Page images
PDF
EPUB

STATEMENT SUBMITTED BY DR. CHESTER D. SWOPE, CHAIRMAN, DEPARTMENT OF PUBLIC RELATIONS, AMERICAN OSTEOPATHIC ASSOCIATION

Mr. Chairman and gentlemen of the committee, on behalf of the American Osteopathic Association, may I express our appreciation for the opportunity of commenting on the President's Reorganization Plan No. 1, making the Federal Security Agency as executive department, now under consideration by this committee.

I am chairman of the department of public relations of the American Osteopathic Association and engaged in private practice as an osteopathic physician in the District of Columbia with offices in the Farragut Medical Building.

We would have preferred enactment of S. 140 in the form favorably reported by this committee during last Congress because that measure not only would have changed the status of the Federal Security Agency from an independent agency to an executive department but it laid down certain necessary fundamental policies to be followed by the new department. Mr. L. L. Gourley, of Washington, D. C., our legal counsel, testified during the hearings on that bill, and I wish to confirm the recommendations made during that testimony as being equally applicable today.

Among those recommendations was the necessity for a broader representation of the health professions on health advisory committees set up at the Federal level. Although the osteopathic profession are licensed in all the States, they are denied representation on the health advisory committees set up by the various divisions of the Federal Security Agency. This denial of a voice on advisory committees has resulted in adoption of policies prejudicial to the contribution which otherwise might be made by the osteopathic profession in the public interest for effecting the objectives of Federal-State cooperative programs, both at the State and Federal levels.

The Office of Vocational Rehabilitation in the Federal Security Agency set up an extralegal medical advisory committee at the Federal level, without osteopathic representation, and when the osteopathic profession requested certain modifications in the program the question was referred to the medical advisory committee which was dominated by representatives of a single school of practice. The recommendation of the advisory. committee was adverse and the Federal administrative agency took the position that it was bound by that conclusion. In other words, the advisory committee was permitted to determine the administrative policy.

Of course, I have heard it said that many recommendations of advisory committees are ignored by the parent agency. That would suggest that advisory committees are used as buffers on the one hand or as yes-men on the other. One remedy for that would be the necessity for a Federal agency to include in its annual report to Congress a full account of the recommendations made by advisory committees. If that were required and fair representation granted on these advisory committees it would assure that Congress would be informed on just how administrative policies are arrived at in implementing the congressional intent. In reporting S. 140 of last Congress the Senate Committee on Expenditures in Executive Departments made this comment in Senate Report No. 242:

"Section 5 (c) provides for the appointment of advisory committees to advise and consult with the Secretary with respect to major policies in the fields of health, education, and public welfare, as to policies, procedures, and other matters involving technical questions in the public interest. Witnesses representing various health groups, including osteopaths, optometrists, pharmacists, and chemists, contended that under the present administration of health programs, there was a tendency to appoint only persons qualified in medicine to advisory committees affecting policies in the field of health. In order to insure that proper recognition might be given to representatives of other health activities, an amendment has been included in the bill in its present form qualifying for appointment on advisory committees persons who are recognized as proficient in any health field under their respective State laws."

Now it might have been expected that such a statement on the part of the committee would have obtained the respectful attention of the Feedral Security Agency as an indicated reform of procedure. So far as osteopathic representation on any health advisory committee in the Federal Security Agency is concerned there is no evidence that such has been the case.

Furthermore, failure of the Federal agency to include osteopathic representation on health advisory committees induces the States to follow suit by

denying representation on State advisory committees in the respective programs. Over the period of years during health grant-in-aid programs the State agencies have been coerced or intimidated into following Federal administrative patterns. In connection with another Federal-State cooperative health plan administered at the Federal level by the Federal Security Agency, another congressional committee, the House Labor Committee during the Seventy-ninth Congress specifically indicated that State plans for maternal and child health and services for crippled children should be approved at the Federal level should the State agency determine that the services of the osteopathic profession and the osteopathic hospitals were to be utilized in effecting the program. Specifically, that committee favorably reported out H. R. 3922 of the Seventy-ninth Congress, including the following provision:

"Nothing in this act shall be deemed to prohibit the inclusion in State plans of provisions for osteopathic services furnished by duly licensed practitioners of osteopathy within the scope of their practice as defined by State law, or for purchase of care from osteopathic hospitals meeting standards established under the State plan."

