STATEMENT OF MISS ELIZABETH WICKENDEN, WASHINGTON REPRESENTATIVE, AMERICAN PUBLIC WELFARE ASSOCIATION Miss WICKENDEN. Mr. Chairman, my statement is very brief. My name is Elizabeth Wickenden, and I am Washington representative of the American Public Welfare Association, an organization of State and local public welfare departments and persons engaged in public welfare work at all levels of government. We appear in support of Reorganization Plan No. 1. We have long been on record as favoring the elevation of the Federal Security Agency to departmental status on the grounds that the scope and character of its functions warrant this. We feel, too, that the proposal in the plan to leave the internal organization of the new Department to the Secretary is appropriate, but I would like to make one comment. I have talked to a lot of people in the fields of health and education about this plan, and many of them say to me, "Well, we are worried about that title, Department of Welfare. It sounds as if that meant that you people were going to be running the show." That results, I think, from a problem of semantics, that the word "welfare" is used in two different senses. In one respect it refers, I think, in the Constitution, to the general welfare, the well-being of the people; and in another more specific sense it relates to the functions that are now carried on in the Social Security Administration. We do not feel for a moment that welfare should dominate. We think that these are coordinate functions and we hope that the new Secretary, if there is to be one, will maintain the structure of the Public Health Service, the Office of Education, and the Social Security Administration. We do feel, though, from our actual experience, that there is a real value in having these three functions in one department. It is a little bit different at the Federal level then it is at the State and local level, because most of these functions relate to planning and the administering of grants-in-aid to the States, rather than the administering of actual professional services to individuals. Our State agencies particularly feel that there is a great value in having grants-in-aid to the States coordinated so there is a reason-. able consistency of policy, and we have followed with very great interest what has been done in the Office of Federal-State Relations. I know that this committee has a good deal of interest in that subject, so I mention it particularly. Then in addition to that over-all problem of relationship to the States in all of these fields there are many overlapping problems between the different specialties. One that we have been very much interested in lately is the problem of chronic illness. We have found, for instance, that it involves both medical and social and economic problems, and as an example of how closely we feel they are related, we have joined with the American Medical Association, the American Public Health Association, the American Hospital Association, in sponsoring a commission on chronic ailments. Dr. Miller is one of the leaders in that effort. We are finding in these professional associations more and more reason for cooperative activity and we feel that is equally true in the Federal agency. I could mention other examples in the field of mental health-the relationship of mental health with child guidance and other fields, the problem of occasional rehabilitation, which cuts right across all these three fields and others. Of course, the creation of a department will not in and of itself add or subtract from the functions that are now in the Agency, but it will give the head of that department a prestige in speaking to the public, and within the circle of advisers of the President, that we feel is much needed for this field which concerns itself with the well-being of individuals. The CHAIRMAN. Did you not know that that is one of the principal objections of this plan? That is, the prestige that you speak of! They are afraid, and those fears are well justified, that speech will be in the interest of what they term "socialized medicine." Miss WICKENDEN. Socialized medicine seems to me to be such a small part of the problems of this total department. Now, for instance, in our association, we are primarily interested in the grants-in-aid problem. We think the grant-in-aid to the States is the principal problem. That has nothing to do with socialized medicine at all. it. The CHAIRMAN. I mentioned that is one of the apprehensions about Miss WICKENDEN. Yes. I did want to say in closing that while I am presenting a statement from my own association, that for many years I have worked with a wide variety of groups that are interested in this department, and I think there may be a few who fear prestige in this total field of health, welfare, and education but the great bulk of organizations in health, in welfare, and in education, and among lay groups- I would mention particularly the women's clubs, the churches, the labor unions, some that I have worked with-who would welcome the recognition and prestige for this field of human welfare. I think you can well find a position on both sides in that regard. The CHAIRMAN. Thank you very much. Are there any questions? Senator SMITH. Mr. Chairman, I have no questions, except that I would like to say that I am glad to hear someone say that we need some prestige in Government. Thank you very much. The CHAIRMAN. Are there any other questions? If not, we thank you, Miss Wickenden, and your full statement will appear in the record at this point. Miss WICKENDEN. Thank you, Mr. Chairman. (The statement is as follows:) TESTIMONY IN BEHALF OF REORGANIZATION PLAN No. 1 PRESENTED TO SENATE COMMITTEE ON EXPENDITURES IN THE EXECUTIVE DEPARTMENTS, JULY 22, 1949, BY ELIZABETH WICKENDEN, WASHINGTON