difference in them. The dispensary was growing to be organized practice of medicine. If the same change in attitude could be secured on the part of workmen generally that he had seen in these two dispensaries, if that spirit could be carried into all the medical part of health insurance, he thought the administrators would have done the biggest thing they could do. Specialists were employed in the evening dispensary at a minimum rate of $5 for two hours. He had carefully considered the matter of payment, and he was sure that the only proper basis was the time basis. The patients paid 50 cents a visit and they also paid for their supplies extra.

MR. LAPP said that was group medicine, and asked how widely it could be found in adequate form. Were many of the dispensaries organized with any degree of adequacy?

DR. WARNER replied that practically all of them, at least all of the big dispensaries, were. There might be a few dispensaries left. working along the old lines, but cooperative group medicine was the keynote of all modern dispensary work.

Visiting Nurse Service

EDNA L. FOLEY, of the Chicago Visiting Nurse Association and a member of the Illinois commission, believed that in framing any law which would cover the needs of those ill in their homes, whether employed people or members of their families, the commissions. should consider the nursing service, which was essential if the physician's orders were going to be followed up with any degree of intelligence. She had been wondering also, in case provision were made for nursing service, whether it would be institutional nursing service, home nursing service, or state nursing service. There seemed to be a wide difference of opinion as to whether or not a provision for adequate nursing service should be made in a health. insurance bill, for the reason that if there were such a provision it would be almost impossible to supply such service at this time. She was, however, in favor of inserting such a provision. Some proposals said that adequate nursing service should be provided. She did not think that that was sufficient unless it was definitely stated what "adequate " meant-whether it meant a graduate nurse or a six-day trained nurse.

MR. JULIAN asked whether that implied that the nursing profession was not completely a graduate profession.

MISS FOLEY replied that that was absolutely correct. The service, she added, craved very many more intelligent nurses, but not six-day instructed nurses.

MR. WINSLOW inquired by whom the Illinois public health nurses were paid.

MISS FOLEY said that with one exception they were kept up absolutely by voluntary contributions; one nurse was paid by the school board for school inspection work. The rest of the money was all given by public-spirited people.

DR. G. B. ROBBINS, of the medical advisory committee to the Ohio commission, thought that the discussion about the public health nurse was one of the most important points that had been touched on. He was very closely connected with the work of public health nurses in Chillicothe, and as a physician he would rather dispense with the services of the doctor than do without the nurse. Their educational work alone had been worth while. They had decreased sickness in Chillicothe immensely, and they did it tactfully.

Third Session

MONDAY EVENING, MAY 13, 1918

SENATOR W. A. ALBERS called the session to order and announced that the first question to be considered was to what extent cooperative methods could be developed in special studies.

Tabulation of Draft Data

MR. LAPP explained that a great many people had proposed cooperation, and a great many others had suggested that cooperation was not feasible. A number of topics had been mentioned as possibly lending themselves to such treatment, one of them being the data on draft rejections. In the discussion which followed it was

brought out that in Ohio 34 per cent. of those examined in the first draft were rejected on physical grounds, and 55 per cent. in Pennsylvania, Mr. Lapp suggesting that perhaps the high rate in the latter state was due to its not having had an adequate child labor law for some twenty-five years.

PROFESSOR MILLIS reported on negotiations then going forward with the federal government with regard to tabulating the material so that it could be used by the commissions, and agreed to furnish any findings he secured.

Operation and Cost of Medical Benefits

After some discussion of methods for securing comprehensive data on the operation and cost of medical benefits in establishment funds, it was decided to request the United States Public Health Service and the United States Burau of Labor Statistics to compile the material which they had on this subject for the use of the commissions jointly.

Educating the Public

MR. LAPP then raised the question of a commission's duty in educating the public. Should it act as a continuous bureau of information while making its study. or should it wait until it had completed its report?

T. J. DONNELLY, secretary of the Ohio Federation of Labor and a member of the Ohio commission, said that his commission believed in publishing reliable information continuously as it was collected. If facts were thus given to the public, interest would be awakened and maintained, and more study would be given to the subject. When the matter finally came before the legislature there would be much more general knowledge about it than if the commission merely conducted its study by itself and then printed a book about it.

DR. ALICE HAMILTON, special investigator for the United States Bureau of Labor Statistics and a member of the Illinois commission, thought the commissions should take the public along with them. If they waited until their final reports were ready they would

not find the public prepared to give proper consideration to the facts and conclusions presented.

MR. LAPP asked what good public hearings would be if the commissions did not disclose the facts they had discovered. People who appeared would not be able to give concrete suggestions based upon knowledge.

D. F. GARLAND, of the Ohio commission, thought the commission should educate the public by giving out the facts they discovered.

PROFESSOR MILLIS explained that in Illinois the commission was cooperating with various groups and organizations by personal touch and correspondence, but was doing no propaganda work. When public hearings were about to be held in the autumn a statement of the facts so far collected would be issued as a basis for discussion, otherwise the hearings would not be worth anything. The hearings were simply to get information.

MATTHEW WOLL, president of the International Photo-Engravers' Union and a member of the Illinois commission, wished to confirm what Professor Millis had said.

MR. HOOKER said that when the Illinois Commission on Public Pension Systems had compiled its information it sent out certain of the results in a printed circular, along with questions as to how certain matters of policy ought to be settled, to people interested in the various funds and asked them to meet the commission for discussion. Those discussions were very lively, and they led to recommendations which were supported by three out of the four groups which favored immediate legislation.

PROFESSOR MILLIS remarked that the problem before the pension commission was one of revising an existing system, not of adopting a new policy.

PROFESSOR HAMMOND pointed out that the Massachusetts commission had considerable difficulty in getting public interest in its

hearings when they were called without giving previous information.

MISS FELTON reported that the California hearings were well attended and brought out valuable information.

MR. LAPP asked whether the commissioners should refrain from public addresses.

MR. WOLL stated that he had refrained and intended to do so. He would also refrain from writing on the subject. He did not think the commissioners should give out anything.

MR. LAPP answered that if a commission gave out nothing its work would never be heard of. He could see no objection to a commission's telling the public what it was doing.

MR. WOLL replied that it was a matter of individual judgment.

SENATOR ALBERS said that the hearings of the commissions would be puble and the newspapers could gather what they wanted out of them.

MR. HOOKER declared that the results the first pension commission produced were quite sensational in certain respects. Nobody knew the facts before. The secretary of the commission prepared a preliminary statement which the commission sent to the press. The press made the statement the basis for a great deal of comment, and it was a means of getting the whole subject into the minds of the people.

MR. T. J. DONNELLY thought it was after all a matter for the different commissions to decide. A man might be able to speak upon a subject and give out information collected without being biased, and it might accomplish a great deal of good. For himself, he was absolutely convinced that there was only one way to tell the people, that was to give them the information when it was gotten. The country was full of all kinds of reports containing wonderful information. But the information was in such shape that the ordinary man would not wade through it. The mission of a news