Ask the Scholar
Document scope · 1 page
Scholar
Ask about this object, its catalog metadata, its source description, or the page inventory.
For page-specific OCR and visual context, open one of the page chats.
Scholar Source Context
Document identity
localId
485978600
label
PPF 1031: Milbank, Jeremiah
core
doc
dtoType
document
citationUrl
pageCount
1
Source metadata
id
485978600
contentType
document
title
PPF 1031: Milbank, Jeremiah
citationUrl
collections
Papers as President, President's Personal File
President's Personal Files
largeImageUrl
imageCount
1
hasImages
yes
source
import
hasTranscription
no
Source extras
naId
485978600
levelOfDescription
fileUnit
recordType
description
ocrSource
nara-archive
Single page context
seq
1
pageIndex
0
type
document
mediaId
4bfbe3cc615aa587
ocrText
PPF 1031
MILBANK, JEREMIAH
KINGSBURY, John A.
Milbank Memorial Fund,
New York City.
See 944 for President's letter dated November 2,
1933, to -- regarding Mrs. Harrison Eustis
who has used trained dogs in connection
with infantile paralysis cases.
1031
MILBANK, JEREMIAH
TOMI
a quarterly, which 1 am sending under sepa-
rate cover in the hope that you will have an opportunity to glance at
it, I have outlined briefly a plan which I have formulated as a result
FDR-MD
December 4, 1935.
1031
Door John:
I on dolighted to have your 1n-
toresting lottor. I wish much you would
have n talk with the Socretary of Labor,
the Secretary of the Interior and the
li
Hoad of the Public Health Service. I
an inclined to think that by noxt wintor
it will be time for us to tako up the
General hoalth problem from the national
point of view.
X103 Gen
t PPF 528
Always sincerely,
John A. Dingsbury, Enq.,
Milbank Monorial Fund,
#
40 Wall Street,
New York City.
MILBANK, JEREMIAH
in the Milloank Quarterly, which 1 am sending under sepa-
rate cover in the hope that you will have an opportunity to glance at
it, I have outlined briefly a plan which I have formulated as a result
MILBANK MEMORIAL FUND
40 WALL STREET NEW YORK
OFFICE OF THE SECRETARY
November 24, 1933
Dear Mr. President:
I wonder if by any chance you saw the outline of a
national health plan which I presented in the last Milbank Quarterly.
It was so widely and on the whole favorably reviewed, with editorial
comments in papers throughout the country, that I thought it might
have come to your attention in spite of the multitude of matters
which are pressing through the fringe into the focus of your con-
sciousness.
Before you went to Washington you were good enough to
indicate that you would like to talk to me about national health, and
I have sought several opportunities to do so; but I recognize that
more pressing matters were occupying your time and attention. In the
opinion of most recognized experts, there is a health emergency facing
this country, the initial effects of which are just beginning to mani-
fest themselves as a result of serious malnutrition. As Dr. Welch,
of Johns Hopkins, said at our Advisory Council meeting more than a
year ago: "Any undue retrenchment in health work is bound to be paid
for in dollars and cents as well as in the impairment of the people's
health generally. .Undernourishment of children, for example, is
not likely to show itself immediately, but is bound to show its effects
later, when it is probably too late to remedy. The ground lost by
undernourishment in childhood may never be regained."
At a recent meeting of the Administrative Committee of
the American Public Health Association, the existing emergency in
state, city, and local public health organizations was reviewed, and
the serious implications were recognized. Action was taken expressing
enthusiastic support of the statement in your introduction to the
New York State Health Commission report, that nothing is more important
to the State than the health of its people. And hope was expressed
that you would exert the great influence of your office to arouse the
people of the nation, as you aroused the people of your State, to the
end that a national health plan might emerge.
In the Milbank Quarterly, which I am sending under sepa-
rate cover in the hope that you will have an opportunity to glance at
it, I have outlined briefly a plan which I have formulated as a result
-2-
of and conferences with Commissioner Parran, Homer Folks, Dr. Linsly Williams,
would be glad to have an opportunity to present a more detailed plan for your
other recognized experts in this field. This is an outline only. I
consideration and to discuss the subject with at convenience. You
will find in this same number of our Quarterly you several your very important articles
on the results of the depression on the health of the people, which have grown
with the United States Public Health Service and the Health Service of the
out of studies which we have been carrying on for the past year in cooperation
League of Nations. Dr. C.-E. A. Winslow, Professor of Public Health, Yale
University, recently wrote me as follows concerning this report:
This is a most remarkable document not only on
account of your far-reaching and inspiring "Health
Plan for the Nation" and the fascinating preview of
"Red Medicine" but also for the very remarkable series
of papers on the depression and its effects on health.
I have seldom seen more of interest packed between
two covers.
I have, of course, been following with enthusiasm the develop-
ment of your great program step by step. Naturally, I have been hoping that
your program would soon embrace a health plan for the nation as comprehensive
as the one which you developed for the State of New York. I want you to know
that all those who worked with you then are ready to respond to your call at
any time, Indeed, I wish I might go to Warm Springs to discuss this important
matter with you.
