Dr. DRAPER. It seems like a very small number, but it is the number allowed in the estimate.

Mr. HARE. How do the medical societies feel toward this proposition?

Dr. DRAPER. The American Medical Association has recognized the desperate shortage of physicians. The American Medical Association is very anxious that the Government should be able to assist in the communities where there is desperate need and where there is a shortage of doctors.

Mr. TARVER. Does the American Medical Association think that the relocation of 35 doctors will meet the situation?

Dr. DRAPER. I am sure that the American Medical Association would not feel that 35 doctors would be a sufficient number to meet the needs that might arise.

There is an editorial in the American Medical Association Journal, which is being issued today, in which it endorses the plan that I am presenting here. Of course this is in principle and does not mention numbers.

Mr. TARVER. This editorial discusses the problem that we all realize exists, the furnishing of adequate medical and dental attention to the civilian population of the United States. There is no argument about that. Everybody realizes that there is need for meeting that situation if it is possible to do so. But you are running along here with a popgun to try to do something that will probably require heavy artillery.

Dr. DRAPER. We feel that something would be better than nothing. It is impossible to say right now exactly how many demands from the communities will be made during this next year. We just do not know. Mr. HARE. Will this be the first step towards socialized medicine, doctor? We have heard something about socialized medicine in the last few years.

Dr. DRAPER. There is nothing in this program that will lead to socialized medicine. This plan is designed to meet the needs of an emergency situation and it is the expectation that it will be discontinued at the end of the emeregency.

Mr. TARVER. I think the doctor prepared a very interesting statement and I believe it is of sufficient importance to justify its insertion in the record, if you have no objection, Mr. Chairman?

Mr. HARE. There is no objection on my part and I am glad to have it inserted at this point.

(The statement referred to is as follows:)

CIVILIAN MEDICAL CARE PROGRAM

(Submitted by the United States Public Health Service, April 1943)

One hundred and eighty thousand physicians were listed in the United States as of January 1943.

Fifteen thousand are employed full time in public-health departments, medical schools, insurance companies, or other agencies not engaged in the practice of medicine.

Twenty-eight thousand are over 65 years of age and are counted as one-third effective.

Seven thousand under 65 are completely or partially ineffective.

Three thousand are residents in hospitals.

Forty-two thousand five hundred effective physicians were remaining in civilian private practice on January 1, 1943.

Eleven thousand five hundred of the above number will be made available to the armed services during 1943.

Eighty-three thousand effective physicians will be left to provide essential medical services for the civilian population on the basis of an over-all ratio of 1 physician for 1,500 population.

The distribution of the 83,000 physicians in civilian practice is such that many communities do not have a sufficient number to meet the critical needs.

The problem is to distribute the remaining physicians so that communities may have the minimum number absolutely essential for their needs.

The solution of the problem as agreed upon jointly by the Procurement and Assignment Service and the Public Health Service, and endorsed by the American Medical Association, is summarized as follows:

1. Encourage localities to organize the services of physicians and dentists already there so that they may be extended to as many persons as possible.

2. Secure the voluntary relocation of physicians and dentists by persuading them to move from places where they are not urgently needed to other places within the State where the need is very great.

3. When relocation cannot be accomplished otherwise, payment by the Public Health Service of the cost of moving the physician or dentist, his immediate family, and his household effects, to the new location; also payment to the physi cian of the sum of $250 a month not to exceed 3 months to cover living and office expenses while becoming established in practice.

4. When it is impossible to provide physicians or dentists in critical areas by any other means, and upon request of the appropriate State agency, the assignment by the Public Health Service of a medical or dental officer to the State agency for the purpose of rendering medical or dental care in accordance with the laws of the State-fees to be collected under arrangements to be made by the State health officer, and the money so collected to be expended for services, supplies, and equipment incident to the work.

To date, requests have been received from 7 State and Territorial health departments for the assignment by the Public Health Service of 13 physicians and 2 dentists in 9 localities and from 1 other State health department for assistance in relocating a physician within the State.

From information available, it is estimated that the Public Health Service should be prepared to pay the relocation expenses of 35 private physicians and dentists, and to assign as Public Health Service officers an additional 35 physicians and dentists in order to meet critical community needs during the coming fiscal year. An appropriation of $175,000 is requested in order to carry out this work.

Summary chart, medical care estimates

I. COMMUNITIES STUDIED JOINTLY BY U. S. PUBLIC HEALTH SERVICE AND PRO CUREMENT AND ASSIGNMENT SERVICE AND FOUND TO BE IN CRITICAL NEED OF ADDITIONAL PHYSICIANS

Summary chart, medical care estimates-Continued

1. COMMUNITIES STUDIED JOINTLY BY U. S. PUBLIC HEALTH SERVICE AND PROCUREMENT AND ASSIGNMENT SERVICE AND FOUND TO BE IN CRITICAL NEED OF ADDITIONAL PHYSICIANS

II. OFFICIAL REQUESTS ALREADY RECEIVED FROM STATE AUTHORITIES BY THE

NOTE. A joint survey of Durango, Colo., recommended that 1 physician be located in that community to assist in caring for the local population and an estimated 40,000 persons living in the surrounding area. This community is not in the above chart, since comparable statistics cannot be given.

STATEMENT OF OBLIGATIONS-EMERGENCY HEALTH AND SANITATION ACTIVITIES

Mr. HARE. We will insert page 150-A of the justification in the record at this point.

(The statement referred to is as follows:)

Statement of Obligations—Emergency health and sanitation activities

SUPPLEMENTAL ESTIMATE FOR CONTROL OF TUBERCULOSIS

Dr. PARRAN. Mr. Chairman, during my general statement, Judge Tarver requested that the estimate submitted by us to the Bureau of the Budget on tuberculosis control be inserted in the record. As it would be a supplemental to the appropriation, "Emergency health and santitation activities," which you are now considering, it should be inserted at this point.

The estimate is as follows: