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was most recently expressed in detail in a resolution adopted in December 1950 which provided :
Resolved, That the house of delegates of the American Medical Association urges all officers and members of the American Medical Association and all constituent State associations to take immediate steps to implement the passage into law of a bill providing for the coordination and integration of all Federal health activities under an independent agency with executive status except the medical services of the Armed Forces and the Veterans' Administration.
On Saturday, March 14, the house of delegates of the American Medical Association met in special session to consider Reorganization Plan No. 1 of 1953. We were signally honored by the President of the United States, and also by Senator Robert Taft and Congressman Walter Judd being present and addressing the organization.
In summing up the final action of the association in this matter, I should like to read a portion of the board of trustees report which was adopted unanimously by the house of delegates on last Saturday.
REPORT OF THE BOARD OF TRUSTEES ON REORGANIZATION PLAN No. 1 of 1953,
ADOPTED UNANIMOUSLY BY THE HOUSE OF DELEGATES ON MARCH 14 The house of delegates of the American Medical Association has for nearly 80 years been on record as favoring an independent Department of Health in the Federal Government. The reason for this stand has been that the House has felt that health and medicine should be given a status commensurate with their dignity and importance in the lives of the American people, and that they should be completely divorced from any political considerations.
The board of trustees, after a careful study of the policy of the American Medical Asssociation with respect to the administration of health activities in the executive branch of the Government and after studying the reorganization plan for elevation of the Federal Security Agency to Cabinet status submitted by President Eisenhower to the Congress, finds that Reorganization Plan No. 1 of 1953 provides for a Special Assistant to the Secretary of Health and Medical Affairs. This provision is a step in the right direction which should result in centralized coordination under a leader in the medical field of the health activities of the proposed department. Health, therefore, is given a special position. The proposed plan, properly administered, will permit more effective coordination and administration of the health activities of the new department without interference or control by other branches.
Previous attempts to raise the Federal Security Agency from an independent agency to the level of an executive department have been opposed by the association because the plan did not meet these aims.
Inasmuch as Federal health benefits and programs are established by the Congress, an administration bent on achieving the nationalization of medicine cannot reach that goal except with the support of Congress. Therefore, an: organizational plan through which Federal health activities are administered, although important, is not nearly so vital an issue as the policies adopted by the Congress of the United States.
The board of trustees recommends that the house of delegates reaffirm its stand in favor of an independent Department of Health but that it support the Reorganization Plan No. 1 of 1953 as being a step in the right direction; that the American Medical Association cooperate in making the plan successful and that it watch its development with great care and interest.
It should be understood, however, that the association reserves the right to make recommendations for amendment of the then existing law or to press for the establishment of an independent Department of Health, if the present plan does not, after a sufficient length of time for development, result in proper advancement in and protection of health and medical science and in their freedom from political control.
Senator Smith of Maine. Thank you very much, Dr. Henderson, for your statement.
Mr. Hoffman, do you have any questions?
The CHAIRMAN. I have no questions myself. I believe most of the questions have already been asked.
Mr. Brown, do you have any questions?
The CHAIRMAN. I understand the Rules Committee had something. Mrs. Harden?
Mrs. HARDEN. No questions.
Mr. Dawson of Illinois. The board of trustees, after studying the policy of the American Medical Association with respect to the Administration of health executives, in the executive branch of the Government, and after studying the reorganization plan for elevation of the Federal Security to Cabinet status submitted by President Eisenhower to Congress, finds that Reorganization Plan No. 1 of 1953, provides for a Special Assistant to the Secretary for Health and Medical Affairs.
Where did you find that provision in the plan No. 1?
Mr. Dawson of Illinois. You are speaking not as a special—the Secretary of Health and Medical Affairs which you designate here is the Secretary of the Department that is created by this plan. Is that the one you are referring to?
Dr. HENDERSON. The special Assistant.
Mr. Dawson of Illinois. But this department is known as the Department of Health, Education and Welfare, and you are speaking when you said here, in your statement, provision for a Special Assistant to the Secretary for Health and Medical Affairs, who is the Secretary for Health and Medical Affairs?