The Litvinov dinner last night was indeed an historical occasion.
I wish you could have heard the round of continuous applause when Colonel
Cooper stated that this would go down in history as one of the great achievements
of your administration. I most heartily congratulate you upon the outcome of
these important negotiations.
Cordially yours,
JohnasKing
Secretary
The Honorable Franklin D. Roosevelt
Warm Springs
Georgia
JAK: EB
1031
PERSONAL
Waxm Springs, Ga.,
December 4, 1934.
My dear Mr. Milbank:-
Perhaps you have read of the plan
initiated by Colonel Henry L. Doherty and approved
by the Trustees of the Georgia Warm Springs Foundation,
for holding on January 30, 1935, throughout the Nation,
in every town and community, a Birthday Ball in honor
of my fifty-third birthday.
I am enclosing copies of the letters
which fully describe the purpose of this birthday
celebration and how the funds so raised will be used.
As a part of this plan, thirty per cent of the money
is to be presented to me by the National Committee
for the Birthday Ball for the President, which money
I will in turn give to a special commission for the
express purpose of advancing through financial ase
sistance, the research work now being carried on in
the fields of Infantile Paralysis immunization and
prevention.
I have designated this special com-
mission "The President's Birthday Ball Commission for
Infantile Paralysis Research" and I am asking that
you serve as a member and Vice Chairman of this
Commission.
The Commission itself will consist
of eleven people, the Chairman of which will be
Colonel Henry L. Doherty and you, of course, as Vice
Chairman.
See P.P.F. 310"The President's Birthday Ball Commission for
MILBANK, JEREMIAH
Infantile Paralysis Research" for correspondence
It is my thought that if you and the other
members of this Commission will meet shortly and plan
the necessary machinery for the functioning of your
Commission, and also the appointment of an Advisory
Medical Committee, should you deem it wise, that your
plans can be so comprehensively laid that only a second
meeting will be necessary after the nation-wide cele-
bration is over and the amount of money is ascertained.
Perhaps at this meeting you could appoint a small
executive committee to disburse, if possible, the funds,
be
within a period of twelve months, BO that early financial
assistance may be given to bring about this vital and
far-reaching objective.
I have followed with interest the splendid
work which you have done toward the welfare of your
fellow citizens, and I can assure you that it has given
me great personal pleasure to have you accept this
appointment.
Always sincerely,
Jeremiah Milbank, Esq.,
40 Wall Street,
New York, N. Y.
MILBANK, JEREMIAH
(Enclosures)
MORGAN, Hon. Keith
New York, N.Y.
1031
June 17, 1937
Writes Miss LeHand, submitting suggested letters which the
President may want to use in writing the members of the President's Birth-
day Ball Commission for Infantile Paralysis Research and Advisory Medical
Committee to the President's Birthday Ball Commission for Infantile Paralysis
Research. - Chairman Jeremiah Milbank wrote the President on May 17 send-
ing copies of two reports, one by Dr. Paul deKruif, Sec. of the Commission
and second, a letter from Dr. George W. McCoy, Chairman of the Advisory
Medical Committee, giving their views and results or this work so far. -
On May 17, Henry L. Doherty also sent the President his report re this work.
On June 29, the President wrote to the following, thanking them for their
services and fine work: These are similar letters but not identical -
Chairman Milbank, NYC; Dr. Donald B. Armstrong, NYC; John S. Burke, NYC,
Mrs. James Couzens, Birmingham, Mich. (widow of Senator Couzens, who was on
this Commission); Dr. DeKruif, Holland, Mich.; Edsel B. Ford, Fordson,
Mich.; Rev. Dr. Raymond B. Fosdick, NYC; Edward S. Harkness, NYC, Dr. Geo.
W. McCoy, Wash., D.C.; Mrs. Wm. J. B. Macaulay (formerly Mrs. Nicholas
Brady), Rome, Italy; Dr. Max M. Peet, Ann Arbor, Mich.; Dr. Thomas M.
Rivers, NYC; Lessing J. Rosenwald, Abington, Pa.; Felix Warburg, NYC; --
On June 30, Mr. Morgan wrote Miss LeHand asking re these letters and also
suggesting a press release on this subject. - Mr. Early wrote Mr. Morgan
on July 12, saying he has condensed this 8--page report to a 4-page digest
for a press release. Asks for comments. - Mr. Morgan wrote Miss LeHand on
July 13 further re this subject. - Mr. Morgan wrote Mr. Early on July 14,
saying press release has the approval of Basil O'Connor and himself. --
On July 16, Mr. Early replied suggesting this be released on or about
July 25th. Asks advice. - Mr. Morgan replied July 21st leaving release date
up to Mr. Early. - Attached is press release dated Wednesday, July 28th.
SEE - P.P.F. 310 - The President's Birthday Ball Commission For
Infantile Paralysis
Research.
vmb
P.P.E.
P.P.
1031
April 6, 1938.
