We believe that the efforts of the Federal Government should be directed to assisting in the solution of the problems of the shortages of institutional facilities; the subsidizing of the education and training of doctors, nurses, and technical personnel who will agree to serve for a limited time in areas of greatest need; to utilize voluntary prepayment plans as far as possible; and to provide grants in aid to the States for the care not only of the totally indigent but for the medically indigent as well. We believe that the 33,000,000 American people now covered by Blue Cross voluntary hospital prepayment plans and the almost 20,000,000 more who have commercial insurance or other benefits to help with their hospital bills, as well as the vast number of others who have sufficient resources of their own and who can take care of themselves and their families through voluntary effort want to continue to do so. We want to maintain the intimate personal relationship between physician and patient and the autonomy of our hospitals.

It is our fervent hope that through voluntary effort and private initiative, aided by governmental financial support, we can develop a national health program which will assure to each citizen and the members of his family as adequate medical, health, and hospital care as can be provided under the circumstances and we pledge our best efforts to cooperate in achieving this objective.

Senator MURRAY. Thank you very much for your statement, Father. Monsignor SMITH. I would like to mention that Father Donald McGowan will testify on behalf of the Bureau of Health and Hospitals and supplement our testimony.

Senator MURRAY. Father Donald McGowan from the National Catholic Welfare Conference?

Monsignor SMITH. Yes.

Senator MURRAY. Of course, we are all working to the same end, to try to solve this tremendous and serious problem that confronts our country. I have had many meetings with representatives of the Catholic Hospital Association and I have always found them very helpful in trying to find a solution to our problems. I am very glad to have had your testimony here today.

There is, of course, a division of opinion amongst Catholics with reference to those programs. I get letters from around the country. I see articles printed in Catholic papers in which they commend our program, the national health program, and others criticize it. I have a copy here of the Pittsburgh Catholic and it has this statement in it. Monsignor SMITH. I think that Father McGowan as a direct representative of the National Catholic Welfare Conference will perhaps go further than I can on that.

Senator DONNELL. Mr. Chairman, may I interrupt? There is a quorum call. I have no doubt you and I both ought to be there. I wonder if Monsignor would be kind enough to wait for us. I would like to ask him a few questions.

Senator MURRAY. All right, Monsignor, if you will just wait until we get back.

(After recess :)

Senator MURRAY. You may question.

Senator DONNELL. Monsignor, may I ask you right at the outset, do you happen to have with you a list of hospitals that are in your association?

Monsignor SMITH. No.

Senator DONNELL. The reason I asked you is this: I referred to a hospital back in my own home town, back in Missouri, and I called it St. Joseph's Hospital. I am inclined to think I was wrong in the name of it. Do you happen to know?

Monsignor SMITH. No. We have a directory here from Father McGowan's office. We can get it for you.

Senator DONNELL. I would like to have it put in at this point. I do not care to have it changed, but I would like to have the correct

name.

Monsignor SMITH. Mr. Reed of NCWC is here.

Senator DONNELL. It is Maryville, Mo., and I would like to have the correct name of it for the record.1

Monsignor SMITH. Maryville, Mo. I do not recall, sir.

Senator DONNELL. Well, it is not strange. You have approximately 800 hospitals in your organization.

Now, Monsignor, I would like to ask you just a few question along the line of your own experience. Now, you are president of the Catholic Hospital Association of the United States and Canada. Are you from South Carolina?

Monsignor SMITH. Yes, sir.

Senator DONNELL. I wanted you to tell us, if you will for the record, something of your personal knowledge and experience of the hospital situation. I do not mean as set forth in your statement, but something of your own personal background to go into the record at this point.

Monsignor SMITH. Well, I am past president of the South Carolina State Hospital Association, and I am more familiar perhaps with the conditions in the southeastern area than in some other sections of the country, although I have had to travel about the United States and Canada in the fulfillment of my duties as president of the Catholic Hospital Association.

