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Address in Philadelphia at the American Hospital Association Convention

September 16, 1952

Mr. Chairman, ladies and gentlemen:

It is a great pleasure for me to be here today. This meeting gives me an opportunity to talk on one of my favorite subjects-the health of the American people.

When I stood up here awhile ago and presented this Certificate of Merit to Mr. McNamara, he was under the impression that that was a put-up job, and it was--I was a party to it. And the mayor and myself maneuvered the situation so that the President of the United States could get two introductions instead of one.

I was standing up here at the singing of "The Star-Spangled Banner," and I noticed in looking around over the audience that everybody kept looking at me, and wondering why in the Sam Hill I wasn't doing a little singing myself. And I will tell you why. I am like Artemus Ward, as a "singist'' I'm not a success. I am saddest when I sing, and so are those who listen to me. The singer in the family is now in California.

I feel very close to you people who are here today. In fact, I think perhaps I can qualify as a hospital administrator myself, because the Federal Government operates the largest group of hospitals in the country. You see, I have some of the same headaches that you do. Just some. I know something about the nature of your problems, and I also know about the wonderful work you are doing.

I am proud of our Federal hospitals, and I am proud that they are members of the American Hospital Association. All our hospitals--voluntary, municipal, and State, as well as Federal--and all the people who serve in them can take great pride in what they have done to help lift the Nation's standard of health in recent years.

We now have the highest standard of health in our history. Life expectancy has never been so high; the occurrence of communicable diseases has never been so low.

Typhoid fever, smallpox, diphtheria, pellagra, rickets, and malaria have been virtually wiped out. In fact, these diseases are so rare today I am told that many of our younger physicians have never even seen a
Case.

We have overcome the major causes of infant mortality, and today only one mother in 1,400 dies at childbirth.

From 1944 to 1950, the general death rate in our Nation declined 10 percent. Deaths from tuberculosis were reduced 46 percent; from influenza and pneumonia, 50 percent; from syphilis, 53 percent.

Contrary to what some of you may have been led to expect, I do not claim sole credit for these remarkable achievements. I am sometimes accused of claiming credit for everything good that has happened in the United States while I have been President, and, by the same token, I am also accused of never having made a mistake.

As for mistakes, I know that I make them like everyone else, and I do admit them from time to time. However, it has not seemed necessary for me to spend a great deal of time calling attention to my mistakes because there have always been plenty of other people who were willing to do that for me.

You hospital administrators know what I mean because you have to serve as the whipping boys for a lot of other people, too.

Actually, our magnificent achievements in the field of health have resulted primarily from teamwork. We could not have made this record unless everyone had done his part--doctors, nurses, and hospital administrators, and all the other workers who are devoted to keeping people well. We all have our places on the team, and none of us could do the job without the help of all the others.

One of the best illustrations of what can be accomplished through teamwork is what has happened in our medical program for veterans.

At the end of World War II, we set out on a program to revitalize the medical services of the Veterans Administration and to make sure that men and women who had been disabled in the defense of our country would receive medical care second to none. That program has been successful beyond what everyone thought would be possible.

This success has been made possible by the wholehearted cooperation of the private practitioners, professional schools, and hospitals. The Veterans Administration has secured the part-time services of over 100,000 experts in the medical field to aid its full-time staff. And the faculties of nearly every leading medical school in the country are now working with the Veterans Administration to provide an ever-higher quality of medical care.

I am delighted it's that way. This unexcelled medical care for our veterans shows how the Government and the American medical profession can work together for the benefit of everyone.

While we have been making these advances in veterans' medicine, we have made equally impressive gains in national defense medicine--in caring for the men and women in the armed services.

In the fighting in Korea, the mortality rate among the wounded who reach medical aid is only half the rate of World War II--and that was remarkably low. Eighty-five percent of the wounded are now returned to active duty. The most amazing thing is that this wonderful record is being made with one-half the number of physicians per 1,000 troops that were used in World War II. We have been able to do this only because there has been the closest kind of coordination among our three medical services and civilian health agencies.

And while we are speaking of teamwork, I want to pay tribute here to the contribution that you, and the medical profession, and the Red Cross, and the American people, have made to the national blood program. It has been a magnificent achievement. But let us remember, however, that we dare not relax our efforts. The supply of blood needed for our troops in Korea, for the patients in your hospitals here at home, and for civil defense reserves is dangerously low. I appeal again to every American to give blood if he can.