Personal
My dear John:-
I am greatly appreciative of your
letter -- it is the kind I need -- and I am
delighted with your pamphlet.
The same old crowd that has fought
us so often 1s still at it -- and only death
will mend their ways. Nevertheless, you are
right about the plain people of this country.
xpp782
Even if it is almost impossible for them to get
xpp74962
to
honest news, they sense that fact and still be-
lieve in people who are working for them.
I do hope to see you one of these
days.
e
Always sincerely,
John A. Kingsbury, Esq., #
3 Fairfield Place,
Yonkers,
New York.
March 29, 1938
Dear Mr. President:
Permit me to congratulate you on your admirable Gainsville
Speech. It ought to convince economic royalists and fascists that,
in your fight on behalf of the submerged third, you will never beat
retreat, despite their barrage of echo lett rs and telegrams.
As I have wired you on similar occasions: I am confident that
"the world steps aside for the man who knows where he is going".
Unhappily this is true momentarily, oven when he is going in the
wrong direction, but surely is an eternal truth when the man is going
in the right direction, as you certainly are.
I said this to Aubrey Williams a few days ago and he suggested
that it would be encouraging to have an old friend say it directly
to you. From what I hear in my travels, I am confident that the
plain people of America believe in you as they always have. They
are still strongly back of you. They are not deceived by the cry
of voices in the subsidized press, any more than they were in 1936.
You may be interested to know that, although I was fired from
the Milbank Fund, largely because I loaned its expert staff to your
Committee on Economic Security, I am still working, through all
channels open to my voice and pen, to make medical care available
to all the people.
I wish you might find time to read my "Pugsley Award" Address
entitl a "Health Insurance in a National Health Program", inclosed
herewith. I venture to think it may be worthy of your attention,
X121-A
since it has been so highly commended by Dr. Parran, Sir Arthur
x103
Newsholme and other distinguished health authorities. If it does
interest you I would be glad to have the privilege of a talk with
you about the plan therein outlined.
With highest esteem and admiration for your Lincolnion fight
to free the people from economic slavery, I am, as ever
Sincerely your friend
JAK:AB
Hon. Franklin D. Roosevelt
John a Kingshing
Warm Springs, Georgia
March 29, 1938
Dear Miss Lehand:
Aubrey Williams suggested that if I sent you the inclosed
letter to the Presid nt it would reach him. I recall that
in the old days this was always true, but I have felt that, under
present circumstances, it was hardly fair to bother you.
However, since I have rarely had a reply to anything I have
sent "through regular channels", I am venturing to ask you if you
will be good enough to bring the inclosed to the President's
attention. At least once in four or five years, I would like him
to know that I am one of many old friends who are still standing
by; and that, in this disjointed world, I glory in the fight ne
is making for the plain people. Indeed, his fidelity to their
cause, his courageous spirit, is one of the few bright spots on
the dark horizon.
I know the President is deeply interested in the ubject of
R
the inclosed paper, and I venture to believe the plan outlined
will appeal to him.
Assuring you that I will a preciate your kindness in bring-
ing my letter and inclosure to the President's attention, with
kindest personal regards and admiration for the great service
you continue to render to the President and to the country, I
am
Sincerely yours
JAK:AB
johnashiphing
Miss Margaret Lehand
Warm Springs, Georgia
XPP7200 Ginsville speech
PP7. - 1031
MORGAN, Keith
COMMITTEE FOR THE CELEBRATION OF THE
PRESIDENT'S BIRTHDAY
New York City, N. Y.
June 12, 1942
Letter to Miss Tullyy saying that he has a letter from
Jeremiah Milbank advising that he has in his files three years correspondence relating
to the President's Birthday Ball Commission for Infantile Paralysis Research. Mr. Milbank
was the Vice Chairman, but actually the Acting Chairman of this group, and he wants to
know what to do with these files. Mr. Morgan thought possibly the President might like
to have them for the Franklin D. Roosevelt Library as they evidently have some interesting
information in them. Ackd. June 16, 1942, by Miss Tully saying that the President would
like very much to have this file for the Library and asks Mr. Morgan to make the arrangements
for them to be sent direct to Mr. Shipman at the Library.
SEE - PPF 4885 - Committee folder
VSI"
mcg
P.P.F
KINGSBURY, John A.
1031
Lavorika, Shady, N. Y.
April 17, 1944.
Wrote the President concerning a report which Governor Thomas E.
Dewey made and was published in The New York Times on April 15th, entitled "Report
on the First Year of His Governorship," wherein he virtually charges the President and
his other immediate predessors with failure to recognize the vital importance of
Public Health to the people of the state. Mr. Kingsbury felt that the public's at-
tention should be called to the Governor's gross misrepresentations and therefore he
has written a letter to the Editor of The New York Times which it is hoped will be
published. Encloses a copy for the President's information. In closing Mr. Kingsbury
says he hopes the President is feeling fit again and that Mr. Harry Hopkins will re-
gain his health in order to relieve the President of some of his heavy burden. - -
Presidential Memorandum for the Surgeon General of the Navy dated April 21, 1944, the
President forwarded the above letter from Mr. Kingsbury and said "Admiral McIntire to
read with great care and prepare a le tter to Dr. John Kingsbury. Be rougher than you
have been before." The President wrote Mr. Kingsbury on May 3, 1944, thanking
him for bringing to his attention the inaccuracies in Governor Dewey's statement on
health conditions in his report on his first year in his governorship. The President
agrees with Mr. Kingsbury in calling to the attention of the people of the State his
inaccuracy in stating that the health department of the State of New York has grown
like Topsy. Says that Mr. Kingsbury is correct in his statement that the organization
of a special commission to make recommendation to the governor resulted in making the
1913 law operate efficiently. The President looks with great pride on the fine work that
has been done in the care of tuberculous citizens of New York. Another outstanding con-
tribution made by the Health Department during those years while the President was
Governor was the improvement in the care of mental patients, and New York today stands
as a fine example of what can be done for those unfortunates. In closing the President
says that Mr. Kingsbury or he has no reason to apologize for anything at all that was
done through the years in which they were responsible for conducting the affairs of the
Public Health Service of the State of New York.
Penciled
notation
-
Copy
of
this
reply sent to DE. McIntire's Office - 5-4-44.
-
-Telegram to the President from Mr.
See - 3850
Kingsbury dated May 8, 1944, requesting permission
to publish the President's letter to him of May 3,
1944, Further states that N.Y. Times has refused
to publish his letter but is hopeful of getting
PM and Chicago Sun to publish it. - Memo to
Mr. Early May 9, 1944, from Mr. Blake stating that
he talked it over with Judge Rosenman, who felt
that the President should not be drawn into the
situation but that Dr. Parran, mentioned in Mr.
Kingsbury's letter to N.Y. Times should reply. - -
Mr. Early in a letter to Dr. John A. Kingsbury on
May 9, 1944, re request to quote from the Presi-
dent's letter of May 3rd. Says that the letter
was a personal letter and not written with the
thought of its publication and does not think it
should be released to the Press.
"I heartily concur in the decision of the Conference
to give you the award for the outstanding contribution to
the meeting. What an enormous amount of time and thought
must have gone into the preparation of this article! It
is the most complete statement of all of the health needs
of the country that I have seen. "
Quoted from letter from Hon. Thomas Parran, Jr , M.D.
Surgeon General of the United States Public Health Service.
SOCIAL work 01 an those presented NY
nual meeting. The Pugsley Award is the gift of Chester D. Pugsley and
has been granted after each annual meeting for the past several years.
Reprinted for private circulation from
THE PROCEEDINGS OF THE NATIONAL CONFERENCE OF SOCIAL WORK
64TH ANNUAL SESSION (Indianapolis, Indiana, 1937)
PRINTED IN THE U.S.A.
HEALTH INSURANCE IN A NATIONAL
HEALTH PROGRAM
JOHN A. KINGSBURY
THE 1937 PUGSLEY AWARD
The Conference Editorial Committee voted unanimously that Mr. Kings-
bury's paper made the outstanding contribution to the subject matter of
social work of all those presented by professional social workers at the an-
nual meeting. The Pugsley Award is the gift of Chester D. Pugsley and
has been granted after each annual meeting for the past several years.
Reprinted for private circulation from
THE PROCEEDINGS OF THE NATIONAL CONFERENCE OF SOCIAL WORK
64TH ANNUAL SESSION (Indianapolis, Indiana, 1937)
PRINTED IN THE U.S.A.
NATIONAL HEALTH INSURANCE
475
of America had been organized to serve their cause with half the
zeal with which the American Medical Association served its
vested interest in sickness, wage-earners and others of small
HEALTH INSURANCE IN A NATIONAL
means would not have been left unprotected against the serious
HEALTH PROGRAM
economic consequences of illness. A small, selfish group so con-
trived that America's program for social security was brought
(PUGSLEY AWARD)
into being without health insurance. Accordingly, our system
John A. Kingsbury, Associate Fellow
of social security lacks completely that unit which long ex-
New York Academy of Medicine
perience abroad has shown is the first essential in social insur-
Yonkers, New York
ance. We are still without protection in this country against
the costs of sickness, despite the fact that in ordinary times
sickness is the principal cause of poverty and dependency.
I
A comprehensive national health program should be designed
T
fare HERE of is no greater need today, in promoting the wel-
not only to protect all the people from contagious disease, to
our nation, than a comprehensive national health
promote their health and vitality, to give special protection to
program. Within the framework of economic
mothers and children, but also to furnish protection against
program. insurance must have an important place in compulsory any such
health and under existing conditions of social insecurity, our system
wage loss and to make good medical service available to all the
people. Our health services have grown up without plan or
design. It is time that this was reduced to order and the glaring
The more Social Security Act of 1935 provided for the
deficiencies were made good.
than of adequate federal, state, and local development
There are five broad elements in a national health program:
Such through have preventive we elapsed appropriations have encouraging hitherto services possessed. made as progress under In Titles has the been year public V and and made, health VI a of half especially the services which Act.1
(1) public health; (2) protection for maternity, infancy, and
childhood; (3) public medical services; (4) medical-care insur-
ance; (5) disability and invalidity insurance.
fare the public health and the wel-
No one of these is a substitute for any other. If we would
authorities can furnish to communities as whole public have been
have real protection of the nation's health, if we are to see the
greatly next strengthened, and more may be expected a in the
mass of our people safeguarded against sickness, we must have
loss of of small and moderate incomes to budget the
families ahead; but no provision was made to enable self-supporting years
all five.
