Evening star., 1939-01-31

DISCUSSES NATIONAL HEALT
ner, who spoke last night in tn
Federal Government 60 into the
business of furnishing medical care,
or interfere with the States in the
licensing of medical or other prac-
titioners. Far from displacing the
existing efforts of charitable organi-
cations, the localities and the pro-
fessions, the bill would forge tech
nical and financial sineWs to help
them to bear more effectively the
burden which they have so long
carried alone.
Would Hold Down Initial Costs.
The initial costs of the program
have been kept within the limits
of our immediate resources. I am
exploring every possibility Of provid-
ing temporary as we'll as permanent
disability benefits without increas-
ing the pay roll taxes already au-
thorized by the Social Security Act.
AS for the grants in aid to the
States, authorizations in the first
year will not exceed 10000, 900
in the aggregate. This sum, grad
ually increasing over the years,
will be made available on the basis
of matching formulae which take
into account the special health
needs and financial resources Of the
several States. In this way Federal
aid will improve the general level
of health work throughout the
country, while reducing the wide
variations which now exist among
various localities and various groups
of the population.
1t is imperative that beginning,
however modest, be made now.
States now considering plans Of
medical care should have clear in
dication Of the help and co-opera-
ton contemplated to be rendered by
the Federal Government.
Again and again I have been
asked: do you propose a plan OF
compulsory health insurance." To
my mind the projection of this
question to the forefront of discus
sion emphasizes controversial is
sues, to the exclusion of matters
on which there is universal agree
ment. Broadly speaking, millions
of consumers of medical services
want compulsory health insurance;
on the other hand the medical pro-
fession Is divided as to the wisdom
of compulsory features. But there
is substantial agreement among all
groups and all classes on every other
aspect of the program, including
provisions for public health, mater
nifty and child care, disability in.
surance and medical care for the
needy.
Free Choice by States.
The question of compulsory health
insurance arises only in connection
with State plans Of general medical
care. The answer Is simple and
clear: The bill will not impose a
Federal strait jacket upon the de-
velopment OF State plans. Subject
to necessary basic standards, each
State will be at liberty to set up a
plan of its own choosing and geared
to the needs Of its own people. The
plan may be supported by contribu-
tions from beneflciaries or by gen.
eral taxation, or both. It may be
limited to some phases Of medical
care or be more inclusive. It may
cover only the relief population or
include other groups higher in the
economic scale.
The States will be free to estab-
lish compulsory health insurance II
they choose to do so. It Is impor-
tant that this election be left open
to them.
Health insurance for medical care
is entirely compatible with Ameri-
can concepts. Old-age insurance
and unemployment insurance are
familiar analogies. And In the his
tory of our own country, there are
ample precedents for health insur-
ance itself. The very first step taken
by the Federal Government in the
field of health was to create in effect
compulsory health insurance sys-
TEN for seamen in the American
merchant marine. Established in
1898 and administered through the
Marine Hospital Service, this plan
Of medical care was maintained for
three-quarters of q century by the
regular deduction of 20 cents-later
40 cents-a month from seamen's
wages. Today the system is admin
istered by the United States Public
Health Service and supported by
general tax funds.
A better and more widely known
American precedent is workmen's s
compensation, the first type of social
security adopted in this country for
industrial workers at large. This is
essentially q form Of health insur-