Now, all these evidences of collaboration between the health profession and the Government may come as a surprise to you. I am sure they will be a surprise to most people in view of all that has been said about the terrible things I have been trying to do to the medical profession.

The fact is that the medical profession has more to do with determining the policies of the Federal Government today than ever before in history with regard to health. All the groups concerned with health have come together in the Health Resources Advisory Committee, under the chairmanship of Dr. Howard Rusk, to give their help and advice to the Government. The president-elect of the American Hospital Association is a member of this Committee, and a high official of the American Medical Association serves as vice chairman. The Committee is doing a marvelous job. And I am paying tribute to them.

All this doesn't mean that there is nothing left to argue about. I expect we will go right on in the American way having differences of opinion about the part the Federal Government should play in helping to meet the health needs of our citizens. Now, personally, I have always understood that the Constitution of the United States imposes upon the Government of the United States a responsibility with respect to the general welfare of its citizens. And certainly no one can pretend that good health is not a matter of first importance so far as the general welfare is concerned.

That is why, ever since I have been President, I have recommended programs which I believe will provide better medical and health services for all our people. Some groups have received these proposals enthusiastically. Others have been strongly against them. That is what happens every time we try to move forward. We have to make each advance by overcoming the objections of those who want to pull back.

My only interest in this matter is better health for all our people. That is why I have constantly asked the "pullbacks" to come forward with plans of their own. But you know, it is a failing common to the "pullbacks"--they don't want to move ahead at all, no matter how it's done. They just want to stand still, with things as they are, or they even want to move backward.

Even now they seem to be advocating the amazing proposition that Government should have nothing to do with health except for "locally administered indigent medical care programs."

That's about like saying we don't need any form of social security except the county poorhouse. These people really want to go back to horse and buggy days. I am here to tell you we are just not going back to horse and buggy days. We can't, if we wanted to.

Fortunately, we have gone ahead in this country, despite the "pullbacks," to accomplish what we could over their opposition.

Now I will tell you a story right here that is most interesting. I have collected since I have been in the White House a great many stories about the improvement of that structure and about the various Presidents and First Ladies who have been in it.

There is a story around the White House that Mrs. Millard Fillmore brought the first bathtub into the White House. There is also a story in connection with it, that the local medical association in Cincinnati, Ohio, passed a resolution calling Mrs. Fillmore an indecent person because she had put the bathtub in the White House. This medical association in Cincinnati said that it was unsanitary, that it was unhealthy, that no person should take all his clothes off at one time.

Well, my friends, there has been some progress since that date, and I want to say to you that there are more bathtubs in the White House now than there are in the Benjamin Franklin Hotel.

As a matter of fact, we have accomplished a great deal, as this story I have just told you illustrates.

We established in 1946 a Federal aid program for the construction of hospitals to be owned and operated by the people in local communities. As a result, thousands upon thousands are getting hospital care who never had it before, especially in the rural areas. By now more than 1,800 projects for hospitals, health centers, and other medical facilities have been approved. Already, this program has added 88,000 beds and about 350 health centers to the Nation's health resources.

One of the best things about this program is that more than one-half of these facilities are in towns which never had hospitals before. This is going to help correct the problem of the proper distribution of doctors. More young physicians will set up their practices in the country if they have modern hospitals in which they can work.

This hospital survey and construction program is an example of a happy and successful partnership between the Federal Government, the State Governments--governments of the local communities. The States take responsibility for orderly planning to meet hospital needs. Local citizens take responsibility for raising about two-thirds of the funds and for operating their hospitals.

This is the kind of teamwork by which we were able to meet the needs of 18 million Americans--one in eight of our population-who required hospital care last year. It is an achievement in which Americans can take real pride.

Now I want to remind you that behind all the work in our hospitals, behind all the advances in health, and behind all the health profession can do for the sick, is the underlying force of medical research. The key to all past accomplishments has been in painstaking research brought to the point of practical application.

This will be just as true in the future as it has been in the past.