The five elements are not sharply separable, one from the
wages suffered on account of disabling illness against among
other. Each overlaps one or more of the others in scope, in con-
to wage-earners and salaried workers, and no provision made
tent, and in administrative method. I will not undertake to
while give people protection against the costs of medical was If,
elaborate the details of a comprehensive health program, but I
1 Title that important act was before Congress, the social care. workers
will briefly characterize each of the main elements:
services V authorizes appropriations for grants to states for health
1. A strong, co-ordinated public health program-co-ordinated among the
habilitation; studies, Title for crippled children, child welfare services, maternal and child re-
federal, state, and local agencies. The Surgeon General of the Public Health
services and VI authorizes appropriations for grants to states and for for vocational public health
Service is our recognized leader in this cause. He has mapped out his cam-
for investigations by the Public Health Service.
paign and the nation is following him enthusiastically.
474
476
NATIONAL HEALTH INSURANCE
477
JOHN A. KINGSBURY
2. A comparable public service for maternity, infancy, and childhood. The
II
Children's the Bureau, under the leadership of Miss Lenroot, has the vision and
3. courage A to fight this cause. We are giving her our earnest support.
I do not propose at this time to present in detail any particu-
tax-supported development of those medical services which only
lar plan of health insurance. I laid such a plan before this Con-
government and can furnish. This means principally state action, aided financially
ference at its Kansas City meeting in 1934, and my proposals
tuberculosis, medical care of the handicapped, provision of specialized and expensive
technically by the federal government. It deals with mental disease,
may be found in the Proceedings for that year. I do not advo-
centers, etc.
cate any hard-and-fast plan. Nor do I favor compulsory health
4. Medical-care insurance, state-wide in scope, with federal financial and
insurance as an alternative to public medicine or as an alterna-
quality technical aid, and broad enough to guarantee comprehensive service of high
tive to an extension of federal, state, and local public health
made to people of small and modest means and-through contributions
facilities. We now have public medicine, notably in the care of
5. on their behalf from tax funds—to cover people without income.
the insane, the mental defectives, and the tuberculous. It is
Compensation for wage loss from temporary and disability.
not a question of whether we shall have public medicine, but
and The of machinery the of the federal-state system of unemployment permanent compensation
whether we shall have more of it-and I favor more of it.
federal system of old age benefits can deal with this program.
Public medicine is meeting a great need, and, in the main, it is
There are other elements to be considered in national health
efficiently administered.
program. the The special health aspects of education a and nutrition,
I am in hearty accord with the plan for extension of public
vocational provision of decent and healthful housing, the means for
health facilities favored by the Surgeon General, by most of
halt, rehabilitation of the handicapped, the care of the
the leading state and local health authorities, and by many
the lame, and the blind-these and many others all have
voluntary health agencies. Of course, we need more and better-
five appropriate places within the broad framework outlined in the
equipped health centers; more clinics for specific preventive
categories which I have enumerated.
functions; more centers for the diagnosis and treatment of
No sensible group in our national life would object to four of
tuberculosis and of the venereal diseases; and more maternity
my five cardinal points. A particular group objects to the
centers and baby and child welfare stations.
fourth-medical-care to insurance. They have fought every move
We are making progress both in the direction of public
modernize our health program. Latterly, these have
medicine and public health service. But our progress is too
attempted to hide their real purpose by pretending persons to take a
slow. We are reaching hundreds of thousands through these
positive instead of a negative and obstructive position. They
facilities and by voluntary health and hospital insurance, group
are now shouting for public health and for medical care of the
indigent. is But this, if I may be permitted to mix metaphors,
medicine, and contact practice; but we must meet the needs of
tens of millions of our fellow-citizens. While we are cogitating
program-because they know that an aroused public has al-
only a red herring. They now say they want a my public health
wisely, while we are debating cleverly, while we are splitting
ready decided we shall have it; they say they want a system of
hairs, tens of thousands are dying from preventable causes and
medical care for the indigent-because they are asking for their
millions are suffering from remediable sickness. I am convinced
system and they know there is little likelihood of getting it.
that we can meet the needs which confront us, and do this
What they really want is to divert public attention from the
within the near future, only through a comprehensive national
greatest need of all-a social insurance system which will give
health program which includes compulsory health insurance,
medical care to all who need it.
supervised and subsidized by the federal government.
478
NATIONAL HEALTH INSURANCE
479
JOHN A. KINGSBURY
A national health plan should be flexible enough to permit
is not to be found along this road. Something more than taxa-
the several states to decide whether their local conditions re-
tion must be invoked to meet this need.
quire greater or lesser emphasis on public medicine, on the exten-
It is my judgment that the most promising and productive
sion of public health facilities, or on compulsory health insur-
channel into which we can direct customary expenditures for
ance. But federal aid-financial and technical-should be avail-
health and medical services is a nationally subsidized system of
able to the states equally for all three procedures. Within broad
contributory, compulsory health insurance. The combination
limitations laid down in federal statute, the choice of each pro-
of public health tax funds, public medical service tax funds, and
cedure and the extent to which it is applied should depend upon
health insurance contributions is the only answer to America's
conditions in each state and should fall within the sphere of
need for health security. Add provision for contributory insur-
state action.
ance to give workers protection against disabling sickness and
invalidity, and the broad framework will be fashioned to furnish
III
substantial security against sickness and its dreaded conse-
We now spend in any normal year nearly four billion dollars
(or thirty dollars per person) for health and medical services;
quences.
IV
and this is nearly enough to buy adequate medical care for
It seems to me there can hardly be disagreement, at least
everyone. The basic problem is not to find more money than is
now spent for these services, but to find new and better ways of
among social workers, as to the need for a comprehensive na-
nels directing customary expenditures into more productive chan-
tional health program. Nor should there be disagreement among
others not blind to the facts SO convincingly presented in the
and of reducing the burdens caused by unequal costs. It
scientific studies which have made their appearance within the
future, any considerable portion of this four-billion-dollar sum
seems to me obvious that we are not going to obtain, in the near
past decade. Surely everyone, even the most politically minded
from tax funds.
member of organized medicine, who has read these studies must
be aware that the time is ripe for a change from the present
Before the Social Security Act was adopted, the Public Health
negligible sums for subsidies to state and local health services.
Service had from time to time received appropriations of only
chaotic system of medical organization to an integrated health
program for the nation.
"Here is one-third of a nation ill-nourished, ill-clad, ill-housed
The Act authorized annual appropriations of $8,000,000 for al-
lotments to states. I understand that there are now pending
-now," said the President of the United States in a recent
address. Social workers of the nation know this is not an over-
before Congress requests for similar purposes amounting to ap-
statement of the deplorable condition in which over forty
proximately $60,000,000. It would be optimistic to assume that
million of our fellow-citizens find themselves today.
one-half or even one-third of this sum will be appropriated this
In that striking speech of his at the "Victory Dinner," the
year. that Furthermore, it would be absurdly optimistic to assume
President, pleading for a higher standard of life for the Ameri-
within the next five or ten years Congress would add to
the funds available to the Public Health Service SO much as
can people, must have had in mind that the principal cause of
$500,000,000 or $200,000,000 or even $100,000,000. Yet almost
the poverty he uncovered is due to sickness and ill-health which
he himself has referred to as one of the major hazards and
$4,000,000,000 are required to bring adequate medical care to
viscissitudes of life. Surely this must have been in the Presi-
all the people. Expand the tax-supported public health pro-
dent's mind. And surely, in order to guard against this largely
gram as we will, the complete answer to a great national need
480
JOHN A. KINGSBURY
NATIONAL HEALTH INSURANCE
481
preventable cause of undernourishment, inadequate clothing,
V
and bad housing, he will take appropriate steps to secure a
It is very significant that when the President's Committee
suitable amendment to the Social Security Act as soon as the
on Economic Security set up its professional advisory com-
time is propitious to move forward in carrying out the mandate
mittees this was the first time in the history of social insurance
the people gave him last November.
that the professions concerned with health insurance were
One may find reassurance in the President's message of Janu-
brought in at the beginning by the government to help formu-
ary 17, 1935, transmitting to Congress the report of his Com-
late an official program. In Germany, more than half a century
mittee on Economic Security. He said, "I am not at this time
ago, health insurance was virtually established by the edict of
recommending the adoption of so-called health insurance, al-
Bismarck as a measure not only of economic, but also of po-
though groups representing the medical profession are co-
litical, security. In Great Britain, a quarter of a century ago,
operating with the federal government in the further study of
hardly consulting the medical profession, Lloyd George put the
the subject and definite progress is being made." These words
National Health Insurance Act through Parliament while the
were reassuring, but I think the President will pardon some of
doctors remained aloof or in opposition until the eleventh hour.
us for becoming impatient for action now.
