(1) That the limited legislation embodied in H.R. 3920 would inevitably expand into a complete program of socialized medicine.

(2) That it would wreck the social security system as set up in its present form.

(3) That a knowledge of foreign experience with socialized medical schemes should be sufficient to cause us to avoid such a program as that set up by the King-Anderson type of legislation.

(4) That a great Government lobbying effort has been made which continues and much taxpayers' money has been illegally spent in an effort to force passage to this kind of legislation. In other words this legislation it is assumed would not be acceptable to the people on its merits. It has to be forced on them by propaganda paid for by taxpayers' money.

INEVITABLE EXPANSION

It is necessary in evaluating this contention to take a broad view of the general philosophy of the New Frontier. Briefly this is a philosophy dedicated to advance by every possible political device, the centralization of all control, the gathering of all power into the executive branch of the Federal Government, also to add to bureaus already established and to establish new bureaus to control areas not already under the domination of the Federal Government. In short the objective seems clearly to be executive dictatorship. The multitudinous efforts of the executive branch of our Government bent in this direction are evident to all and requires no further comment.

Superimposed on this general philosophy is a well-established method of legislative procedure which can be easily explained. That is the device of starting a program with a small limited initial bill and with that as a starting point the ultimate objective is attained a little at a time. This is the technique used to establish programs which would never be acceptable to Congress if the total objective were outlined in the original legislation. This device is so well known and so often practiced that no further explanation is needed to those even only slightly sophisticated politically. This approach is undoubtedly being employed in the case of H.R. 3920 as it was in 1961 with H.R. 4222. The proponents of this legislation of course deny that this procedure is being employed here but history proves otherwise there have been many attempts to establish a system of health insurance so-called attached to the social security system. All have failed. The scope of these bills have been progressively narrowed year after year with the hope that finally the demanded legislation will seem limited enough to convince the people and Congress that it will not carry with it the threat of later socialized medicine. The tipoff is without doubt the willingness of the administration to accept through Secretary Ribicoff as negotiator any compromise as long as the program was attached to social security H.R. 4222. In other words, everything would be sacificed except placing it under the centralized control of Washington under one of its bureaus where the regulations having the effect of law would be promulgated by a political appointee. Thus a start of expansion would be guaranteed at once. That would be a start that would eventually give the hungry Federal Government the indispensable base from which to implement further piecemeal expansion.

A few examples of how this device has worked in the past are most convincing. The principle could be again applied to any limited initial King-Anderson type of legislation.

First consider the income tax. In 1913 when Cordell Hull introduced the original legislation the amount of the tax by present-day standards was infinitesimal. It is doubtful if the original legislation would have been passed and it is conceivable that the legislation would have failed of enactment at all if the request was made to permit a tax that would allow the Government to confiscate 80 to 90 percent of the profits of our large corporations as it now does, 52 percent as a tax on the profits of the corporation as such and a second tax of 25 to 40 percent on what is then left of those same profits when that remainder is distributed to the stockholders as dividends. The total being confiscated in the neighborhood of 75 to 90 percent. Yet this has been the ultimate unforeseen result of a small beginning. Would H.R. 3920 provide a similar opportunity for later expansion? The answer must be yes.

Second, consider the Rural Electrification Administration. This was set up originally with the reasonable and laudable objective to provide electricity to isolated farms that could not be supplied by the private utilities. When the

original legislation was passed the question of undesirable and unfair competition with private utilities was brought up and the sponsors, the late Senator George Norris and the late Speaker of the House Sam Rayburn, gave unqualified assurance that such competition would not take place. Speaker Rayburn said in response to questioning, "We are not in this bill intending to go out and compete with anybody." Senator Norris likewise gave similar assurance. He said, "There is no intention of going into a farming community which is already supplied with electric current and go into competition." Today REA has escaped from control by Congress and is building unnecessary lines alongside of private utility lines to supply cities as well as rural areas. From their million-dollar Washington building they are apparently guiding and masterminding an effort to take over all electric utilities, an objective which was not only not contemplated by the framers of this legislation but was positively denied by them. The original legislation again was only a starting point with a final development far different from the unqualified assurances given at first. We are again given unqualified assurances by the proponents of H.R. 3920 and H.R. 4222 as we were in the case of REA. Can we be certain that these assurances are this time worth listening to? It is doubtful. Third and last, consider foreign aid. Senator Wayne Morse has said that if a referendum were held on it today it would be defeated and abolished. The history of the inception, development, and the present practices of foreign aid are not known by many people. Indeed the present practices of this program are concealed as much as possible from the people as well as Congress insofar as the Washington bureaucracy can accomplish this.

