Senator SCHOEPPEL. How do you and Mr. Studebaker agree or disagree on this general proposition? Dr. Zook. I do not know exactly what Mr. Studebaker might say with respect to this. I only know what my own experience is and what my own belief is with respect to this. May I still further say that I am sure you must be referring to the fact that there were some disagreements between Mr. Studebaker and the present Administrator of the Social Security Agency? Senator SCHOEPPEL. Not on their personal disagreements, but disagreements as to policies. That is what I have in mind, sir. Dr. Zook. Yes. I simply wanted to say that it seems to me that we should separate that kind of thing from the consideration of this proposal here. I do not believe that the matter of whether Mr. Ewing should be the head of this Department or not is germane to the discussion of this issue. Senator SCHOEPPEL. I take it that you are interested in keeping and maintaining on the local level to the States their prerogatives, rights, and privileges, that the sundry State constitutions grant unto the educational departments of the respective States. Dr. Zook. I think that no one here in Washington has been a more consistent upholder of that principle. I said that one of the main reasons why I did not favor a separate department of education was because it seemed to me that that might give notice to the country that the Federal Government was really intending to take over the function of education. May I say, further-this gives me the opportunity to do so that I think that no Federal legislation with respect to edu cation should require or prohibit the expenditure of Federal subsidies for the support of private schools. That seems to me to be so completely a State function that it is unwise on everybody's part to try to boss that situation around from Washington, D. C. Senator SCHOEPPEL. I am glad to have your view on that. The CHAIRMAN. I do not quite understand why there would be any more power in a department of education to dominate the States and their policies with reference to education than there would be by having the education department in a department of welfare, with the Welfare Secretary having the same power that the Secretary of the Department of Education would have. Where do you make the distinction? Dr. Zook. I think it would be extremely difficult to prove that. Dr. Zooк. I am only saying that it seems to me it would be saying that education is of such tremendous importance that the Federal Government will take over. That is pretty largely a matter of opinion, Senator. The CHAIRMAN. There is no basis in fact for it. Dr. Zook. I wouldn't quite say that. The CHAIRMAN. Name one. Dr. Zook. I don't think it would be very easy to name one. Senator SCHOEPPEL. There is one other question I would like to ask, You elaborated on the educational activities of the Agricultural Department by way of illustrating how various departments have certain educational features and factors involved. Now let us assume that this situation were developed to a point where it would be acceptable that a Cabinet rank be set up. Do you think in your coordinating activities that type of educational activity might be desired to be transferred out of that department into this one agency for direction? Dr. Zook. You will notice I did not use agricultural extension or labor extension as being the kind of activities that were so germane to the success of the particular departments there named that it seemed to me they were necessarily integral parts of those departments. I have; therefore, often felt that agricultural extension and labor extension might very well be carried on by the educational organization that is here in Washington rather than by the divisions of agriculture and labor, respectively. They do not seem to me to be so germane to the success of the Department of Agriculture and Labor, respectively, as is the case in other situations. Senator SCHOEPPEL. No further questions. The CHAIRMAN. Thank you very much, Doctor. Dr. Zook. I wonder, Mr. Chairman, have you had a copy of this report, and if not, may I leave it? The CHAIRMAN. You may file it. It will not be printed in the record. It will be filed for reference only. Thank you very much, Doctor. Dr. Zook. Thank you. (The document referred to is on file with the committee.) The CHAIRMAN. General Hawley? (No response.) Dr. Borzell? Will you come around, please. Before you begin, may I ask the reporter to incorporate in the record a statement which has been handed to me from Dr. William C. Woodward and a statement from Dr. Robert E. S. Young. (The statements referred to follow :) AMERICAN MEDICAL ASSOCIATION, SENATE COMMITTEE ON EXPENDITURES IN THE EXECUTIVE DEPARTMENTS, GENTLEMEN: There is attached a statement submitted by William C. Woodward, M. D., who at different times was commissioner of health of Washington and Boston and who for years was the legislative representative of the American Medical Association. It was his great desire to present this statement in person, but due to his age and to the extreme temperature, he has decided that it would be unwise for him to come and has asked me to present his statement to the committee on his behalf. Respectfully submitted. Jos. S. LAWRENCE, M. D. STATEMENT OF WILLIAM C. WOODWARD, M. D., FORMER COMMISSIONER OF HEALTH OF WASHINGTON, D. C., AND BOSTON, MASS. I have read generally whatever I have seen published in the press concerning the proposed Federal Department of Health. Nothing has come to my notice, however, relating to our one-time National Board of Health, and I have been surprised at the small number of people who are aware that there ever was such a board organized and operating. The fact that such a board was at one time created by Congress may be useful in arguing in favor of an analogous agency, a Federal Department of Health, and a knowledge of how that board was destroyed may be of use in the present campaign for a department. The National Board of Health was organized under an act of Congress, approved March 3, 1879, entitled "An act to prevent the introduction of infectious and contagious diseases into the United States, and to establish a National Board of Health." To facilitate your study of that organization, if you are not already familiar with it, I enclose in duplicate a copy of that act, copied from the National Board of Health