Today it is very difficult to find a physician in Great Britain
In that report, the Committee on Economic Security said:
who is not making at least a decent living or one who would
"As a first measure for meeting the very serious problem of sick-
consider for a moment abandoning health insurance, the Journal
ness in families with low income we recommend a nation-wide
of the American Medical Association and other American medical
preventive public-health program," to be "financed by state
journals to the contrary notwithstanding. Indeed, the British
and local governments and administered by state and local
Medical Association and the local panel committees of doctors
health departments, the federal government to contribute
all over Great Britain have gone on record over and over again
financial and technical aid." The Committee then went on to
for extension of the benefits of National Health Insurance to
say "The second major step we believe to be the application of
embrace not only the workingman but all members of his
the principles of insurance to this problem." The Committee in-
family as well, and also to extend the medical benefits to include
formed the President that it had enlisted the co-operation of
hospitalization and the services of various specialists.
advisory groups representing the medical and dental professions
Listen to the following quotations from a statement by Dr.
and hospitals management in developing "a plan for health
G. C. Anderson, Medical Secretary of the British Medical As-
insurance which," it said, "will be beneficial alike to the public
sociation:2
and the professions concerned." These advisory groups had, the
Soon or late, I predict, every modern civilized community must acknowl-
Committee stated, requested an extension of time "for the
edge its duty to make provision for the health of its members if they cannot
further consideration of these tentative proposals, and such an
secure it for themselves. In America and elsewhere, there are large numbers
extension has been granted to March 1, 1935." The President
who suffer from this disability.
I think that, after twenty-two years, we may be said to have passed the
was further informed that the Committee has effected arrange-
experimental stage in Great Britain and are able to evaluate the merits and
ments for a close co-operative study between its technical staff
defects of our health insurance plan. That it has some defects may be freely
and the technical experts of the American Medical Association.
admitted, but they are emphatically not those which the American Medical
Are we being inconsiderately hasty if we now call for action on
Association has thrust into the foreground.
health insurance?
2 Detroit News, September 29, 1934.
482
JOHN A. KINGSBURY
NATIONAL HEALTH INSURANCE
483
Chiefly, the American Medical Association and its members who oppose
national health insurance allege that it has proved to be a failure and detri-
Advisory Board, be it said to their credit, who were independ-
mental to the interests of both profession and public. It is said that the so-
ent of this action and were not party to this political trickery.
called "panel system" has tended to stifle initiative and reduce all professional
Like certain other big business organizations, still endeavor-
service to the same level of mediocrity.
ing to defeat other aspects of the New Deal program, the Ameri-
Nothing could be farther from the truth.
As a matter of fact most
can Medical Association is exerting all its power to prevent
of our physicians are eager for panel service.
Without such steady in-
come many would have found it difficult to earn a living by the exercise of
compulsory health insurance from taking its proper place in the
their profession alone.
Social Security Act. So-called "organized medicine" is using
every device known to pressure groups and politicians to
Continuing, Dr. Anderson says:
prejudice the country against a comprehensive national health
From the viewpoint of the public, the insurance act has been equally suc-
program, and particularly against compulsory health insurance.
cessful and any attempt to represent it as being otherwise proceeds from a mis-
apprehension of the facts.
The American Medical Association and its satellite societies
The benefits of the scheme are evident to
the public and the public pays its share cheerfully.
have printed in their medical journals false and misleading
statements concerning the operation of health insurance in
I have already remarked that, in the formulation of a na-
England and other European countries. And this campaign of
tional health insurance plan, the United States is the only coun-
misinformation still continues. They have passed resolutions
try where the professions were let in on the ground floor. Here
based strictly on selfishness and their vested interests. Like
they were invited and urged to participate in the formulation
ordinary lobby groups, while the Social Security Bill was pend-
of the plans. The President's Committee on Economic Security
ing, they saw to it that thousands of telegrams were sent to
delayed its final report-until now it is long overdue-to give
the President and to the Congress, seeking to exert pressure
the doctors, the dentists, the hospital administrators, the
without reference to the merits of the proposals under considera-
nurses, and the public health authorities not only every oppor-
tion; they used personal influence on those in high places; they
tunity to be heard but every facility for criticism and suggestion
spent tens of thousands of dollars in publicity campaigns of mis-
concerning the program under consideration. How did they
information; they spread false rumors and resorted to scurvy
utilize their opportunity? The dentists helped; the hospital
attacks on individuals. They even pulled the purse strings of
people helped; the nurses helped; and the public health people
reputable research agencies in an effort to curb the freedom of
helped. Each gave intelligent and critical advice and counsel.
speech of their opponents on the staffs of such organizations.
But the doctors "co-operated" with the President's Committee
with a technique which has its own unique effrontery. While
VI
certain of their leaders and officers were in the full confidence
One has wondered how long the real leaders of the medical
of the official studies which were still in progress, and while the
profession, and the rank and file of the various auxiliary pro-
President's Committee and its staff were still deliberating, the
fessions-dentists, nurses, hospitals, and others-will permit the
American Medical Association held a special session of its
medical politicians, who too often control medical societies and
Houses of Delegates-the first since the World War-and
the editorial columns of the journals, to continue to obstruct
passed resolutions condemning compulsory health insurance
progress and to delay and forestall sound legislation. A ray of
and important health and welfare sections of the then pending
hope has just begun to shine over the horizon of organized
Social Security Bill! There were members of the Medical
medicine, shining from a massive report recently issued by the
American Foundation, entitled American Medicine: Expert
484
JOHN A. KINGSBURY
NATIONAL HEALTH INSURANCE
485
Testimony Out of Court. Most strikingly it presents the doctor's
will take an aggressive position in the ranks of organized medi-
dilemma in the testimony of 2,200 representative leaders in
cine, or whether they will continue to permit themselves to be
every branch of American medicine from every state in the
represented (and misrepresented) by officers and editors who
Union, most of them in practice over twenty years.
