroom facilities, and the fundamental, basic problem of financing education, both in private and public colleges, both in elementary and secondary private schools as well as public schools. I think on the face of it, this plan reveals that there has been a political consideration present here.
I am going to support the plan. I think the plan is very much similar to what it was in 1950, and I supported that plan; but I am rather shocked to see that, just because somebody puts up the big hue and cry, we appoint a special assistant to the Secretary, standing in between a professionally trained Surgeon General and the Secretary, when we don't do the same thing for the millions of our aged people, who are in real difficulty on the basis of their annuities, pensions, and insurance, and we don't do the same thing on the basis of education and the educational need of millions and millions of American children, an educational need that isn't being fulfilled. I think the administration owes us an explanation.
If you need a special assistant to the Secretary of Health, don't you need a special assistant to the Secretary in terms of education, or does the administration feel that education is being properly met today?
Mr. DODGE. Well, I would answer that this way: In the first place, the new special assistant does not stand between the Secretary or Administrator and the Surgeon General.
In the second place, on the education side, involving as its does the Department which makes very large payments to States in this area, the belief was that to balance that off with this special advisory committee of wider scope would serve the same purpose.
Senator HUMPHREY. I appreciate the soundness of that suggestion, sir.
I must say, in all candor, that I strongly supported the 1950 plan. I felt it was desirable. I thought the issue that was raised was a phony issue.
I think your assistant has answered it very well. You cannot alter the basic law of this land by appointment of an administrator because the laws pertaining to medicine are laws passed by the Congress.
Mr. Ewing's position may have been an untenable one and an undesirable one, but he couldn't alter the law.
Now, I recognize the desirability of placating the opposition. You have gone to some extremes in having a meeting in Washington to see whether or not the American Medical Association would go along with this plan. In fact, however, I thought it was the Congress which was to determine whether or not this plan was to be adopted. But if your approach will get the plan through, I am perfectly willing to cooperate and get the plan through.
I commend the administration for its political savvy in this instance; but I wonder what you are going to do about the schoolteachers. I wonder what you are going to do about the PTA's that are very concerned with the educational problems of America.
I don't think a committee, an advisory committee, is quite as effective as a special assistant to the Secretary, and this special assistant has a considerable amount of latitude—“shall review the health and medical programs of the Department and advise the Secretary with respect to the improvement of such programs and with respect to necessary legislation in the health and medical fields."
Now, one final question with reference to your special assistant: I realize the importance of his having wide nongovernmental experience, and I would recognize leaders amongst persons who are recognized leaders in the medical field. Does this also include people who are recognized leaders in the matter of medical economics as well as medical practice?
The main problem today is the cost of medicine, not the quality. The quality of medicine in America is the world's best. Its cost is a serious problem to millions of people.
Are we to assume, therefore, that this special assistant will give real attention to the problem of the cost of medical care to the American people?
Mr. DODGE. Well, I can't answer that question specifically. I should think that would be within the realm of his consideration. He is not limited.
Senator HUMPHREY. Then it is your opinion this plan does nothing to jeopardize the authority of the Surgeon General ?
Mr. DODGE. It does not.
Senator HUMPHREY. It is also your opinion that the special assistant to the Secretary in the field of health and medical matters is in an advisory capacity and not in an administrative capacity; is that correct?
Mr. DODGE. It is so stated in the plan.
Senator HUMPHREY. And, therefore, that special assistant will not be able to supersede the statutory powers and authority of the Surgeon General ?
Mr. DODGE. It is not so provided in the plan.
Senator HUMPHREY. I want to commend the administration for the plan. I hope that we pass it. I think that we shall, and I shall give it my vigorous support.
Mr. DODGE. Thank you very much, Senator.
Mr. Dawson of Illinois. Mr. Dodge, I would like to say that we have always been in favor of giving Cabinet status to the FSA. We believe that the health, the education, and the security of the American people, the common people, is just as important as any other matters: under any other department, and we wish to congratulate the administration on the fact that its first plan does deal with this matter in seeking to give it Cabinet status.
I was interested, though, in the observations of my distinguished friend from Minnesota, Senator Humphrey, about this new position created here, and I was also interested in reading in the newspapers that the President had made a visit to the American Medical Association, and now when I learn that this new position created is not to perform any administrative services, I am very much interested to know the amount of salary you think will be paid to this newly created office.
Mr. DODGE. The same as an Assistant Secretary.
Mr. DODGE. $15,000, I believe the same as an Assistant Secretary.
Mr. Dawson of Illinois. And how much is the salary of the Surgeon General ?
Mr. DODGE. I have a list of them here some place. I'll find it.
The Federal Security Administrator presently has a salary of $17,500. Under the new status it would be $22,500.
Mr. Dawson of Illinois. I mean the Surgeon General.
Mr. Dawson of Illinois. And $15,000 for this new position created as adviser?
Mr. DODGE. That is correct.
Mr. Dawson of Illinois. And I believe you said there would be no conflict in authority there; the Surgeon General would perform his functions under the law as heretofore?
Mr. DODGE. There is no disturbance of that, according to the plan.
Mr. Dawson of Illinois. Now, are you of the opinion that this plan carries out the Hoover recommendations which say there should be clear authority existing always from the head of the department on down?
Here we have several people under the Secretary, appointed by the President, and with the consent of the Senate, whose duties are statutory. Do you anticipate or do you believe that, under those circumstances, the Secretary has a clear authority on down to run that Department as the Secretary sees fit?
Mr. DODGE. Well, there is always some dispute about that point, not only in this agency, but others, where there are direct appointments made by the President with the consent of the Senate. I think the answer to that is the relationship between the appointments and the recommendations of the individual at the head of the agency. If it is a cooperative appointment between the administration and the head of the agency, the general result would be satisfactory. If it is not, it may not be satisfactory.
Mr. Dawson of Illinois. Well, do you think it would take into consideration the question of cooperation of people qualified to do a job rather than to be pleasing to an individual?
Mr. Dodge. I didn't quite understand it, sir.
Mr. DAWSON of Illinois. I said : You said if it would seek to appoint only those who satisfy the President, seek to appoint only those who satisfy the will of the Secretary, or
Mr. DODGE. No.
Mr. DODGE. I said if there was a cooperative approach to the problem between the head of the agency and the President in making the appointment of someone qualified to do the job, the result would generally be satisfactory.
Mr. DAWSON of Illinois. I wish to state that I wish for your new Secretary and for the administration one of the most successful administrations that we have ever had, sir.