Opinion ID: 1297458
Heading Depth: 1
Heading Rank: 1

Heading: Public Purpose Doctrine.

Text: The first attack on the constitutionality of the law appropriating funds to the medical school is based on the public purpose doctrine; it is contended the appropriation is not for a public purpose because: (1) It supports a private school which is not a public purpose, and (2) the effect on public health is not direct and immediate benefit. We need not go into the origin or the validity of the doctrine which commands that public funds can only be used for a public purpose. The doctrine is beyond contention and recently was the subject of exposition by this court. State ex rel. Bowman v. Barczak (1967), 34 Wis. 2d 57, 148 N. W. 2d 683; State ex rel. La Follette v. Reuter (1967), 36 Wis. 2d 96, 113, 153 N. W. 2d 49. See also Mills, The Public Purpose Doctrine in Wisconsin, 1957 Wis. L. Rev. 40; Soens v. Racine (1860), 10 Wis. 214 () Heimerl v. Ozaukee County (1949), 256 Wis. 151, 40 N. W. 2d 564; State ex rel. Wisconsin Development Authority v. Dammann (1938), 228 Wis. 147, 175, 277 N. W. 278, 280 N. W. 698. Nor need we discuss the presumption of constitutionality, which every act of the legislature is entitled to be accorded. This doctrine is too well and rightly established to be challenged. Gottlieb v. Milwaukee (1967), 33 Wis. 2d 408, 147 N. W. 2d 633; Madison Metropolitan Sewerage Dist. v. Committee (1951), 260 Wis. 229, 50 N. W. 2d 424; Petition of Breidenbach (1934), 214 Wis. 54, 252 N. W. 366; State ex rel. Thomson v. Giessel (1953), 265 Wis. 558, 61 N. W. 2d 903. We recognize, too, that to render a statute unconstitutional, its conflict with a constitutional provision must be clear and free from doubt. Chicago & N. W. Ry. v. La Follette (1965), 27 Wis. 2d 505, 521, 135 N. W. 2d 269. Although this court is not bound by the declaration of public purpose contained in an act, nevertheless what constitutes a public purpose is in the first instance a question for the legislature to determine and its opinion should be given great weight. The legislature, of course, cannot call black white or even gray white to reach a result; but it does have discretion in its declaration of public purpose. State ex rel. Bowman v. Barczak, supra ; David Jeffrey Co. v. Milwaukee (1954), 267 Wis. 559, 578, 66 N. W. 2d 362. In State ex rel. Reynolds v. Nusbaum (1962), 17 Wis. 2d 148, 115 N. W. 2d 761, this court did not accept the declaration of the legislature but determined the purpose of the school bus law in its realistic operation was to benefit the private schools rather than promote the safety of children. We have no such problem in this case because the declaration of the legislature is supported by the facts. The declaration states the level of physician resources for health care in Wisconsin is below the averages for the midwest and the nation and needs to be improved; and to provide adequate physician manpower, this state must expand its program for training new physicians. The legislature accepts the recommendations of the governor's task force on medical education, that financial support is needed to increase the number of medical students at Marquette School of Medicine. And, most importantly, the legislature determined ... this improvement of medical education opportunities is essential to the health and welfare of this state, and is in the public interest and required to meet the health needs of our expanding population. This is a clear-cut and unambiguous statement of public need and purpose. It is now our duty to evaluate the public purpose and the means of attaining it provided by ch. 3 of the Laws of 1969. Some of the factors for determining public purpose were laid down years ago in State ex rel. Wisconsin Development Authority v. Dammann, supra, at page 180: The course or usage of the government, the objects for which taxes have been customarily and by long course of legislation levied, and the objects and purposes which have been considered necessary for the support and proper use of the government are all material considerations as well as the rule that to sustain a public purpose the advantage to the public must be direct and not merely indirect or remote. The court recognized that the concept of public purpose is a fluid one and varies from time to time, from age to age, as the government and its people change. Essentially, public purpose depends upon what the people expect and want their government to do for the society as a whole and in this growth of expectation, that which often starts as hope ends as entitlement. Until recently, man has accepted sickness as a normal phenomenon. But in this century, science has discovered many health hazards can be eliminated or controlled. Preventative medicine and earlier care have become the expectations. It is common knowledge the rising trend in the demand for health services is beyond present resources. As said in Laughlin v. City of Portland (1914), 111 Me. 486, 90 Atl. 318, and as quoted in State ex rel. Wisconsin Development Authority v. Dammann, supra, at 182, Times change. The wants and necessities of the people change. The opportunity to satisfy those wants and necessities by individual efforts may vary, and consequently, what could not be deemed a public use a century ago, may, because of changed economic and industrial conditions, be such today. . . .Its two tests are: First, the subject matter, or commodity, must be one `of public necessity, convenience or welfare.' ... The second test is the difficulty which individuals have in providing it for themselves. It cannot be seriously questioned that the health of the people of this state is of great concern and the proper object of our state government's interest. We stated over twenty-five years ago in State ex rel. Martin v. Juneau (1941), 238 Wis. 564, 571, 300 N. W. 187, that the promotion and protection of public health is a matter of statewide concern. See also State ex rel. Wisconsin Development Authority v. Dammann, supra . But the respondent does not dispute that public health is a public purpose so much as he argues the appropriation will support a private school which is not a public purpose. This argument confuses the means with the end. An act is constitutional if it is designed in its principal parts to promote a public purpose so that the attainment of the public purpose is a reasonable probability. We cannot take the short rather than the long view of the problem because a private school is used as a means to attain the end. The appropriation is not primarily to benefit the Marquette School of Medicine but to promote and maintain public health. This law is no frivolous pretext for giving money to a private school but the using of a private school to attain a public purpose. What benefit is derived by the medical school is necessary and incidental to the main purpose. The advantage to the public of increasing the number of doctors in Wisconsin to maintain and promote public, health is direct and not indirect or remote. Because there are several necessary steps in the process does not make the end remote and certainly not indirect. The means used by the legislature to attain this public purpose are not only reasonable but necessary. It is argued, however, the appropriation will not attain its purpose because only 35 percent of the medical graduates of the Marquette School of Medicine stay in Wisconsin to practice medicine. About the same percentage is true for the University of Wisconsin Medical School, but it has not been argued that all graduates of the state university must stay in Wisconsin to justify the existence of the school. The legislature did recognize some merit in this argument and provided that as a condition to the release of funds under ch. 3, Laws of 1969, the medical school must give first preference of admission to residents of this state. We think, too, the strengthening of the faculty of the school of medicine will promote postgraduate medical study opportunities in the Milwaukeearea hospitals, which, in turn, will increase the number of young doctors who remain in Wisconsin to practice. The respondent relies on Curtis' Administrator v Whipple (1868), 24 Wis. 350, 358, for the proposition that state tax money cannot be used to aid a private educational institution. But Whipple is distinguishable from this case. In this case we are primarily dealing with the public health and the medical school is merely the means by which health care is to be improved, while in Whipple the matter of helping a school was the end in itself and the public benefit was incidental and indirect.