Mr. CRUIKSHANK. Well, it was prepared in conjunction with a number of people, and a draft was sent to Mr. Woll, which he corrected and made some amendments to, and then sent back, so that it is really his statement.

Senator DONNELL. At any rate, it was prepared by a number of people and a draft sent to him, and he made some corrections and sent it back?

Mr. CRUIKSHANK. So that it is his statement.

Senator DONNELL. Well, that remains to be seen, of course, whose statement it is, but did you have anything to do with the preparation of it?

Mr. CRUIKSHANK. I had some part in it; yes, sir. I believe he transmitted the copy in accordance with the rules of this committeetransmitted a copy with a covering letter stating it was his statement. Senator SMITH. This telegram from Mr. Woll-I will read it at this point for the record. It is addressed to Mr. Rodgers, clerk of our committee:

Regret unforeseen circumstances prevent my being in Washington to present testimony on health bills July 10, as scheduled. Am asking Nelson H. Cruikshank, our director of social insurance activities, to present the position of the American Federation of Labor before Senate subcommittee. The statement presented by Mr. Cruikshank will be the same as that forwarded to you with my letter of July 3. Mr. Cruikshank has full authorization to represent position of American Federation of Labor before your committee.

MATTHEW WOLL,

Second Vice President, American Federation of Labor.

Mr. Cruikshank, will you proceed?

Mr. CRUIKSHANK. My name is Nelson H. Cruikshank and I am director of social insurance activities for the American Federation of Labor. I am presenting the following statement at the request of Mr. Matthew Woll, second vice president of the American Federation of Labor and chairman of its social security committee. Mr. Woll regrets that unforeseen circumstances prevent his appearance before your committee this morning. He has asked me to present the following statement on his behalf as representing the approved position of the American Federation of Labor with respect to both Senate bill 1320 and Senate bill 545.

Senator SMITH. Might I ask you a question, Mr. Cruikshank?

I understand from that telegram-perhaps I read it wrong-that you were chairman of the social security committee of the American Federation of Labor.

Mr. CRUIKSHANK. No, Mr. Chairman.

Senator SMITH. Mr. Woll is chairman of the social security committee?

Mr. CRUIKSHANK. Yes, sir.

Senator SMITH. And what is your position?

Mr. CRUIKSHANK. Director of social insurance activities, a staff position.

Senator SMITH. I see. Proceed.

Mr. CRUIKSHANK. On behalf of the 712 million men and women who today make up the American Federation of Labor, I am here this morning to support the national health insurance program as proposed in S. 1320 and to register our opposition to the Taft governmental charity bill.

For several weeks now you have been listening to representatives of the medical, dental, and hospital groups give their reasons why they prefer the Taft bill, S. 545, as a means of meeting this country's great need for medical care. Is it not significant that, despite the ample opportunity given to proponents of S. 545 to present their views, not one representative of a people's group has come forward to endorse this bill before your committee?

I do not mean to ignore or disparage the remarks made by the distinguished representatives of the medical profession who appeared before this committee. Indeed, their technical opinions on medical care should be—as I am sure they will be-fully weighed and evaluated. However, I submit that as professional men, they can scarcely be considered outstanding authorities on the economic problem of how people can best pay their medical bills.

pro

Senator SMITH. I notice all the way through here you use the noun "I." Is the "I" Mr. Matthew Woll or is the "I" Mr. Cruikshank? Mr. CRUIKSHANK. The "I" is Mr. Matthew Woll.

Senator SMITH. You began by saying "My name is Nelson H. Cruikshank, and I am director of social insurance activities," and so on, and "I am presenting the following statement" and then you go on "I" in other places. I cannot be quite sure whether you are speaking for yourself or Mr. Woll.

Mr. CRUIKSHANK. You can make it "we" if you wish, but it is Mr. Woll, because he transmitted this document officially to you over a letter of transmittal bearing his signature.

Senator SMITH. All right, Mr. Cruikshank, proceed.

Mr. CRUIKSHANK. I was saying that as professional men doctors can scarcely be considered outstanding authorities on the economic problem of how people can best pay their medical bills. That is a problem that our more than 7,000,000 members and their families must constantly face. That it is a pressing problem is borne out by the fact that sickness and disability are the two most important reasons for poverty in our country, barring the problem of unemployment during severe depressions.

It is time that we do something about this problem. That is why I am here this morning: to tell you what the millions of workers in the American Federation of Labor want done about this problem. At our Last annual convention in Chicago, the delegates unanimously passed a declaration in support of compulsory health insurance which reads in part:

*

*

*

A national system of health insurance providing health services to all workers and members of their families. Such a system should be augmented by grantsn-aid to the States out of general revenues of the Federal Government for: 1) The construction of health facilities, (2) training of medical personnel, (3) medical research, (4) expansion of public-health services, and (5) continuing and extending the present program of maternal and child-health services. A comprehensive national program of social security must include services to all workers and members of their families. * The need for some national action in this field is no longer denied by the opposition. The ssue now is whether medical care should be extended as a charity and in accordance with public-welfare concepts or whether it should be made universally available by an extension of the insurance principle. We reaffirm our unfalterng support of the insurance principle.