Bulletin, vol. I, No. 1, page 1, June 28, 1879. The copy of the act as published does not give a citation to its official source, the United States Statutes at Large. I am under the impression that the passage of this act was due to one or more epidemics of yellow fever at or about the time of its enactment, but of this I cannot be certain. The records of the association ought to show something about this. What is now known as the United States Public Health Service was then known as the United States Marine Hospital Service. It seems to have had its origin in the fact that seamen and others engaged in interstate and foreign trade sometimes had difficulty in obtaining treatment when sick or injured because they were not residents of the States in which they happened severally to be, and the Federal Government found it necessary to provide for them in some way. As our customs service gradually developed, the Marine Hospital Service was charged with various duties connected with it and in that way became involved in such interstate and foreign quarantine work as the Federal Government then undertook. It undertook very little for most if not all of the States claimed the right to maintain their own quarantine services, and did so. Congress, however, by "An act to prevent the introduction of infectious and contagious diseases into the United States," approved June 2, 1879, vested the National Board of Health with authority over interstate and foreign quarantine. When it appeared that the Board would take over from the Marine Hospital Service its function in that field, the Marine Hospital Service objected, and a bitter rivalry arose. Unable to procure the abolition of the National Board of Health, the Marine Hospital Service seems to have been able to have the appropriations necessary for the Board's operation discontinued, and the National Board of Health existed for a number of years on paper only. Meanwhile the Marine Hospital Service succeeded in having its name changed to, I believe, the Marine Hospital and Public Health Service, and later to the Public Health Service, taking on public-health functions. It was eager to assume the role of a Federal department, if not actually to become one, and for many years fought bitterly and by every means within its power to prevent the creation of a national department of health. Of course, my knowledge as to what it did with respect to this matter is largely hearsay, but it comes generally from reliable sources for I was a very active member of the Committee of One Hundred, organized to procure the establishment of such a department, and also of the committee of the American Medical Association, created by the house of delegates, for the same purpose. At about that time a vacancy occurred in the office of health commissioner of the city of Chicago, and an officer of what is now the United States Public Health Service was allowed to accept the appointment. That he was active in aiding the then board of trustees of the association to defeat the purpose of the house of delegates, I am sure, for I have seen a letter written by him to a fellow officer in the Public Health Service in which he said, "I was sent to Chicago to keep the American Medical Association quiet, and I have done so." What the position of the Public Health Service is now with respect to the creation of a department of health, I haven't the slightest idea. Sometime in the nineties, I believe, a clause was inserted in one of the appropriation bills repealing the act creating the National Board of Health, after it had been in fact dead for a number of years because of lack of appropriations. [Copied from National Board of Health Bulletin, vol. 1, No. 1, p. 1, June 28, 1879] CONSTITUTING ACT The National Board of Health was organized under the following act of Congress, approved March 3, 1879, entitled "An act to prevent the introduction of infectious and contagious diseases into the United States, and to establish a National Board of Health": "Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled, That there shall be established a National Board of Health to consist of seven members, to be appointed by the President, by and with the advice and consent of the Senate, not more than one of whom shall be appointed from any one State, whose compensation, during the time when actually engaged in the performance of their duties under this act, shall be $10 per diem each and reasonable expenses, and of one medical officer of the Army. one medical officer of the Navy, one medical officer of the Marine Hospital Service, and one officer from the Department of Justice, to be detailed by the Secretaries of the several Departments and the Attorney General, respectively, and the officers so detailed shall receive no compensation. Said Board shall meet in Washington within 30 days after the passage of this act, and in Washington or elsewhere from time to time upon notice from the president of the Board, who is to be chosen by the members thereof, or upon its own adjournments, and shall frame all rules and regulations authorized or required by this Act, and shall make or cause to be made such special examinations and investigations at any place or places within the United States, or at foreign ports, as they may deem best, to aid in the execution of this Act and the promotion of its objects. "SEC. 2. The duties of the National Board of Health shall be to obtain information upon all matters affecting the public health, to advise the several departments of the Government, the executives of the several States, and the Commissioners of the District of Columbia, on all questions submitted by them, or whenever in the opinion of the Board such advice may tend to the preservation and improvement of the public health. "SEC. 3. That the Board of Health, with the assistance of the Academy of Science, which is hereby requested and directed to cooperate with them for that purpose, shall report to Congress at its next session a full statement of its transactions, together with a plan for a national public-health organization, which plan shall be prepared after consultation with the principal sanitary organizations and the sanitarians of the several States of the United States, special attention being given to the subject of quarantine, both maritime and inland, and especially as to regulations which should be established between