Hon. Henry Cabot Lodge, Jr., a United States Senator from the State Dr. Paul R. Hawley, chief executive officer, Blue Cross-Blue Shield E. A. van Steenwyk, executive director, the Associated Hospital Serv- ice of Philadelphia, and chairman, government relations committee, Rev. Donald A. McGowan, director of bureau of health and hospitals, Dr. R. H. Hutcheson, president, State and Territorial Health Officers Association, and commissioner of public health, Nashville, Tenn--- Dr. Hugh R. Leavell, professor of public health practice, Harvard School of Public Health, and chairman, executive board, American Public Health Association, New York, N. Y Harvey W. Brown, president, International Association of Machinists- 611 George Nelson, grand lodge representative, International Association III. LIST OF STATEMENTS AND COMMUNICATIONS Carey, James B., secretary-treasurer, Congress of Industrial Organizations, 422 Major benefits provided by health-insurance plan and by United Med- 318 Major benefits provided by health-insurance plan and by Group Health 319 Donnell, Hon. Forrest C., a United States Senator from the State of Mis- Goin, Dr. Lowell S., Los Angeles, Calif., president, California Physicians' Document entitled "A Simplified Blueprint of the Campaign Against Keenan, Dr. A. S., medical director, Health Service System, San Fran- American Journal of Public Health, July 1949, article from, The Qual- 369 243 177 588 437 537 280 Murray, Hon, James E., insertions of-Continued Hawley, Dr. Paul R., chief executive officer, Blue Cross-Blue Shield Page 373 Memphis Press-Scimitar, February 29, 1949, British doctors praise 435 San Francisco News, June 1949, What Price Health?-California Tops Nation in Medical Care Costs-State Surgical Charges 139 San Francisco News, June 17, 1949, What Does It Cost To Be Sick? Cost of Medical Care Unpredictable Factor---- Washington Evening Star, article by Lowell Mellett, On the Other Snyder, Hon. John W., Secretary of the Treasury, letter to, from Olsen, John H., past president, American Protestant Hospital Association, Crain, Kenneth C., article by, which appeared in Hospital Management, January 1949, entitled "To the Congress of the United States-A Brief on Compulsory Health Insurance Under Federal Legislation"- Life Insurance Association of America, New York, N. Y., report of January 6, 1949, A Survey of Accident and Health Coverage in the United States as of December 31, 1947_-. Smith, Rt. Rev. Msgr. George Lewis, president, Catholic Hospital Associa- tion of the United States and Canada, insertion of: National Catholic Welfare Conference and National Conference of Catholic Charities, joint statement of, entitled "A Voluntary Approach to a National Health Thomas, Hon. Elbert D., a United States Senator from the State of Utah, 77 NATIONAL HEALTH PROGRAM OF 1949 MONDAY, MAY 23, 1949 UNITED STATES SENATE, SUBCOMMITTEE ON HEALTH OF THE COMMITTEE ON LABOR AND PUBLIC WELFARE, Washington, D. C. The subcommittee met, pursuant to call, at 10 a. m., in the committee hearing room, Senator James E. Murray (chairman) presiding. Present: Senators Murray, Pepper, and Taft. Also present: Senator Hill. Senator MURRAY. The hearing will come to order. The Subcommittee on Health is today beginning hearings on four bills. Each of them has to do with some or several aspects of a subject which is of utmost importance to this country, the health and physical well-being of its people. Today and tomorrow we hope to gain from the leading sponsors of these bills, and from individuals they have designated, a clear understanding of what each bill proposes to do and of how it would operate. Thereafter, through hearings scheduled to run through the month of June, we will receive testimony on these bills from interested organizations. It is our hope that such testimony will be informative, constructive, and to the point. The entire subcommittee is in agreement in its desire that these hearings shall be both thorough and expeditious. We want to hear all points of view, and we want to get all of the facts necessary to the formation of legislation which will be sound in its objectives and practical in its operations. Despite our present differences of opinion as to the extent and the kind of health problems confronting us, even though we may disagree as to the methods of solving these problems, on some things we are unanimous. We agree that there is a problem and