*

For the information of your committee and for the record I submit herewith a copy of the entire declaration on the subject of social in

surance, which was unanimously adopted by the sixty-fifth convention of the American Federation of Labor held in Chicago, Ill., last October.

(The declaration of the sixty-fifth convention of the American Federation of Labor follows:)

DECLARATION OF THE SIXTY-FIFTH CONVENTION OF THE AMERICAN FEDERATION OF LABOR SOCIAL INSURANCE (UNANIMOUSLY PASSED AT CHICAGO, ILL., OCTOBER 17, 1946)

The principles embodied in the legislation introduced in the Seventy-ninth Congress pursuant to the declaration of the sixty-fourth convention of the American Federation of Labor (the Wagner-Murray-Dingell bill, S. 1050-H. R. 3293) are reaffirmed. The goal and objective of the American Federation of Labor remains the development of a comprehensive national program of social security for all workers not otherwise covered by an existing program, built upon the solid foundation of contributory social insurance. Such a program must include: 1. A system of insurance providing benefits based on past earnings for the aged, the survivors of deceased workers, and the permanently disabled. These benefits must be sufficient to maintain a decent standard of living without reliance on public or private charity. The coverage of the present program needs to be extended to the remaining 40 percent of workers not now protected, and the age of retirement should be lowered by at least 5 years for men and 10 years for women workers.

2. A national system of unemployment insurance providing benefits based on past earnings and with minimum benefits adequate to maintain for even lowincome workers a decent standard of living. All involuntarily unemployed workers, including those unemployed by reason of temporary disability, should be eligible. The administration of such program should be the responsibility of the United States Department of Labor.

3. The reestablishment within the United States Department of Labor of an adequate national employment service.

4. A national system of health insurance providing health services to all workers and members of their families. Such a system should be augmented by grants-in-aid to the States out of general revenues of the Federal Government for: (1) The construction of health facilities, (2) training of medical personnel, (3) medical research, (4) expansion of public-health services, and (5) continuing and extending the present program of maternal and child-health services.

5. A unified public-assistance program providing grants-in-aid to the States adjusted to the relative needs of the States in order to provide more equitable assistance to all needy persons.

Your committee recommends that the committee on social security work with the president of the American Federation of Labor in preparing and submitting to the Eightieth Congress legislation designed to meet the above-stated needs and objectives. In the preparation of such legislation special care should be exercised to see that in the development of policies and in administration it provides for full participation of the representatives of the workers covered by the program. The growing interest in and increasing public support for inclusive health insurance of the kind sponsored by the American Federation of Labor requires that special attention be given this phase of the program. The extensive hearings on the federation's health-insurance bill (S. 1606-H. R. 4730) resulted in a great increase in public understanding of the proposal. The need for some national action in this field is no longer denied by the opposition. The issue now is whether medical care should be extended as a charity and in accordance with public welfare concepts or whether it should be made universally available by an extension of the insurance principle. We reaffirm our unfaltering support of the insurance principle.

Your committee recommends that in addition to the safeguards written into the earlier health-insurance proposals, such as those protecting the right of free choice of physicians, the following provision be included in any health-insurance legislation: (1) A specific requirement that local agencies be given the maximum amount of control possible in the operation of the program, (2) provision for the continued operation of all such existing health programs that can provide suitable medical services, such as those developed by labor organizations, by cooperatives, and by other voluntary groups, and (3) maximum participation in local admin

istration of the program by both the medical profession and by those who represent the recipients of medical care.

The Hospital Survey and Construction Act passed by the Seventy-ninth Congress requires the appointment of a hospital advisory council in each State. Your committee recommends that each State federation of labor be urged to take steps immediately to secure representation on these important State councils.

Pending the enactment of legislation establishing a comprehensive national social-security program there is much that needs to be done within the States to Improve the present unemployment-compensation programs and the employment services. Your committee recommends that the splendid efforts of the State federations of labor to amend their State laws in accordance with the four specific standards adopted by the sixty-fourth convention be continued. We recommend that in addition steps be taken in the States to provide the following: (1) To free the State employment services from policy control by the State unemployment compensation agencies, (2) benefits to workers whose unemployment is due to sickness or other disability. (This is especially pertinent to the 10 States where funds can be made immediately available from employee contributions-only 2 of which now pay such benefits.)

