objective. It established a National Youth Guidance Commission, which has aided aeries in many communities to promote wholesome undertakings for the young-youth centers, local youth guidance institutes, community youth councils, athletics and the like. In 1941 the Eagles at a cost of $160,000 erected a dormitory for Father Flanagan's Boys Town.

About 2 years ago the Eagles set up a National Child Health Commission, and some of the results of this work are already apparent. Some of our aeries have set up well-baby clinics in cooperation with local health authorities, and have made available medical facilities. to examine children and advise mothers on diet and the healthful upbringing of their children.

The Fraternal Order of Eagles has wholeheartedly supported health legislation which it believes will contribute materially to an improvement in the health of our Nation. Our fraternity endorsed the Federal school-lunch appropriations to the States, and scores of our aeries passed resolutions advocating such aid. Our order, too, endorsed the maternal and child welfare bill, sponsored by Senator Pepper, because it feels that the services proposed, medical and hospital care when children are sick, school-health services and dental care and child-guidance clinics, are essential for the well-being of our future citizens.

The Fraternal Order of Eagles favors certain provisions of the National Health Act of 1947, S. 545, sponsored by Senators Taft, Smith, Donnell and Ball. It regards the proposed legislation as a forward stride in solving some of the health problems that challenge solution. Certainly, the proposed expenditure of $200,000,000 a year to provide general health, hospital and medical services for families and individuals with low incomes is a real approach to aiding the welfare of the underprivileged. Our order endorses the proposed establishment of a national health agency and the program this agency would administer. We are glad to see two objectives included among the proposed work of the agency, because they are objectives which our order has gone on record with its support. I refer to "the promotion of maternal, prenatal and child care, and the study and dissemination of information on child growth, development, and nutrition" and to "the training and rehabilitation of persons vocationally handicapped because of permanent disability with the objective of placing such persons in remunerative employment."

Our order, at its 1946 national convention, pointed to this need for Vocational training both for our disabled war veterans and the victims of industrial accidents. The Eagles National Commission on Stimulation of Employment, in its report to the convention stated:

Too often have the various State agencies, charged with the responsibility of caring for injured workers, failed to properly discharge their trust. Too often have crippled workers been relegated to the human scrap heap and the conscience of legis'atures and public officials salved by the payment of a pittance in money. The injured industrial worker often needs to be re trained and rehabilitated so that he may return to work and earn his own livelihood by the best utilization of his personal talents.

I have just quoted in part from the report of the Eagles' National Commission on Stimulation of Employment.

Other provisions of S. 545 are formidable assaults upon ill health. The distribution of funds for dental care, cancer control, a National

Institute of Dental Research, a survey of health and medical care resources, a dental care survey, are appropriations which our order believes will appreciably advance the public health services.

The means by which these funds would be allotted to the Statesthe grants-in-aid principle-is the guiding principle of the Social Security Act. Our order indorses such use of Federal funds. In fact, in our support of the Social Security Act, we stressed the soundness of Federal grants to States to provide for the public assistance of needy persons.

The Fraternal Order of Eagles wholeheartedly subscribes to the statement in the National Health Act of 1947 which would establish as the policy of the United States Government—

to aid the States, through consultative services and grants-in-aid, to make available medical, hospital, dental, and public health services to every individual regardless of race or economic status.

Our order further believes that a Federal health program to be adequate to meet the needs of all economic groups in our population should take into account the necessity for establishment of a system of national health contributions to the Social Security System on the part of employers and employees to pay for cash disability benefits and medical cost reimbursements.

We must recognize the fact that even if adequate provisions are made for medical services for low-income families and the needy, there will still remain millions of Americans upon whom illness will fall as a crushing economic disaster. The Census Bureau recently published figures which revealed that the median income. for American families living under one roof was $2,378 in 1945. Presumably these are families which cannot be classified as lowincome groups, but it is very evident that they must struggle to maintain even a fair standard of living. Such families have no income to tide them over to meet medical expenses and ordinary family requirements when the wage-earner takes sick. Our order believes that a system of national health insurance is necessary to provide protection for vast numbers of American families.