REPRESENTATIVE, AMERICAN PUBLIC WELFARE ASSOCIATION My name is Elizabeth Wickenden, and I am Washington representative of the American Public Welfare Association, organization of State and local public welfare departments and persons engaged in public welfare work at all levels of government. I appear before you to express support for the President's Reorganization Plan No. 1 to create a Department of Welfare. Our organization has long been on 94651-49-5 record as favoring the elevation of the Federal Security Agency to departmental status on the grounds that the scope and character of its functions warrant this recognition. We feel, too, that it is appropriate to leave the internal organization of the proposed new Department to the Secretary as in other comparable departments. However, in this connection I would like to mention one possible misconception that arises from the dual use of the word "welfare." In the title of the proposed Department it is evidently used in the broad constitutional sense of general welfare embracing all those specific functions which serve individaul human wellbeing. One of these specific areas of service, along with health and education, is the narrower functional concept of public welfare now represented in the Social Security Administration with its programs for social insurance, public assistance, and services to children. In supporting a new Department of Welfare we wish to make it very clear that we look upon health, education, and public welfare as coordinate functions with no thought that any one should dominate the other. On the contrary we hope and assume that the present internal structure in which the United States Public Health Service, the Office of Education, and the Social Security Administration maintain their separate administrative entities will be maintained. On the other hand we do feel that there is every justification for and advantage in grouping these closely related functions into one department at the Federal level. Since the Federal functions in health, welfare, and education are chiefly in the area of planning and the administration of grants-in-aid to the States rather than the actual furnishing of professional services to individuals it would seem that the administrative structure could not properly be compared to that at the State and local level where operational responsibility lies. On the contrary the desirability of working toward a comprehensive policy in dealing with the States on grant-in-aid relationships is self-evident and the work along this line which has been carried on in the Office of Federal-State Relations of the Federal Security Agency has been followed with much interest by the State agencies comprised in our association. In addition to the over-all interrelationships of Federal-State grant-in-aid policies there are many specific functional interrelationships which can and are greatly facilitated by a common departmental grouping of administrative agencies. To take one example now very much to the forefront of public and interprofessional attention I might mention the problem of medical care and related problems involved in chronic illness. On the professional side my own association, the American Public Welfare Association, has joined with the American Medical Association, the American Public Health Association, and the American Hospital Association in setting up a Commission on Chronic Illness for the study of this problem. This cooperation has been stimulated by a growing recognition of the close interrelationship between medical, social and economic factors in chronic illness, an interrelationship which is, of course, of equal if not greater importance in the area of governmental policy. Similar examples could be cited in the fields of education, mental health, vocational rehabilitation, services to children, and others. The fact of the matter is that while these functions involve professional specialties the individual human beings whose welfare they serve are one and the same and deserve the benefit of reasonable coordinate planning from their Federal Government. The creation of a Department of Welfare will not in itself either add to or subtract from the functions of the Federal Government in the fields of health, education, and welfare. The scope and character of these functions depend as always on other legislation and on the appropriations made available to support them by the Congress. On the other hand we feel that these functions can be more effectively and appropriately carried out if the Federal Security Agency is given recognition as an established department of Government with its head speaking from the prestige of a Cabinet office both to the country as a whole and within the President's circle of advisers in behalf of the welfare of individuals, not in their capacity as farmers, workers, or businessmen, but as human beings the end objective of all government. The CHAIRMAN. Dr. Marjorie Shearon, will you come forward, please? While she is coming around, I wish to file for the record a letter and a resolution from the American Legion that will be made a part of the record and placed in the appendix. (The letter and resolution are as follows:) Hon. JOHN L. MCCLELLAN, THE AMERICAN LEGION, NATIONAL LEGISLATIVE COMMISSION, Washington, D. C., July 20, 1949. Expenditures in the Executive Departments, Senate Office Building, Washington, D. C. MY DEAR MR. CHAIRMAN: The Senate Committee on Expenditures in the Executive Departments has scheduled hearings on Reorganization Plan No. 1, to create a Department of Welfare, commencing July 21. I am enclosing herewith, for the information of your committee, Resolution No. 813, approved by the national convention at San Francisco, September 30 to October 1-4, 1946, on this