Although many billions were thrown away in Europe prior to the Marshall plan that was the beginning of our present extravagant, wasteful, nonproductive, and positively harmful foreign aid program as carried out by the bureaucracy at great expense to the taxpayer.

There was a plausability about the Marshall plan that disarmed its critics who were tired of seeing the lack of good result from the many billions sent to Europe beginning with the First World War, than the Export-Import Bank and lendlease during World War II. It took an impressive array of important people to convince the Congress of the apparent desirability of this plan. Few people know that one of the prime movers in this program was Alger Hiss. This plan was sold to Congress and the taxpayers as a definitely limited effort. Under Secretary of State Dean Acheson pledged to Congress that the expenditure of $17 billion over a period of 4 years would end all foreign aid. After that there would be no more he told the Senate and House committees. It was with this understanding that this multibillion-dollar foreign aid appropriation was passed as the European Recovery Act in April 1948. Never was Congress so badly mistaken or perhaps so completely misled.

1

Note the title "The European Recovery Act," remember the $17 billion 4-year assurance and then consider the fact that $100 billion of the taxpayers' money has been sent all over the world and to over a hundred countries and apparently the end is not in sight.

We should also know and remember that Charles Sawyer, who was President Truman's able Secretary of Commerce, headed a survey team which was sent to many countries by the President to survey Europe's economic condition and prospects. A very competent team of experts it was and its report to President Truman recommended an end to foreign aid. "Trade rather than aid" was the sloganized report and facts were presented to support it.

Again we have had unqualified assurances, again we have had limited original legislation, but to what avail. We have again had unlimited expansion.

President Truman was near the end of his term and disregarded the recommendations of his own competent and reliable committee.

President Eisenhower merely changed the name from Mutual Security Administration to Foreign Operations Administration, increased the amount of money and the scope and the objectives of the original framers and the pious purposes of the advocates of the limited European recovery plan were tossed aside, ignored, and forgotten.

The Congress and the American people should reject any statements sug gesting, asserting, or purporting to guarantee that any legislation such as H.R. 4222 or H.R. 3920 or any similar bill attaching hospital care for the aged in any way at all ever so little to social security with the Federal Government in control. If they know history and politics they would understand the device used to attain a concealed objective. They should not be fooled again. The

above examples are few but with time and effort many, many more examples of this same principle could be cited. Certainly this principle of procedure could be and probably would be applied to the small beginning embodied in any legislation of the type of King-Anderson.

Raymond Moley, one of Franklin Roosevelt's original brain trusters, in fact, its organizer and an astute student of politics and politicians writing in his column in the New York Tribune on March 25, 1962, under the caption, "The Control of Hospitals," ended his discussion of the King-Anderson bill with the following advice: "The Kennedy-King-Anderson plan starts us on a long and probably endless road which we should avoid here and now."

Much legislation would never be introduced much less passed if the ultimate effect and its full accomplishment could be foreseen.

There are other ways in which legislation may be changed, also certain legislation does not mean what it says. This device depends on the bureaucratic approach whereby clauses, paragraphs, or whole sections are qualified by such phrases as "As determined by the Secretary" or "in accordance with the regulations, as determined by the Secretary." These or similar qualifying phrases can nullify or change the apparent meaning of a law, wholly or in part, and the King-Anderson type of legislation abounds in such phrases. What the draft says may be quite different when the Secretary gets through exercising his powers delegated under phrases such as these.

The recent change in the income tax law is a case in point. When the law was passed by Congress laying down different methods governing the deductions for entertainment by business nobody knew what the law really was until the head of the bureaucracy made the rules and regulations which were the real law. The exact details could not be found in the law.

It is also well known that there will be other strong forces willing to expand any such limit approach as King-Anderson.