That recommendation of the House Labor Committee also might have been expected to obtain the active respect of the Federal agency, but the fact is, that the Federal Security Agency refuses to approve State plans which include osteopathic services for children under the maternal and child welfare programs. Reorganization Plan No. 1 will provide for an integrated department and clothe the head of the department with the necessary power and responsibility to carry out the policies of all the divisions of the department. We think that is good organization and we believe it will result in the adoption of policies less steeped in petty bureau prejudices.

Senator JOHN MCCLELLAN,

BOSTON, MASS., July 20, 1949.

Chairman, Senate Committee on Expenditures in the Executive Departments, Senate Office Building, Washington, D. C.:

The executive committee of the Association of State and Territorial Health Officers urges the creation of a United Medical and Hospital Administration Agency as provided in S. 2008. Introduced by Senator Thomas of Utah. Pending the development of such an agency or a separate Department of Public Health, the association wishes to endorse the creation of a combined department of health, education, and security as a second choice. The Reorganization Plan No. 1 of 1949-Department of Welfare was presented by the President to create such a department. The association recommends that the name of this Department be the "Department of Health, Education, and Security," provided that the creation of a combined department does not in the future preclude or in any way jeopardize the creation of a separate health department or separate united medical and hospital administration agency.

The president of the association, Dr. R. H. Hutcheson, of Tennessee, in testifying before the Senate Committee on Labor and Public Welfare early in July in a statement referring to S. 1106, S. 1456, S. 1581, and S. 1679, stated: "We are still willing to make second choices and are especially gratified to see that this bill requires that the 'Administrator' shall have demonstrated outstanding ability in the fields of medicine and administration. We want to go on record as stating, without fear of successful contradiction, that the present organization of the United States Public Health Service is sufficiently organized, staffed with well-trained specialists in all branches of medicine, and allied arts and sciences, and, in general, big enough to be given the leading role in any reorganization plan. We know what anyone who will take the trouble to investigate superficially can learn-that no agency of the Federal Government has the respect of comparable branches of State government equal to that enjoyed by the United States Public Health Service.

"The reasons are obvious. We would like to think that this state of affairs will continue." The State and Territorial health officers are anxious to preserve the excellent Federal-State relations which have existed between the Public Health Service and the several States. We are primarily concerned that the Public Health Service should serve as a nucleus about which all other Federal health services both in preventive and curative medicine be built.

In conclusion, therefore, realizing the improbability of the formation of a separate Department of Public Health, the association wishes again to endorse

as it did in 1947 and again in 1949 the creation of a combined Department as proposed by the President in the Reorganization Plan No. 1 of 1949 with the amendment that the name of the Department be changed to that of "Health, Education and Security." This suggestion is respectfully submitted by the State health officers who are concerned with the title of "welfare". The term "welfare" may be misunderstood by many people as meaning charity.

We believe that the suggested title of "Health, Education and Security" is not only more descriptive but therefore more acceptable to a majority of the people.

R. H. HUTCHESON,
President (Tenn.).
L. E. BURNEY,

Secretary (Ind.).

V. A. GETTING,

Member of Executive Committee and Spokesman (Mass,).

WASHINGTON, D. C., July 21, 1949.

Hon. JOHN L. MCCLELLAN,

Chairman, Committee on Expenditures in Executive Departments,

Washington, D. C.:

We understand certain organizations may oppose Reorganization Plan No. 1 for reason it should not be allowed to go into effect prior to the establishment of United Medical Administration proposed by Hoover Commission. The Disabled American Veterans is unalterably opposed to the creation of a United Medical Organization or any other Government organization that would take away operation veterans' hospitals from Veterans' Administration. Would appreciate this wire being inserted in hearing records.