The State federation of labor and members of our affiliated unions who serve on State unemployment compensation commissions or advisory boards can render invaluable assistance to the national program by demanding that their respective State administrators cease the lobbying activities against the social-security program of the American Federation of Labor which they have been carrying on in the National Capital either as individuals or through the Interstate Conference of Employment Security Agencies.

We recommend for the favorable consideration of all national and international unions, State federations of labor, and city central bodies affiliated with the American Federation of Labor that social-security committees be appointed in each of these affiliated organizations for the purpose of assisting in the promotion of the social-security program of the American Federation of Labor.

WORKMEN'S COMPENSATION

While the ultimate goal of the American Federation of Labor is a comprehensive, unified system of social insurance, it is recognized that workmen's compensation-the oldest of the social insurances in America-is embodied in separate State laws. These laws vary widely in the protection they afford wage earners and a review of their effectiveness is long overdue. The American Federation of Labor favors for all States

1. Compulsory insurance under workmen's compensation laws, covering all workers without exception.

2. Coverage by exclusive State funds, eliminating the profit motive from a program designed to give protection to workers and their families.

3. Minimum weekly benefits sufficient in amount to support the worker and his family during incapacity due to injury without his having to rely on additional aid from public or private charity. (Present maximum benefits of $15 to $20 per week existing in many States fail to meet this standard.)

4. Full coverage for every type of industrial disease with no lesser payments in cases of disability from disease than from injury.

5. Effective enforcement of accident-prevention laws and regulations by every available means.

6. The establishment of workmen's compensation committees in each State federation of labor which, with the aid of competent legal experts, will study their State laws and assist in carrying out the above principles by (a) proposing and supporting legislation to improve their laws; (b) keeping in touch with workmen's compensation commissions to see that administration is on a high level and the rights of workers protected, (c) cooperating with the United States Department of Labor and with the American Federation of Labor in creating more uniformity in the workmen's compensation laws and eliminating special provisions which favor employers, such as reduced amounts for silicosis cases, unusual proof for hernia cases, waivers. etc.; and (d) cooperating with rehabilitation agencies.

NOTE-The four standards relating to State unemployment compensation laws referred to on page 2 and which were adopted by the sixty-fourth convention are as follows:

1Standards referred to are appended to this declaration.

1. That the present limitations existing in some States on coverage by the number of employees employed in an establishment or by an employer be removed. 2. That maximum unemployment benefit payments be increased to $25 per week.

3. That the maximum period for which benefits can be paid to eligible workers be raised to 26 weeks.

4. That the restrictive disqualification provisions which prevent workers who are involuntarily separated from their employment from drawing benefits be modified so as to remove the penal provisions from the State unemployment insurance systems and restore the traditional freedom of workers to change their employment.

Mr. CRUIKSHANK. Here are copies of that, Mr. Chairman, if you wish to have them.

This action of the convention is not the first evidence of interest in this subject or of support for the enactment of health insurance. The concern of the American Federation of Labor and its affiliated bodies with matters of health goes back for over 40 years when our State branches began to consider enactment of workmen's compensation laws. We have likewise been vitally interested in the health aspects of the work place and in the living conditions affecting our workers and their families as evidenced by our long struggle in behalf of sanitation laws and for better housing.

In the convention of the American Federation of Labor held in 1938 there was adopted a resolution brought forward by the California State delegates favoring national health insurance. Significantly that same year the Wisconsin federation brought forward a resolution condemning the position of the American Medical Association in opposition to voluntary health insurance plans. Both of these resolutions were adopted by the convention of the American Federation of Labor.

In 1939 again the American Federation of Labor convention adopted a statement submitted by its executive council endorsing national compulsory health insurance.

Again in 1941, 1942, and 1944 the convention adopted resolutions favoring the establishment of a national health-insurance program. There was no convention held in 1945 due to wartime conditions and in 1946 the convention adopted the declaration which I have submitted for the record.

The Taft and Murray bills have this in common: They recognize the great need existing for medical care in our country today. They also recognize that a major reason for inadequate medical care is the people's inability to pay for it. But there the similarity ends.

The Taft bill seeks to meet this need by offering the American people Government charity. In a country that always prided itself on the virtues of independence, and self-reliance, this is, to say the least, a surprising solution. Even though we disagree with Senator Taft's estimates he has asserted that his bill would provide medical care on the basis of proven need to about one-quarter of our population. If we were to accept the American Medical Association's statement made in 1939 that people with incomes under $3,000 cannot afford comprehensive medical care, then the goal of Senator Taft's bill would be to provide medical care through a Government dole to the greater part of our population. Taking into account the decline in the value of the dollar, a $3,000 income in 1939 had the same purchasing power as a $4,500 income today.. Applying the AMA estimates to people