Walter Reuther, head of United Auto Workers, and George Meany, head of the AFL-CIO complex, have powerful lobbies and much money, both of which have been used in the past to force the passage of the various unsuccessful socialized medical bills and will be used to push any similar legislation in the future. Walter Reuther says it "is only a start." George Meany prefers complete alien system of social security with medical care such as some European system such as Sweden.

Former Congressman Forand who sponsored two such bills has said of this limited legislation "If we can only break through and get our foot inside the door then we can expand it."

Wilbur Cohen, Assistant Secretary of Health, Education, and Welfare, speaking of so-called social insurance "that it can be changed from time to time." His philosophy would unmistakably indicate expansion. The liberals in Government are doing all they can to gain the passage of this type of legislation. There are many others in fact committed to this cause some of which will be taken up later.

The vaunted pragmatic approach to all problems of which the New Frontier is so proud means nothing more or less than an approach governed entirely by political expediency. Pragmatism as conceived by the New Frontier is synonymous with political expediency. Political expediency is undoubtedly the motivating force responsible for the above-described expansion. We should also never forget that a great talent to lead inevitably carries without the talent to mislead.

THE SOCIAL SECURITY SYSTEM

That the social security system might be destroyed by political changes such as loading it with the burden of medical care is no figment of the imagination. In a recent speech entitled "Politics Can Destroy Social Security," Hon. Thomas B. Curtis, member of the Ways and Means Committee, discusses the question. He said in part, "Many premature statements are being made by casual observers that the program has proved successful simply because it has not broken down in its childhood and youth. If the general public were to adopt this premature judgment, damage and ultimate destruction of the system might follow. If these statements as time goes on prove not to be true, they will have prevented action to correct errors that honest constructive criticism might have called to our attention."

This speech by a recognized authority on this subject should be thoroughly studied by this committee if this has not already been done. Those who are incensed at any suggestion of a study or investigation of social security and

oppose such a study are the ones who do a disservice to the country, not the ones who suggest an honest and complete evaluation of facts pertaining particularly to administration, fiscal soundness both at present and in the future.

The stubborn insistence that the social security approach is the only feasible way to provide the limited hospital care which all those past 65 are alleged to sorely need should alone be enough to cause a complete study of the social security. We should begin this study at the beginning. Factual information on the history, origin, and background of social security can be found in the testimony of Dr. Marjone Shearon on the Social Security Act Amendments of 1949, hearings before the Ways and Means Committee of the House of Representatives, 81st Congress, 1st session, on H.R. 2893, part 2, beginning on page 1840.

Dr. Shearon was for 5 years in the Bureau of Research and Statistics in the Social Security and for 2 years Senate consultant on social security.

Anyone seriously interested in medicare or social security should read her entire testimony. It is original source material and cannot be ignored by the earnest student seeking the real truth about social security. A study of this material will indicate the necessity of a thorough study at once not with the idea of destroying it or the confidence of the people in it but in an attempt to correct its weakness while they are still amenable. If social security is to bear the added burden of medicare the soundness of the system must be established beyond question. As set up at present there is more than a reasonable doubt that it is sound.

FOREIGN EXPERIENCE WITH SOCIALIZED MEDICINE

There is a wealth of material available in German to those who can read this language fluently and less but still a worthwhile amount in French and Italian. In English on their National Health Service, there is considerable information available.

It is a difficult task to obtain sober reliable evaluation of activities that have been monopolized by governments where political fashion and expediency have been the governing influences in setting up, administering, and maintaining establishments of socialized medicine.

Some of these systems as in Germany and Austria have been in existence for 75 to 80 years, yet if the people had it to do over again, it is very doubtful if they would select their present system.

The systems vary but there is enough similarity between the various countries to draw an overall conclusion that these systems are not for the United States. The fact that so many foreign patients and so many doctors and medical students come here for training and many fully trained doctors come here to remain and practice negates the assertion that we are lagging behind and that there is an inexorable tide toward socialized medicine, that is Marxist doctrine.

Switzerland has maintained a system of medical care devoid of centralized government control. The politicians have wanted it badly and both Swiss legislative bodies have twice approved such a scheme by a wide margin but the people have rejected it in popular referendum twice in no uncertain terms.