Now, I feel that the building of hospitals, even with the aid of Public Law 725, is meeting only part of the problem because you cannot have a good hospital just with the physical structure. There has to be some incentive to get competent young men trained in medicine and surgery to stay in that area to serve, use that hospital as their workshop; you have the same problem with nurses and with other Technical and professional personnel, so that there is a danger in my mind that if you build hospital beds and do not keep pace with the development of personnel and doctors to staff it, that you are going to have a lopsided result; you are going to have hospitals that cannot give the kind of hospital care that should be given; so you have to have a coordinated development of hospital construction and the stimulation, the education, the training of personnel and staff, and all that goes with the making of a good hospital.

Senator DONNELL. You have been a student of the hospital situation in this country and Canada for a good many years, I assume.

Monsignor SMITH. Yes. I have served as chairman of the board of the Catholic Hospital Association since 1938 or 1939.

1 The name of the hospital at Maryville, Mo., is the St. Francis Hospital.

Senator DONNELL. Would you be able to tell us, Monsignor, just roughly, how many hospitals you have visited from time to time? It is quite a large number, is it not?

Monsignor SMITH. I cannot tell you, but quite a considerable num

ber.

Senator DONNELL. Quite a considerable number. So that you are not only officially the head of this organization, but you have actually personally studied it?

Monsignor SMITH. Yes.

Senator DONNELL. And you know something of the problems of the hospitals and are, therefore, undoubtedly acquainted with many of these questions that arise under compulsory health insurance.

Monsignor, Senator Murray referred to some differences of opinion and read from the Pittsburgh paper. There are many-I do not know how widespread the opinion contrary to your own is among Catholics; but there are certainly others that take the same view that you take, I take it. Are you acquainted with Father Schwitalla in St. Louis? Monsignor SMITH. Very well; he is my predecessor. I spent a few days with him a fortnight ago.

Senator DONNELL. Father Schwitalla is one of the prominent monsignors in the United States, and he has testified before our committee, and I might say his views are in accord with your suggestion. Is that not your understanding?

Monsignor SMITH. Yes. As a matter of fact, we had quite a long discussion within the last fortnight in St. Louis about it.

Senator DONNELL. You mentioned S. 1679. I wonder if you had occasion to study what is called the Taft bill, S. 1581.

Monsignor SMITH. I have read the bills, but we are not in a position at this hearing today to go on record concerning specific legislation for this reason that in matters of public policy, legislation, and public relations have to be passed upon by our administrative board which meets in St. Louis the week of June 13, so that I am not in a position to make any commitment one way or the other as to specific legislation.

Senator DONNELL. May I ask you, Monsignor, if that meeting to be held in St. Louis in June should express itself upon any of these bills, S. 1581, S. 1679, or Senator Hill's bill, S. 1106, with the approval of the chairman of our committee, would you be kind enough to furnish us with copies of the resolutions or other official action that might be taken so that they might be either filed with the committee or incorporated in the hearings?

Monsignor SMITH. We should be glad to do that.

Senator DONNELL. Might I have leave to do that, Mr. Chairman? Senator MURRAY. Yes. I will see that they are furnished with the record.

Senator DONNELL. Thank you.

I notice that you do express yourself in this statement as being in favor of the view that the efforts of the Federal Government should be directed to various points which you mentioned, included among which is the provision of—

grants-in-aid to the States for the care of not only the totally indigent but for the medically indigent as well.

Monsignor SMITH. Yes.

Senator DONNELL. Are you familiar with the fact that S. 1581 does contain a series of grants-in-aid to the States?

Monsignor SMITH. Yes.

Senator DONNELL. Well, I notice also that you say on page 4:

We are opposed to a totalitarian program to take care of everybody, regardless of need, from birth to death according to Federal specifications.

Are you familiar, Monsignor, with the fact that S. 1581 takes into consideration the need and is based upon the proposition of need as distinguished from taking care of everyone?

Monsignor SMITH. Yes.

Senator DONNELL. So that I take it in those two respects, even though you are not prepared now officially to present the views of your organization, your own personal views would be favorable to those principles expressed at any rate in S. 1581?

Monsignor SMITH. Our principles are expressed in this statement which we have filed as part of this record.

Senator DONNELL. Well, you are in favor of those two principles to which I have referred as being embodied in S. 1581?