Ďr. HENDERSON. I had reference to the Assistant to the Secretary.
Mr. Dawson of Illinois. You did not mean what you said, for a Special Assistant to the Secretary of Health and Medical Affairs. There is no such Secretary created by this plan?
Dr. HENDERSON. There is no such Secretary, but there is an Assistant created, an Assistant to the Secretary of the Department.
Mr. Dawson of Illinois. You said-paragraph, 1, 2, 3, 4 Inasmuch as Federal health benefits and programs are established by the Congress, an administration bent on achieving the nationalization of medicine cannot reach that goal except with the support of Congress.
Dr. HENDERSON. That is right.
Mr. Dawson of Illinois. What was the reason in the law that you opposed plan No. 27 in 1950 ?
Dr. HENDERSON. Plan No. 27 in 1950 did not provide for an Assistant in health and medical affairs.
Mr. Dawson of Illinois. The support of the trustees of the house of delegates as adopted here, was made in the light of that creation of a post of a Special Assistant to the Secretary, is that right?
What powers had that Special Assistant to the Secretary, to stop the nationalization of medicine that would exist without it, since it must be done by Congress?
Dr. HENDERSON. There is no reason why that Special Assistant or anyone else in the Department can bring on nationalization of medicine, but that Assistant can make recommendations to the Secretary.
Mr. Dawson of Illinois. This report is based on the fact that President Eisenhower, Senator Taft, and Dr. Judd appeared before you and pointed out that they made certain promises relative to the activities
Dr. HENDERSON. Not at all. Those recommendations were passed by the board of trustees, before the President and Senator Taft and Dr. Judd appeared before the house of delegates.
The CHAIRMAN. I have been advised that this is your last appearance as a witness, and that your health is not too good.
Dr. HENDERSON. My health has not been good, but it is all right now.
The CHAIRMAN. Do you have heart trouble?
Mr. Dawson of Illinois. I am wondering in the light of your past attitudes and the bitterness with which you fought the effort about this--on the ground that if departmental status was given to this bureau, it would become more difficult for you ever to get a department independent of the Department of Health, and I, for the life of me, I cannot see anything in here that makes it any easier for the American Medical Association to ever get a Department of Health and that was the reason given before.
Dr. HENDERSON. I wish to assure you, if the present Secretary or any future Secretary of the Department advocates nationalization of medicine, we will fight just as hard as we have fought in the past.
The CHAIRMAN. If you are satisfied-some of us don't care if it it suits you gentlemen.
Mr. Dawson of Illinois. Some of us do, whether it is advocated by the American Medical Association or anybody else. Some of us can differ with the American Medical Association, and do so in good · grace and do so honestly. Merely because the American Medical Association issues an edict, that does not mean everybody who differs with this, becomes less of a citizen or thereby believes in anything that is not good for the American people, for instance.
Do you advocate the Blue Cross Health Plan? Are you an advocate of that?
Dr. HENDERSON. I am a member of the Blue Cross Health Plan.
Mr. Dawson of Illinois. When did the Blue Cross Health Plan come into being?
Dr. HENDERSON. It is better than 20 years. I think it was in 1931 or 1932.
Mr. Dawson of Illinois. When did the American Medical Association adopt it as a thing to be universally used by the American people?
Dr. HENDERSON. Very shortly after that.
Dr. HENDERSON. I certainly do, but I don't believe in compulsory health insurance.
Mr. Dawson of Illinois. Do you believe in social security?
Mr. Dawson of Illinois. Do you believe in compulsory social security?