Sir Stafford Cripps, the architect of the National Health Service in Britain, when sick, went to Switzerland. When he became again ill he went to Switzerland and died there. He wouldn't put up with his own socialized medical service. A study of these foreign systems as discussed by Helmut Schoeck, associate professor of sociology at Emory University in Atlanta, Ga., a native Austrian who studied at Munich and Tubingen, in "Financing Medical Care." Caxton Caldwell, Idaho, would give anyone pause who thinks we should adopt a system of medical care based on any of these alien systems. It is strange that there is not more detailed information produced by the proponents of socialized medicine about these systems if they are so successful. Instead they say we lag behind but do not go into detail with a description of a desirable plan. Probably for the simple reason that such a plan is not to be found.

GOVERNMENT PROPAGANDA-ILLEGAL EXPENDITURE OF TAXPAYER MONEY

That there has been and continues to be a powerful bureaucratic lobby and the illegal expenditure of taxpayers' money for the purpose of forcing the adoption of a system of socialized medicine can easily be proven.

As far back as 1947 a report of the Subcommittee on Publicity and Propaganda from the Committee on Expenditures in the Executive Departments made a report to the House of Representatives under the title "Investigation of the Participation of Federal Officials in the Formation and Operation of Health Workshops" as House Report 786, 80th Congress, 1st session.

This report said in part "it (the committee) 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 are named, individuals are named and the method of procedure is described. It speaks of "unauthorized and illegal expenditures of public moneys" of "so-called health workshops to mobilize pressure groups." It speaks of “extraordinary executive pressure exerted on the U.S. Public Health Service to further the campaign * * * for socialized medicine."

It goes on to say "the latest figures from the Budget Bureau show that for the fiscal year 1946 total expenditures in the executive branch for publicity and propaganda activities were $75 million. During that fiscal year 45,000 Federal employees were engaged full or part time in such activities." Further it said, "Testimony indicates that resources of the Social Security Board were devoted freely from time to time to preparation of pamphlets and propaganda literature for the CIO, the AFL, and the Physicians Forum. Much of this material for CIO and other groups was prepared by the Social Security Board at Government expense."

It continues "Your committee concludes from the testimony that most if not all of this literature as distributed by the CIO, the AFL, the Farmers Union, and the Physicians Forum originates in and emanates from the Bureau of Research and Statistics in the Social Security Board."

The Assistant Surgeon General, USPH, was asked "if the literature prepared by the Federal agencies offered all sides of the discussion or was limited merely to supporting material to carry out the President's order."

He replied, "We would naturally give emphasis to that because that is why we are in Government. Otherwise we should get out of Government."

This House Document 786, 80th Congress, 1st session, is a very interesting document which today would probably be classified or in some way kept from the Congress and the people. Yet somehow the New York Tribune discovered after the Madison Square appearance of President Kennedy in May 1962 that 10 or a dozen White House staff were working preparing material for various groups to use as propaganda material. Thus the taxpayers' money is still being used illegally. This illegal use of taxpayers' money has probably continued since exposed in 1947 as reported in House Document 786, 80th Congress, 1st session, but it has been well concealed from both the Congress and the taxpayers.

SUMMARY

Important factual material which has a significant relation to legislation of the King-Anderson type and to social security is presented. This material is largely lacking in previous hearings on bills dealing with medical or hospital care related to social security.

This material supports the contention that—

(1) Any bill such as H.R. 3920 providing for mutual limited benefits would with little question be greatly expanded probably into a program covering most if not all of the people.

(2) It would wreck the social security system if its present fiscal setup and administration is continued.

(3) A study of foreign systems of government medical care (socialized medicine) should teach us to avoid this approach as a solution for our medical care problems. Our system under private enterprise delivers more and better medical care than any of these alien systems.

(4) Tax money in large amount at times, has been and continues to be illegally spent on bureaucratic propaganda to help the proponents of this type of legislation. Government personnel have been detached from their usual jobs to help this illegal effort.

(5) Photo copies of several public documents and public utterances by national figures are attached to simplify access to these original documents. This statement is referred to the House Ways and Means Committee on behalf of the Tompkins County Medical Society by its legislative committee. Respectfully submitted.

HENRY B. SUTTON.
C. STEWART WALLACE.
GEORGE MCCAULEY.

November 27, 1963.