Monsignor SMITH. So far they are in accordance with the expression of our official statement.

Senator DONNELL. Yes. Monsignor, I wonder if I might take a look for just a moment at the joint statement that you have. Monsignor SMITH. It was attached to the statement.

Senator DONNELL. Yes, I see. Very well.

Well, Mr. Chairman, I will not take any further time. I thank the monsignor for his testimony.

Senator MURRAY. Father McGowan.

Senator DONNELL. Mr. Chairman, was the booklet entitled "A Voluntary Approach to a National Health Program" to be incorporated in the record?

Monsignor SMITH. It was.

Senator DONNELL. I think it would be well to insert it.

Senator MURRAY. You asked for it.

Monsignor SMITH. I asked for it.

Senator DONNELL. Thank you.

STATEMENT OF REV. DONALD A. McGOWAN, DIRECTOR OF THE BUREAU OF HEALTH AND HOSPITALS, NATIONAL CATHOLIC WELFARE CONFERENCE, WASHINGTON, D. C.

Senator MURRAY. You may proceed, Father McGowan.

Reverend McGOWAN. Mr. Chairman and members of the committee, first of all, I want to thank you, Senator Murray and Senator Taft and Senator Donnell and the other members of the committee for the privilege of appearing before you.

I am the Reverend Donald A. McGowan, director of the bureau of health and hospitals of the National Catholic Welfare Conference. Few things in life are more precious to a person than his health. Because this is true, governments have always shown an honest interest in the physical well-being of their members.

In our own country, this solicitude has become clearly and narrowly focused on a so-called national health program, or to use the latest

term, "A National Health Insurance and Public Health Act." The fury and debate concerning such a program have swung from one extreme to the other. Unfortunately, there has been an unwholesome amount of name calling, which at best is unproductive and at worst merely camouflage for prejudices.

As usual, the true solution to a problem of such social significance is to be found somewhere between the antipodes of heated opinion.

Besieged, as we were, from all sides for a statement of policy in this field of national health, three Catholic organizations, the bureau of health and hospitals of the National Catholic Welfare Conference, the National Conference of Catholic Charities, and the Catholic Hospital Association, made public our views.

On April 18 of this year, 1949, a news release sponsored by the three groups made clear our stand on compulsory health insurance in a statement called A Voluntary Approach to a National Health Program.

Senator DONNELL. Pardon me, Mr. Chairman. That is the pamphlet that was filed by the monsignor.

Reverend MCGOWAN. Yes, Senator Donnell. The statement was written after long study and deliberation. It was inspired by a strong desire to achieve the goal of even better health for the healthiest Nation in the world. Its prime purpose is constructive rather than critical. It does not, however, presume to take on the character of a health bill. The complicated business of writing legislation must remain the prerogative of our duly elected representatives in the Senate and the House. Our efforts have been directed toward the achievement of a common objective. Unfortunately there is a disagreement among men of good will in this entire matter of health care. That the interests of the Catholic Church are inseparably bound up to health care is made abundantly clear by 2,000 years of sacrifice and labor in this field. That tradition of accomplishment cannot be ignored. It is in complete harmony with the proud history of health care in our own Nation.

We e are grateful that the present controversy is one between men of good will. This being true, we have proposed a series of suggestions for the solution of an admitted problem-namely, more adequate health care for the American people.

We have approached this problem with realism and sympathy for those burdened by the necessary costs of illness.

Perhaps this quotation from page 16 of our statement will explain our method of attack, and I quote:

We suggest that the Congress enact legislation by means of separate bills for each specific project mentioned above, and appropriate the money needed respectively from the general funds. The program of financing should follow a logical and chronological development to assure that adequate personnel and facilities will be available in order to render the service advocated and promised. This procedure would make allowance for the economic conditions prevailing at a given time and would be more equitable with the money coming out of regular income taxes, than if the cost of construction and subsidies were to be assessed against an insurance trust fund created by the contributions of people in the low-income brackets.

That a new job must be done is clearly evident. The method of advance is, we grant, a problem. Our statement, however, represents the sound, solid conviction of a large group in the health field. I repeat: It is not a bill, but it will furnish, we hope, guideposts in our