that it is our responsibility to find a solution. With that in mind I know that I can expect the full cooperation of my colleagues in endeavoring to keep to our schedule and to see to it that both testimony and cross-examination are relevant to the subject matter of the business before us. Our program these first 2 days calls for explanation of S. 1679, the National Health Insurance and Public Health Act, sponsored by Senators Thomas of Utah, Wagner, Pepper, Chavez, Taylor, McGrath, Humphrey, and myself. This will be undertaken by Senator Thomas and by Mr. Kingsley, Assistant Administrator of the Federal Security Administration. Senators Taft and Donnell will then discuss S. 1581, the National Health Act of 1949, sponsored by Senators Taft, Donnell, and Smith of New Jersey. 1 Following their presentation, Senator Hill and Mr. Bugbee will discuss S. 1456, the Voluntary Health Insurance Act, sponsored by Senators Hill, Ó'Conor, Withers, Aiken, and Morse. Then Senator Lodge will discuss his bill, S. 1106, the Medical Aid Act of 1949. I should add at this point that neither titles III and V of S. 1679 or titles IV and V of S. 1581 will be considered by this subcommittee. They have been referred to Senator Hill's subcommittee and have been studied in connection with S. 614, S. 522, and other bills relating to expansion of hospital facilities and public health service. (S. 1106, S. 1456, S. 1581, S. 1679 are as follows:) [S. 1106, 81st Cong., 1st sess.] A BILL To amend the Public Health Service Act, as amended, so as to provide assistance to the States in furnishing certain medical aid to needy and other individuals Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled, That this Act may be cited as the "Medical Aid Act of 1949." SEC. 2. The Public Health Service Act (consisting of titles I to VI, inclusive, of the Act of July 1, 1944) is hereby amended by adding at the end thereof the following new title: "TITLE VII-GRANTS TO STATES FOR MEDICAL AID "APPROPRIATIONS "SEC. 701. For the purpose of enabling the several States to provide or to assist in providing certain medical services and medicines, which are standardized in their nature but which, because of their high costs, are not used in many cases in which their use is desirable, there is hereby authorized to be appropriated for the fiscal year ending June 30, 1948, and for each fiscal year thereafter, such sums as may be necessary to carry out the provisions of this title. The sums made available under this section shall be used for making payments to States which have submitted, and had approved by the Surgeon General, State plans for furnishing medical aid. "STATE PLANS FOR FURNISHING MEDICAL AID "SEC. 702. (a) A State plan for furnishing medical aid must (1) provide that it shall be available to all political subdivisions of the State; (2) provide for financial participation by the State; (3) provide for the designation of the State health agency to administer the plan; (4) provide that the State health agency I will make such reports, in such form and containing such information, as the Surgeon General may from time to time require, and comply with such provisions as the Surgeon General may from time to time find necessary to assure the correctness and verification of such reports; and (5) provide such methods of administration of the State plan, including methods relating to the establishment and maintenance of personnel standards on a merit basis (except that the Surgeon General shall exercise no authority with respect to the selection, tenure of office, or compensation of any individual employed in accordance with such methods) as the Surgeon General prescribes by regulation under section 705 of .this title. "(b) The Surgeon General shall approve any plan which fulfills the conditions specified in subsection (a), except that he shall not approve any plan which imposes as a condition of eligibility for medical aid a residence requirement which denies aid with respect to any person who has lived in the State for three months immediately preceding the application for such aid. "PAYMENT TO STATES "SEC. 703. (a) From the sums appropriated under section 701, the Secretary of the Treasury shall pay to each State which has an approved plan for medical aid, for each quarter, beginning with the quarter commencing July 1, 1947, an amount, which shall be used exclusively for carrying out the State plan, equal |