J. M. WAINWRIGHT,

National Commander, Disabled American Veterans.

WASHINGTON, D. C., July 22, 1949.

Hon. JOHN L. MCCLELLAN,

Chairman, Committee on Expenditures in the Executive Departments,

Senate Office Building:

National Women's Trade Union League strongly supports President's proposal for Department of Welfare contained in Reorganization Plan No. 1. Importance of health, social-security, and educational programs to our people warrants Cabinet status. Further believe administration of these services facilitated by holding them together.

ELISABETH CHRISTMAN, Secretary.

WASHINGTON, D. C., July 22, 1949.

Hon. JOHN MCCLELLAN,

Chairman, Committee on Expenditures in the Executive Departments,

United States Senate, Senate Office Building:

General Federation of Women's Clubs, a national organization with a voting membership of approximately 1,300,000, is officially on record as favoring "the creation of a new executive department headed by a member of the President's Cabinet to promote the national interest in health, welfare, and education, and to administer Federal programs in these fields." We believe such a department would constitute a testimonial to the importance this Nation places on human welfare and that administration of programs in this field would thereby be strengthened. We therefore earnestly hope that the Committee on Expenditures in the Executive Departments will report favorably on Reorganization Plan No. 1 to constitute the Federal Security Agency a Department of Welfare. Would appreciate having this wire included in record of hearings of committee. Mrs. C. D. WRIGHT,

Chairman, Legislation Department, General Federation of Women's Clubs.

Hon. JOHN L. MCCLELLAN,

WASHINGTON, D. C., July 22, 1949.

Chairman, Senate Committee on Expenditures in Executive Departments, Senate Office Building, Washington, D. O.:

On behalf of the National Association for the Advancement of Colored People, I wish to heartily endorse the President's Reorganization Plan No. 1 of 1949 to create a Department of Welfare to deal with programs currently handled by the Federal Security Agency. American people increasingly look to Federal Government for extended health, education, social security, and other welfare services. These programs have a direct effect on the great mass of our citizens and we believe that the agency directing such functions should be raised to the highest policy level. Only by giving such agency Cabinet rank can welfare needs of this Nation be articulated and properly related to other departments and functions of the Government. I request that this communication be made part of the record.

LESLIE S. PERRY, Legislative Representative NAACP.

Senator JOHN MCCLELLAN,

THE MEDICAL SOCIETY OF NEW JERSEY,
Trenton 8, N. J., July 18, 1949.

Senate Office Building, Washington, D. C. DEAR SENATOR MCCLELLAN: The Medical Society of New Jersey wishes to record its opposition to President Truman's Reorganization Plan No. 1, recently submitted to Congress under the new statute granting the President authority to reallocate and "streamline" executive functions, subject to disapproval by a constitutional majority of either House of Congress within 60 days after submission of a specific plan.

The objection of this Society is addressed to the provision in Reorganization Plan No. 1 for inclusion of the health and medical functions of the Federal Government within the proposed new Department of Welfare.

It is pointed out that the Hoover Commission on Organization of the Executive Branch of the Government, in its report on medical activities, recommended that, with certain exceptions relating to the military medical services, all Federal medical and health activities be allocated in a single, separate agency which, it is proposed, should be called United Medical Administration.

The proposed Department of Welfare as recommended by the Hoover Commission, would embrace only welfare, social security, and educational functions. In recommending a separate United Medical Administration, the Hoover Commission cited the size and extent of the medical operations of the Federal Government and the "extreme dissimilarities among the activities which would have composed such a Department" (in the event that medical service were to be combined with social security as now proposed by President Truman).

