64TH CONGRESS, HOUSE OF REPRESENTATIVES. 1st Session. FEDERAL AID FOR INDIGENT TUBERCULOUS PERSONS. MAY 11, 1916.-Committed to the Committee of the Whole House on the state of the Union and ordered to be printed. Mr. RAYBURN, from the Committee on Interstate and Foreign Commerce, submitted the following REPORT. [To accompany H. R. 11864.] The Committee on Interstate and Foreign Commerce, to whom was referred the bill (H. R. 11864) to provide Federal aid in caring for indigent tuberculous persons, and for other purposes, having considered the same, report thereon with amendment and as so amended recommend that it pass. The bill as amended has the approval of the Treasury Department, as will appear by the letter attached and which is made a part of this report. Amend the bill as follows: Page 1, line 5, strike out the word "State" and insert in lieu thereof the word "the." Page 1, line 5, after the word "authorities" insert the words "of any hospital or sanitorium." Page 1, line 6, strike out the word "State." Page 1, lines 7 and 8, strike out the words "citizens of the United States, but." Page 1, line 10, strike out the word " "public." Page 2, line 12, after the word "treatment" insert the words "or any other person.' Page 3, line 19, strike out the words "and establishment of stand ards.' Page 3, line 20, after the word "carrying" insert the words "out the." Page 3, line 21, after the word "use" insert a comma. Page 3, line 24, after the word "institutions" insert the words "receiving aid under this act." Page 4, line 3, after the word "estimates," strike out the period, insert a comma, and add the words "together with a list of institutions to which aid was extended, and the contributions made by local authorities." The purpose and intent of this bill (H. R. 11864) is to prevent the spread of tuberculosis by voluntary hospital segregation and care of indigent tuberculous patients, who are nonresidents of the States in which they may be temporarily residing. This not only provides health protection to the general public but brings relief to those unfortunate individuals who are suffering with tuberculosis and to those communities which at present are subjected to a heavy tax in caring for indigent tuberculous patients who contribute nothing to the expenses of the community in which they are temporarily residing. Section 1 authorizes the Secretary of the Treasury to aid in the care of nonresident indigent consumptives by designating certain hospitals for their care and treatment. Section 2 provides that such hospitals shall receive from the Federal Treasury not to exceed 75 cents a day, per patient, provided such hospitals will pay or expend an equal amount for the care of the patients. Section 3 provides that patients entitled to benefits of the bill may be returned to their legal residence at the expense of the Government, in which case they would cease to receive the benefits provided by this bill. Section 4 provides that the Secretary of the Treasury may make rules and regulations to carry out the provisions of the bill. It is estimated that 10,000 to 15,000 consumptives go to the Southwest annually seeking the benefit of the mild and equable climate. About half of these become indigent or objects of charity some time after arrival. According to the Public Health Service reports, this migration is increasing. This migration began 100 years ago and has assumed great proportions in the past 25 years. While the western country will benefit under this act, its operation will not be limited to that section, as there are nonresident consumptives in all States, especially in the cities which have a large foreign population. Tuberculosis is increasing among the native population of the Southwest due to infection spread by careless consumptive strangers. The people of the West have cared for these homeless consumptives for years. Many families of the West have lost loved ones, who have contracted the disease from a consumptive guest or boarder. The lack of adequate hospital provision in Western States has made it necessary to care for most of these people in private homes. These thousands of consumptives, traveling to and from the West, are a menace and danger to the traveling public. The passage of this bill will stimulate hospital construction and enlargement, not only in the West, but in all States. The proposed return of patients to hospitals in their home States (with their consent) will focus the attention of authorities and citizens of uch States to the need for hospital provision by States, counties, and cities for the care of their tuberculous citizens, now compelled to seek cure by climate, because of the lack of hospital care in their own communities. The enactment of this measure, giving Government aid in caring for nonresident patients, will enable counties and cities of the West to care for patients, instead of shipping them to other places, a practice which now prevails to a considerable extent, and which constitutes a danger to interstate commerce. The return of patients to their homes will terminate Government expenditures for certain cases. Hospital care and treatment under this act will restore many consumptives to lives of usefulness and enable them to support their families, saving public charity the expense of caring for widows and orphans. The care of patients in hospitals will also protect their families from infection. It is not practicable to return these people by force to the place of their legal residence. This proceeding would be more difficult than the extradition of a criminal and would be denounced as brutal and inhumane. Unless confined to a jail or a hospital the patients could not be compelled to remain at the point to which they were returned, and as not all communities have hospitals it would result in transferring infection from one point to another and would often be to the detriment of the patient. The suggestion has also been made that the West should quarantine against tuberculosis patients, but this would not be practicable, even if considered a humane proceeding. That the West does not fear any increase of migration under this act is shown by the fact that this bill and a similar measure pending in the last Congress, received indorsement by governors of Southwestern States, State, county, and city boards of health, county and city authorities, and by officers and members of many voluntary health and welfare organizations. It might appear that the West should not be expected to bear half of the burden of caring for these