When the Fraternal Order of Eagles held its 1945 national convention, it went on record for endorsement of "the general aim and objects" of the then pending Wagner-Murray-Dingell bill which provided for cash benefits for temporary and permanent disability. When I appeared before your committee last year relative to the national health bill, S. 1606, I stated that certain provisions of the WagnerMurray-Dingell bill were in line with the long time fundamental policies and program of the Eagles, and that the same could be said for certain provisions of Senate bill 1606. This also holds true for Senate bill 545 or the national health bill of 1947. The Fraternal Order of Eagles endorses its general objectives and provisions. It conforms with many of the objectives of the Eagles in the national health field. But our order feels now, as it has in the past, that a system of national health insurance should be included in any approach to solution of our national health problem.

Last year before your committee, I made a statement on the Eagle position that was incorporated in the report of our order's National Old Age and Social Security Commission and unanimously adopted by the 1946 annual convention. I should like to restate this position.

There is at least as much reason for using social insurance to protect workers against sickness as there is in using it to provide replacement income during periods of unemployment. The need for providing wage earners insurance against wage loss when they are sick or disabled is an apparent one. Certainly the Eagles who fought for workmen's compensation laws to protect against work-connected disabilities could be expected to enthusiastically support a plan to provide cash benefits for disability identical with those given workers during times of unemployment. The loss of income during periods of sickness-enforced idleness-is as great a menace to those who work for a living as are the costs of medical care involved in such sickness.

Obviously a system of temporary and permanent disability benefits that made no provision for at least partial reimbursement of medical and surgical expenses would have serious shortcomings. If all Americans are to be given some minimum insurance against all common economic hazards, the crushing burden of unexpected medical and hospital expenses incident to illness must be redistributed through some form of social insurance. Particularly in lower income and many-children families, doctor and hospital bills can eat away a family's lifetime savings.

Our organization represents a cross section of America. Undoubtedly there are thousands of our members who might think this statement of policy a very conservative and somewhat negative one. I believe that the average Eagle, who is an average American, favors that all of us will help foot the Nation's doctor bills instead of letting the unlucky or sickly one take the brunt of the burden. But I doubt that the average Eagle or average American is equally enthusiastic about having doctors and nurses become direct or indirect Federal employees, paid by the Government. He wants free choice of a physician, but not necessarily free choice of Government-employed physicians.

To put it differently, I'd venture the opinion that he wants insurance against medical expense provided-but not necessarily the medical care itself provided. In conclusion, I should like to summarize the principal provisions advocated by the Fraternal Order of Eagles in a national health insurance plan.

1. Cash benefits covering wage loss during periods of temporary or permanent disability, identical with those now provided for wage loss during periods of unemployment.

2. Cash reimbursements to workers for major hospital, surgical, and medical expenses for themselves and their families.

3. Increased contributions from employer and employee to the social-security system, on the part of employers and employees, to pay for such cash disability benefits and medical cost reimbursements.

4. A guaranty of the independence of the medical profession, with no limitation on the average American's right to choose and pay his own family doctor or dentist, using social insurance only to guarantee his ability to do so.

5. Continued reliance on the fundamental principles of the original Social Security Act-Federal Government's grants-in-aid to States for the public assistance of the needy, and social insurance to give all Americans protection against the major economic hazards of life.

This program is a contributory system of protection against the economic hazards of illness, and provides for the dignity of the patient and the independence of the medical profession. It is practical and economically sound. The Fraternal Order of Eagles believes that such a program will eliminate a major fear in the daily life of the average family, the haunting fear of sickness-induced poverty. We believe that such a program will be a distinct contribution on the part of Government to the welfare and happiness of millions of our citizens. Thank you very much, gentlemen.

Senator SMITH. We very much appreciate your statement, Mr. Poss. I have just one question I would like to ask.

I think you have made it very clear in your statement, but your whole theory of the plan that you advocate contemplates an over-all tax, you might say, on everybody for contributions to the fund, the same kind of tax we have for Social Security today?

Mr. Poss. Yes.

Senator SMITH. You add this to that tax, but instead of giving service for the money paid in the way of medical service, you simply give compensation in dollars to the person, who could buy their own medical service? Is that the theory? You say here:

I venture the opinion that he wants insurance against medical expenses but not necessarily the medical care itself provided.