For more than a half a century the American Medical Association has urged that the Federal Government should recognize the importance of medical and health activities by uniting and correlating them in a single department with Cabinet ranking. While the report of the Hoover Commission does not propose that the United Medical Administration would be headed by an officer of Cabinet rank, it does, at least, admirably provide for the correlation of these activities and preserves their integrity against the possibility of administration by persons whose primary interest and experience would probably be in almost completely unrelated fields.

We would like to emphasize that objection is not here taken to the principle of integrating related activities nor to the general proposal for creation of a Department of Welfare. We object only to the President's recommendation that this proposed Department should embrace health and medical functions.

We respectfully request that you urge upon Congress the rejection of Reorganization Plan No. 1 as presently drawn, in favor of a plan which would remove from the Department of Welfare the aforesaid medical and health functions and correlate them under a separate agency as above described.

Your consideration of these views and this request will be most gratefully appreciated.

Respectfully yours,

C. BYRON BLAISDELL, M. D., Chairman, Subcommittee on Legislation.

Senator JOHN MCCLELLAN,

LOUISIANA STATE MEDICAL SOCIETY,
New Orleans 12, July 19, 1949.

Chairman, Senate Committee on Expenditures in the Executive Departments, United States Senate, Washington, D. C.

DEAR SENATOR MCCLELLAN: We have learned that there will be hearings before the Senate Committee on Expenditures in the Executive Departments on Thursday, July 21, and Friday, July 22, to consider and hear testimony for or against President's No. 1 Reorganization Plan. This plan establishes the Federal Security Agency as a Department of Welfare and would therefore elevate the present Administrator to a Cabinet post as Secretary.

Attached is statement of our objections to this revolutionary recommendation. We hope that you will give serious consideration to these objections and that in your judgment agree with our organization that such a plan would be very objectionable. We, therefore, trust that you will use your influence and vote to defeat this proposal.

Thanking you very much for your consideration, I am

Very truly,

EDWIN L. ZANDER, M. D., Chairman, Committee on Congressional Matters.

OBJECTIONS BY LOUISIANA STATE MEDICAL SOCIETY TO PRESIDENT TRUMAN'S No. 1

REORGANIZATION PLAN

1. The medical profession has for years been supporting the constructive plan of having a doctor in charge of the Health Department with Cabinet status. We still think that this is the most constructive policy as the question of health and other phases of medicine is a subject which is probably best understood by a physician and not a lay individual.

2. This plan is contrary to the recommendation made by the Hoover Commission on Reorganization of the Executive Branch of the Government in relation to medical service now being rendered by the Government. The Hoover report recommends establishment of a United Medical Service Organization as an independent administration. The Secretary of this agency would be a member of the Cabinet. The agency would be headed by a professional career director general.

3. Even if this recommendation by the Hoover Commission had not been made, the medical profession is opposed to elevation of the Federal Security Agency, with its complex problems, to a position where it would dominate and control the practice of medicine in this country. Furthermore, we are of the opinion that the present Administrator, Mr. Oscar Ewing, would be very objectionable to the citizens of this country in such a position as he and his workers in the Federal Security Administration have been most diligent and persistent in their determination to force compulsory health insurance on the American people.

4. Our profession is opposed to any form of compulsory health insurance or to the elevation of any agency or group which will soft pedal the way or open up the possibility of effecting compulsory health insurance. This recommendation by the President is the first step in that directiion.

THE AMERICAN PUBLIC HEALTH ASSOCIATION,
New York 19, N. Y., July 20, 1949.

Hon. JOHN MCCLELLAN,

Chairman, Senate Committee on Expenditures in the Executive Departments, Senate Office Building, Washington, D. C.

DEAR SENATOR MCCLELLAN: The American Public Health Association wishes to place on record its considered opinion with reference to the proposal of the administration that there should be a Department of Welfare created from the present structure of the Federal Security Agency.

It is our hope that it may be possible for you to insert this opinion in the record of the hearings, which I understand are scheduled for the near future. The American Public Health Association, as a professional society of nearly 12,000 public health workers, believes it manifest that a structure of Cabinet

94651-49-10

« PreviousContinue »