very vital subject matter. Sincerely yours, JOHN THOMAS TAYLOR, Director, National Legislative Commission. [Resolution No. 813, national convention, San Francisco, Calif., September 30 to October 1-4, 1946] RAISING TO UNITED STATES CABINET RANK THE ADMINISTRATION OF THE FEDERAL SECURITY AGENCY Whereas our children's future has always been, and is increasingly recognized as one of our greatest national responsibilities and obligations to posterity; and Whereas the fundamental strength of a nation lies within its people, and the most basic and most difficult task of any country is the conservation and development of its human resources; and Whereas the American Legion realizes that emergent, if not critical, times are now pressing in ever-increasing force upon our people, and that our great national organization of the American Legion must take steps to meet problems with which we are being confronted on the national, as well as the State level: Therefore be it Resolved, That we endorse the growing feeling that the administration of the Federal Security Agency be raised to Cabinet rank; and be it further Resolved, That we here record our firm conviction that only through such action will the best interests of veterans' children and of all children of this Nation be effectively guaranteed at this time in our history when our future lies so clearly in the hands of the oncoming generation. The CHAIRMAN. Dr. Shearon, we will be glad to hear you, and I might say that we have about 9 minutes before we go on the floor of the Senate. STATEMENT OF DR. MARJORIE, SHEARON, EDITOR, AMERICAN MEDICINE, AND THE POLITICAL SCENE Dr. SHEARON. I cannot do it in that time, Mr. Chairman. The CHAIRMAN. I see you have a prepared statement, Doctor. Your entire statement may be placed in the record, and if you will just try to cover the high lights of it we will appreciate it very much, because the Senate convenes at 12 o'clock. Dr. SHEARON. It is a very important bill, and I think the opposition should be given at least as much time as was given on the first morning to those who favor it. The CHAIRMAN. I want to say to you, lady, that the opposition is going to be given every opportunity, because I am not prejudiced against the opposition. You may proceed. Dr. SHEARON. I am appearing in the public interest to oppose Reorganization Plan No. 1 of 1949. I do not represent any organization or vested interest, but speak as an independent editor and legislative consultant. I have studied the organization of the FSA and of its component agencies since 1935 and had an opportunity to see them in operation during the decade I spent with the Social Security Administration and the United States Public Health Service, where I was on the staff of Surgeon General Parran. I am opposed to this plan for three reasons: (1) It bypasses the major Hoover Commission recommendation to establish a United Medical Administration; (2) It bypasses the Senate by making the present Federal Security Administrator the Acting Secretary of Welfare for a period not exceeding 60 days, without the advice and consent of the Senate; section 2 (2) and section 4 (a); and (3) It appears to confer congressional approval on the present FSA, whereas a congressional investigation is in order. (1) Establishment of United Medical Administration. If the Federal Security Agency is to be reorganized, units should be added and subtracted before the agency is elevated to departmental status. Plan No. 1 is not a reorganization plan, but a perpetuation of the status quo plan, with the exception of the transfer of the Employment Service, which many think is an unwise move. That transfer is not incorporated in the plan, but it is a part of the President's recommendation that was printed directly before the plan, and was incorporated in plan No. 2. We are justified in believing that elevation of the present FSA almost intact would result in subsequent unwillingness on the part of the new Secretary of Welfare to relinquish any of his functions. This was printed before I heard Mr. Ewing state that he would oppose the transfer out of the health and medical functions. That is the thing most of us have feared, and now he states that it is his own intention. He would presumably oppose having the medical services transferred to an independent agency. Consequently, if changes were made before creation of the Welfare Department and appointment of a Cabinet officer who might be jealous of his powers, we would be on surer ground. Experience has shown that high Government officials are loath to part with any function once under their jurisdiction. It would thus seem logical to create the United Medical Administration and to reorganize the Labor Department before creating the Welfare Department. The present sequence of plans is illogical, showing more political haste than organizational wisdom. (2) Authorizing a 60-day appointment to a Cabinet post without the advice and consent of the Senate is an unwise precedent. While plan No. 1 calls for appointment of a Secretary of Welfare by the President "by and with the advice and consent of the Senate" it also gives a temporary appointment for not more than 60 days to the present FSA Administrator without such "advice and consent." Obviously such an appointment not only deprives the Senate of its customary prerogatives with regard to appointments to Cabinet posts, but also gives to the present FSA Administrator an unfair advantage over possible contestants for the Secretaryship. If Mr. Ewing became Secretary of Welfare for 60 days, it is unlikely the Senate would remove him in favor of someone else. Furthermore, if he should obtain that post by default on August 19, what opportunity would the Senate have 60 days hence, when presumably it would not be in session, |