patients. Western communities are now bearing all of the expense and this bill will relieve them of half of the burden which they now carry. It is optional with any community to avail itself of the provisions of the bill. There is no feasible legal way by which the home States of patients may be required to bear all of the expense of caring for patients. Precedent exists for the Federal Government maintaining patients in hospitals. The Public Health Service now has contracts with many hospitals for the care of patients under their jurisdiction. This bill is reasonable, just, and humane, as shown by the indorsements of the Public Health Service, many State boards of health, State medical associations, officials of tuberculosis institutions, officials of health, welfare, and labor organizations, and of many private individuals. It is a public-health measure of far-reaching importance. The frightful ravages of tuberculosis in this country constitutes so serious a drain upon the health and economic welfare of this Nation as to merit the enactment of legislation having as its object the control and prevention of the spread of this disease. In view of these facts the committee recommends the speedy passage of this bill. Hon. W. C. ADAMSON, TREASURY DEpartment, Chairman Committee on Interstate and Foreign Commerce, House of Representatives. SIR: I beg leave to acknowledge the receipt of your letter of January 12, 1916, inclosing a copy of bill H. R. 8352, "To standardize the treatment of tuberculosis in the United States, to provide Federal aid in caring for indigent tuberculous persons, and for other purposes," and asking for the views of the department concerning the same. The bill in brief authorizes the Secretary of the Treasury to aid State authorities in providing care and treatment for indigent tuberculous persons, citizens of the United States, but not legal residents of the States in which they are temporarily located, and provides further for the inspection of the institutions in which these tuberculous persons are to be treated. The bill further provides that the Govern ment may pay not exceeding 75 cents per diem for each indigent patient admitted to the approved institutions, with the approval of the Secretary of the Treasury, provided that the State pays an equal amount toward the cost of caring for these patients. It is further provided that subventions under this law shall not be granted in the case of persons who have been assisted to leave their homes, or who have left their homes, in order to receive the benefits of the act, and the Secretary is authorized to issue regulations governing the designation of institutions and the establishment of standards for carrying out the provisions of the act, and to collect and make available for general use information and descriptive matter relative to the construction, equipment, and maintenance of hospitals, sanatoria, and similar institutions. On account of public health and humanitarian considerations the bill has the approval of this department. It is believed that it will act to reduce the amount of tuberculosis in the United States, because it will provide better care and treatment for a class who migrate from place to place, and in consequence are a menace to other travelers and to the public generally; it will encourage improved methods of care and treatment for the tuberculous throughout the country, and therefore enable many otherwise useful citizens to regain their health and to become self-supporting; it will equalize the burden of caring for the nonresident indigent tuberculous, shifting a portion of it from the shoulders of a few States and distributing half of it among all the States. It has been estimated that between fifteen and twenty thousand persons leave their homes annually to go in search of health to sections of the country popularly regarded as having climates favorable to the cure of tuberculosis, such as North Carolina, Colorado, California, Texas, and other States in the Southwest. These persons are passengers in interstate traffic and their presence as such constitutes a problem for solution by the Federal Government. They are frequently unable to work, and upon the exhaustion of their funds they become a burden to States of which they are not citizens. The bill provides, very properly, that one half of the cost of caring for such patients shall be borne by the respective States and the other half by the Federal Government. Respectfully, O W. G. MCADOO, Secretary. INSURANCE COMPANIES AND FRATERNAL BENEFICIAL SOCIETIES. MAY 11, 1916.-Referred to the House Calendar and ordered to be printed. Mr. GRAHAM, from the Committee on the Judiciary, submitted the following REPORT. [To accompany H. R. 12541.] The Committee on the Judiciary, to whom was referred the bill (H. R. 12541) authorizing insurance companies and fraternal beneficial societies to file bills of interpleader, beg leave to report that they have had the same under consideration, and recommend that the said bill be amended by striking out in the twelfth line on the first page, the figures "500" and inserting in lieu thereof the figures "2000"; and the committee recommend that the bill, thus amended, do pass. The purpose of this bill is to meet a situation which arises quite frequently and causes serious difficulty in adjusting insurance losses. It frequently happens that the proceeds of a policy of life insurance are claimed by two or more persons. Often these conflicting claimants reside in different States and different districts. If they reside in the same jurisdiction, the situation is simple, because the insurance company can file a bill of interpleader, joining the claimants as parties, and after paying the amount admitted to be due into court, be discharged from any further liability. Where the claimants reside in different jurisdictions, this can not be done, and frequently two or more suits are brought against the company in different States. The result is expensive and troublesome litigation, which sometimes subjects the company to double liability and generally prevents a fair trial of the issues between the conflicting claimants. This bill makes it possible for an insurance company to file its bill of interpleader in the jurisdiction in which one of the claimants resides. The court in which the bill is filed can then issue process to bring in the other claimant. It does not afford an insurance company any opportunity to abuse the rights granted under the bill in an attempt to avoid liability. In any bill of interpleader filed the |