State or local systems of quarantine and a national quarantine system. "SEC. 4. The sum of $50,000, or so much thereof as may be necessary, is hereby appropriated to pay the salaries and expenses of said Board and carry out the purposes of this act." The National Board of Health, as constituted under this act, is composed of the following members: Preston H. Bailhache, M. D., U. S. M. H. S., Maryland Samuel M. Bemis, M. D., etc., Louisiana John S. Billings, M. D., United States Army, District of Columbia Henry I. Bowditch, M. D., etc., Massachusetts James L. Cabell, M. D., etc., Virginia Hosmer A. Johnson, M. D., etc., Illinois Robert W. Mitchell, M. D., etc., Tennessee Samuel F. Phillips, Esq., Solicitor General, District of Columbia Stephen Smith, M. D., etc., New York Thomas J. Turner, M. D., United States Navy, District of Columbia Tullio S. Verdi, M. D., etc., District of Columbia The first meeting of the Board was held on the second day of April, when the following permanent officers were elected: Dr. James L. Cabell, president; Dr. John S. Billings, vice president; Dr. Thomas J. Turner, secretary. The Executive Committee is constituted as follows: Dr. James L. Cabell, Dr. John S. Billings, Dr. Thomas J. Turner, Dr. Stephen Smith, Dr. Preston H. Bailhache, Samuel F. Phillips. ASSOCIATION OF AMERICAN PHYSICIANS AND SURGEONS, INC., Senator JOHN L. MCCLELLAN, Chairman, Senate Committee on Expenditures in Executive Departments, Senate Office Building, Washington, D. C. DEAR SENATOR MCCLELLAN: It is my understanding that within 5 days following testimony before a Senate Committee, one may file supplementary testimony which may then be entered into the records. If I am correct in this assumption, will you be kind enough to file my supplementary remarks with the records of your committee? Respectfully submitted, ROBERT E. S. YOUNG, M. D.,1 President, Association of American Physicians and Surgeons, Inc. 1 See earlier statement, p. 51. SUPPLEMENTARY STATEMENT BY ROBERT E. S. YOUNG, M. D., PRESIDENT OF THE ASSOCIATION OF AMERICAN PHYSICIANS AND SURGEONS During examination of a witness of July 22, 1949, Senator Long asked why the professions were recommending a doctor of medicine as head of the Federal medical services and in asking the question pointed out that under the direction of a physician the professions might fare worse than under the direction of a lay administrator. This is an important question and relates primarily to policy. In giving an answer to this question I wish to state that the professions realize that there are those few within the profession who have already indicated that they would foster changes which would be contrary to the health and welfare of the people. The recommendation to appoint a physician as director of Federal medical services is based upon well-tried and established principles. It is the custom in government, industry, and other organizations to bring an executive up through the ranks, in his period of training, so that he may have first-hand knowledge of problems at hand. As all except physicians are prohibited by law from gaining experience in the practice of medicine, we recommend that a physician be appointed, for the simple reason that all others are prohibited by law from gaining the necessary experience. This is urged, not as the consequence of professional pride but rather for the hope of executive competence. It was further pointed out that physicians lack ability as administrators. I take exception to this statement, for the availability of physicians with executive and administrative ability of high caliber is evidenced by the recent appointment of Dr. Raymond Allen as Director and Dr. Richard Meiling as Deputy Director of Medical Services to the Armed Forces. During the examination of witnesses on July 22, 1949, the question was raised as to whether the professions fear the increase in prestige of Mr. Oscar Ewing, in his elevation to Cabinet status. In submitting an answer to this question I would like to state that naturally the professions fear the increase of prestige of Mr. Ewing, the history of Federal Security Administrators has shown that they have disseminated propaganda for socialized medicine to the extent of their ability, at times perhaps overstepping the bounds of propriety. Quote, Harness report: "Our first report deals exclusively with activities calculated to build up an artificial, federally stimulated public demand upon Congress for enactment of legislation for compulsory health insurance referred to by witnesses and publications as the Wagner-Murray-Dingell bill. "Your committee reports to the House that, on the basis of hearings held on May 28 and June 18, 1947, it finds that at least six agencies in the executive branch are using Government funds in an improper manner for propaganda activities supporting compulsory national health insurance, or what certain witnesses and authors of propaganda refer to as socialized medicine, in the United States. The departments, bureaus, and agencies known to have participated in this campaign are: 1. The United States Public Health Service; 2. The Children's Bureau; 3. The Office of Education; 4. The United States Employment Service; 5. The Department of Agriculture; and 6. Bureau of Research and Statistics, Social Security Board. "Your committee finds that the use of Federal funds for the purpose of influencing legislation before Congress is unlawful under section 201, title 18, of the United States Code. "The latest figures available from the Budget Bureau show that for the fiscal year 1946 total expenditures in the executive branch for publicity and propaganda activities were $75,000,000. During that fiscal year 45,000 Federal employees were engaged, full or part time, in such activities. The most recent prior compilation by the Budget Bureau covering the fiscal year 1941 showed total publicity expenditures amounting to $27,770,000. An increase of approximately 300 percent in Federal expenditures for publicity and propaganda in a period of 5 years is deemed by your committee to be a proper subject for inquiry by the Congress" (H. Rept. No. 786, 80th Cong., 1st sess.). That Mr. Ewing is interested in the principle of the health workshop is shown by his own statement: "The success of the National Health Assembly as a forum suggested to me the value of holding similar State and local assemblies through |