obviously do not speak for them and who are today the chief,
The concensus of opinion of the American men of medicine
if not the only, real obstacle in the way of realization of a com-
who are credited with the authorship of these volumes is clearly
prehensive national health program.
that the doctor "is no longer concerned exclusively with the
It remains also to be seen whether the social workers of
care of the sick, but also with a guardianship of the health of
America will continue to be intimidated and to remain almost
the nominally well"; that "the present costs of medical care are
inactive in the face of selfish opposition to a measure which
tragically out of reach of a large part of the population"-that
promises as much as any other single proposal now before the
the State has a stake in the health of its people. This is progress,
country to deal with an underlying cause of poverty and de-
and much of it is quite obviously contrary to the official views
pendency. How can social workers expect the President and
of the American Medical Association. Keep in mind that the
the Congress to act on a controversial issue, in the face of such
authors of this report, with apparently few exceptions, are
vociferous and politically powerful opposition to health insur-
members in good standing of the Association.
ance, if there is no organized expression of public opinion in
The New York Times, commenting editorially on this report
favor of it?
of the American Foundation, says:
I venture to say that, in this great fight of 1935 and 1936 for
Not social workers despised by the American Medical Association but
doctors themselves, a veritable "Who's Who in Medicine," wrote the Founda-
one of the principal measures of social security, the social work-
tion's report.
It is now doubtful if the entrenched officers of the As-
ers of America were asleep at the switch. They fell down on
sociation truly speak for organized medicine. The 2,200 representative
their job. This was partly because they were not organized for
physicians demand far-reaching, socially-conceived reforms in medical educa-
a conflict with such powerful and unscrupulous opposition, but
tion and practice because "the best is not yet good enough." But the Associa-
also partly because such organizations as the American Associa-
tion through its journal advocates a policy of letting medicine evolve naturally
tion for Labor Legislation and the American Association for
(while millions lie ill without adequate care or die because it costs too much
to have a doctor) and regards the practice of medicine as a vested interest akin
Social Security were too busy with other aspects of the social-
to that of a plumbers' union in the installation of bathtubs or kitchen fixtures.
security program. Furthermore, it was because the organiza-
On many a page the Foundation's report refutes a Bourbonism which holds
tion which had been the spearhead of the movement to include
that all's well with the general practitioner, that medical care is adequate on
health insurance in the Social Security Act was blackjacked
the whole
If, as the Foundation makes it clear, the practice of medicine
and was unable to offset the mischievous misrepresentations of
needs continual revision in the light of new community needs it is evident that
the clique which controls the machinery of organized medicine.
social and economic changes cannot be ignored. Yet the American Medical
Even the American Federation of Labor, whose members had SO
Association would have us believe that the old laissez faire evolution is good
enough today because it was supposedly good enough yesterday.
much to gain from sound measures of social insurance, were too
much absorbed in the problems of unemployment and old age.
The report of the American Foundation was eminently worth-
However, the Federation is to be congratulated upon the resolu-
while if for no other reason than to elicit from one of America's
tion adopted at its annual meeting in November, 1936, indors-
leading newspapers this editorial comment.
ing health insurance and disability compensation and calling for
It now remains to be seen whether these medical leaders,
a federal commission to further advise on sound legislative
members in good standing of the American Medical Association,
measures.
486
JOHN A. KINGSBURY
VII
One of the greatest needs of the nation today is a comprehen-
sive national health program. There is today no long-range
plan before the social workers of America more important than
concerted action for a health program. They know better than
any other group the devastating effects of illness and the inabil-
ity of the people of low income to budget against sickness except
as large groups. The social workers must line up against the in-
trenched officers of organized medicine; they must align them-
selves beside the leaders of organized labor and beside the real
leaders of the medical professions. Together with these groups,
the social workers of America can bring to pass a real national
health program. They can bring into being a program broad
enought in its scope to enable the industrial states and areas to
protect themselves through compulsory insurance, and the
rural and the sparsely populated states and areas to protect
themselves through public medicine. They can bring into being
a program to authorize the federal government, which must
subsidize any comprehensive plan, to set up standards and to
provide effective leadership and guidance.
Let us put our shoulders to the wheel. We can have, as we
should have, a comprehensive health program to meet a crying
need of the people. It can be sufficiently flexible to meet the
different needs of the several states: public health services for
all, adapted through different techniques to urban and rural
needs; public medical services where these are most appropri-
ate; medical-care contributory insurance for the wage-earners
and salaried workers, and, for those who cannot themselves pay
contributions, public provision of contributions instead of
humiliating hand-out medicine; contributory insurance against
temporary or permanent loss of earnings from disabling illness;
and federal aid and guidance over all.
Marching behind the banners of such a program, the social
workers of America can sound a clarion call for action in a cause
worthy of their highest traditions.