Mr. Poss. Here is what we mean by that: We mean that the insurance be set in such a way that the recipient of the service will be free to call the doctor of his choice. The compensation will be paid to him and he in turn compensates the doctor, rather than to have a list of doctors or a group of doctors who will be paid by the Surgeon General of the United States or by the Government. It will be given to the individual, and the individual receiving the aid will have the right to choose any doctor. Mrs. Brown may have an affection for Dr. Jones, who can best administer to her baby. Well, she will call Dr. Jones. Then the check will be sent to Mrs. Brown and she will pay the doctor. That will eliminate the stigma of socialized medicine. It is, we believe, the real democratic way of operationoperating exactly the same as an insurance company.

Senator SMITH. You probably have in mind what is called the fee for service system, their paying the doctor. We have had some discussion here to the effect that there are three ways to pay doctors' fees for services: The so-called "capitation" method, wherein the doctor is paid so much per patient taken care of; the over-all fixed salary method paid by the State or Federal Government. Your plan will leave the doctors where they are now, and you simply give dollar benefits to people who are insured under this system, so they can go and employ their own doctor and pay whatever fee the doctor charges?

Mr. Poss. Yes; the insurance plan will be a guaranty of medical service to them, and likewise pay for the doctor, but will not confine them to the selection of a Government-proposed doctor. They would have freedom of choice of the doctor whom they wanted to administer to them. I am of the opinion that the application of the law will bring out a plan and a program of how eventually the doctor will be paid. I suspect that over a period of years there might be a general plan of a certain sum for such service. I am just guessing at that. I don't know, but it would appear to me that eventually that would happen.

Senator SMITH. I have in mind such plans as the Blue Cross service plan for hospitalization by insurance, and the Blue Shield, and so on, those different plans that are being developed by the medical profession itself to try to help people to get proper insurance of medical care.

Mr. Poss. I have absolutely no argument with them, except we feel that there are too many who do not come within the scope of those plans.

Senator SMITH. Of course, that is one of the things we are discussing, how we can get over-all coverage in some adequate way. In S. 545,

which I am glad to see you support the principles of, we are thinking in terms of something like that where each State will be challenged to come out with its own plan and give us the benefit of 48 experiments going on continuously, and get the best plans from the States to meet the problem. I think we are all in sympathy with what you are driving at here, to take care of the needy. It is just a question of the best way

to do it.

Mr. Poss. I want to leave this impression with you gentlemen, that by no stretch of the imagination do I appear here as trying to set up a plan or program. We are here to advocate the principles of health insurance; 1,250,000 Eagles are definitely interested in this program, and we are willing and anxious to go along with any program that will get the job done. We have no political axes to grind, as you understand, Senator.

Senator SMITH. I understand that. Senator Donnell, have you any questions?

Senator DONNELL. Mr. Poss, you mentioned in your statement that you appeared before the Committee on Education and Labor last year? Mr. Poss. That is right.

Senator DONNELL. And I think this is your second trip to Washington?

Mr. Poss. Yes.

Senator DONNELL. At your own expense or that of your order?
Mr. Poss. The order pays it.

Senator DONNELL. But you have come here because of your interest in this great subject matter, and have endeavored to give us the views of your organization?

Mr. Poss. That is right.

Senator DONNELL. And your organization has been very active in this matter for some years?

Mr. Poss. That is right.

Senator DONNELL. That is all.

Senator SMITH. Do you have any questions, Senator Murray?

Senator MURRAY. I have only a very few questions. I would join with Senator Donnell in expressing my appreciation of your appearance here this morning, and I am very sorry that I was not able to be present when you were here a short time ago. I aided in every way to make it possible for you to come here this morning.

Senator DONNELL. I did not mean in my questions the slightest criticism. I was simply endeavoring to bring out the fact that the witness was very much interested in the matter and I am sure we all appreciate his being here.

Senator MURRAY. Yes; I appreciate what the Senator says. I merely wish to reiterate what he has said, because I know this gentleman has taken a very deep interest in the problem, and has come here at a great deal of inconvenience for the second time.

I understand, Mr. Poss, that you do not regard this bill, S. 545, as a substitute for a national health insurance?

Mr. Poss. No, sir.

Senator MURRAY. It is merely a stopgap? Isn't that it?

Mr. Poss. That is right. I think we have set forth plainly in our program what we stand for, and we are here to assist, in any way we can, this program.