Dr. HENDERSON. We have it. The CHAIRMAN. You can claim protection of the fifth amendment, if you
want it. Dr. HENDERSON. We of the medical profession are only interested in protecting the health of the American people, and we have stated plans
Mr. Dawson of Illinois. Some people believe your present attitude toward the medical profession is harmful to the American people in that you make it difficult for the average American citizen to get medical education because of high costs. You control the schools; you control the number of students, and many of us believe that we should not be short of doctors, and it is the concensus of opinion that we are short of doctors and nurses to man our hospitals, and that condition should not exist, and the fact that that condition does exist is due to the attitude of the American Medical Association, and due to its influence, and some of us think if that is true, then the American Medical Association is, shall I say, a bar to good health for all the American people regardless of financial circumstances.
Dr. HENDERSON. I am going to ask Dr. Cline to answer that. Dr. CLINE. Mr. Dawson, one, of course, cannot be responsible for what people attribute to any organization or any individual. I imagine you have had the experience in the past, of things being attributed to you, which were not quite true.
Mr. Dawson of Illinois. That is true.
Dr. CLINE. The American Medical Association was formed 106 years ago for the purpose of improving medical education in this country. That has been its position ever since. You made a statement which has been made repeatedly and which has no basis, in fact, that we have limited the number of doctors in this country. That is not true.
The only thing that the American Medical Association has done is to raise medical standards, which could be construed as limitation of doctors. You don't want, I am certain, substandard doctors in this country, so there must be standards. Any medical school which can achieve those standards is approved, and there are no unapproved medical schools in this country at the present time. There are several new medical schools in the process of formation at the present time. There are more students at this time in our medical schools than there ever has been in the history of this country. By 1960, we will be producing about one-third more doctors than we did in 1950. The American Medical Association has gone to great effort and its members have contributed large sums of money to assist our medical schools in their financial problems.
Does that look to you as if the American Medical Association were desirous of limiting doctors?
Mr. Dawson of Illinois. Are we short of doctors in this country? Dr. CLINE. We are not.
Mr. DAWSON of Illinois. Are we short of nurses?
Mr. Dawson of Illinois. When we hear the statement made that it is difficult to get sufficient doctors to man the hospitals, that statement is wrong, as a result of investigations carried on in our various hospitals, they can't get sufficient doctors to man it.
Dr. CLINE. That is true of certain doctors, but that is true of human beings. The city of New York and the city of Chicago, which happens to be your home, and places where large numbers of human beings choose to live; and I think you will find, until there is anything corresponding to compulsory labor laws in this country, that people will go where they choose to go, and certainly those hospitals have not presented the opportunities professionally or economically to induce physicians to go there of their own free will.
Mr. Dawson of Illinois. Isn't there a shortage of doctors in Mississippi?
Dr. CLINE. I don't believe there is a shortage of doctors in Mississippi, although it is one of the States which is furthest down the list, but it has more doctors per population than practically any country in the world.
Mr. Dawson of Illinois. This country has more doctors
Dr. Cline. And the State of Mississippi has more than most countries in the world have.
Mr. DAWSON of Illinois. I don't know whether that would be so much of an advantage, if they haven't got enough there.
How much of the increase in doctors is due to contributions by the Federal Government?
Dr. CLINE. Not very much.
Mr. Dawson of Illinois. Are the contributions by the Federal Government greater today to medical schools than ever before?
Dr. CLINE. Only in the field of research, and that does not produce doctors.
Mr. Dawson of Illinois. What do you expect from the American Medical Association-what is your idea of what will be the activities of this Special Assistant ?
Dr. CLINE. I think we heard that very carefully explained repeatedly this
morning and again this afternoon. This Special Assistant will be in an advisory capacity to the Secretary of the Department.
Senator HUMPHREY. Your name is Dr. Cline?
Senator HUMPHREY. Did the members of the medical association that met here in conference receive a detailed job description of the Assistant Secretary or the Special Assistant to the Secretary?
Dr. CLINE. I don't believe they received a detailed job description. They received a general account from your distinguished colleague, Senator Taft, from Dr. Judd who is also a Member of the Congress.
Senator HUMPHREY. I have been informed that there was available to the delegates at the conference, a sheet which would list the responsibilities, the authority, and the duties of this Special Secretary?
Dr. CLINE. That is correct, sir.