We must remember that we advance from one set of problems to another. Past achievements in medicine have advanced us to the problems of the chronic and degenerative diseases. Having extended the life span, we are now grappling with heart disease, cancer, and other disabilities that people suffer in later life.

These problems are more difficult to resolve than were their predecessors. This means that the research required for their solution is constantly growing more complex and more expensive. It means that the whole structure of medical research must be strengthened. We need more research effort and more research workers.

The American people have given splendid support to medical research through private organizations, and I know they will keep it up. But we have found that the cost of research is so great that we cannot expect it to be met solely through private means.

Right now the Federal Government is supporting by research grants about a quarter of all the research done in medical schools. The Government is giving this aid without any control at all over the scientists or schools. That is the way it should be done and that is the way it must be done.

One of the most exciting developments in the history of medical research has been the use of the radioisotopes made available by the Atomic Energy Commission. Our scientists tell me that the radioisotope, when used as a tracer, represents the most important tool for unraveling the life process since the invention of the microscope in the 17th century.

Our atomic apothecary in Oak Ridge has made about 27,000 shipments of radioactive isotopes to 922 institutions in the United States. Many of you are now using these materials for the diagnosis of patients with thyroid disease, heart disease, and cancer. Now it took billions of dollars to produce these new aids to medicine--billions of dollars. No one except the Government could have marshalled the resources to do the job.

One of the research projects of the Government in which I take a great deal of personal pride is the new Clinical Center of the Public Health Service in Bethesda, Maryland. A little more than a year ago, I spoke at the cornerstone ceremonies for this unique hospital-laboratory. We were pleased to have the trustees of the American Hospital Association present on that occasion. In that great structure, soon to be completed, the Public Health Service will combine a range of clinical and scientific skills never before brought together under one roof. This will make it possible to step up our attack on cancer, heart disease, the viruses, mental illness, arthritis, and neurological disorders.

I honestly believe that our present day efforts in medical research are leading us into a new Golden Age of Medicine.

We should never forget that the best possible of all ways for treating disease and disability is by preventing them from happening. That is why research and preventive medicine and accident prevention are so important.

lust think of all the human suffering that has been prevented and all the money that has been saved by our victories over communicable diseases. Take smallpox, for example. In 1921, we had more than 100,000 cases in this country. Last year, only 11 cases were reported in the entire Nation.

Good health is not only a matter of wiping out disease; it is a matter of reducing our frightful accident toll. Thousands of men, women, and children are being maimed in accidents each month that we could prevent if we had the foresight to do so. Better safety education, more research into safety devices, plus better enforcement of safety regulations, would save us millions of heartaches and hundreds of millions of dollars each year. We could prevent the loss to our productive economy of literally thousands and thousands of people who are now victims of disabling accidents. And we could rehabilitate and return to productive life untold numbers of others at a cost far less than it now takes to care for them.

So, although we have come a long way toward our goal of good health for every American, we still have a long way to go. We have to move ahead with a balanced program that takes account of facts as they are.

You can't take care of sick people just by putting them in a building. The building is a shell and doesn't become a hospital until it is equipped and staffed. You can't make the best modern medicine available to everybody--as it should be--unless there is some way for the people to pay for it.

The overriding fact is that many phases of modern medical and health care are very expensive.

It's not like it was a hundred years ago. Let me read you this little item I found in a magazine last week.

This is from the rules and regulations of the Great Falls, New Hampshire, Medical Association, 1847:

"The members of this Association shall charge for their professional services the fees in the following table:

"For a visit in the village and ordinary medicine, fifty cents. For a visit in the Night, one dollar. For advice in ordinary cases, at the office, twenty-five cents. For extracting a tooth, twenty-five cents. If more than one tooth is extracted for the same patient, at one sitting, each additional tooth shall be 12 1/2 cents." If you had two taken out, you could get them for 37 1/2 cents.

Now this is pretty good: "For obstetrics, a single birth, four dollars. For obstetrics, twins, six dollars." There's no price on triplets, but I guess it would be in the same proportion.

"For excision of tonsils, three dollars." Now it was cheaper to have your tonsils out than it was to have a baby in those days.

But what I am getting at is that things are different now.

The fact that the best medical care costs so much today is not anyone's fault. It is simply because we have found out how to do so much for people who are ill that, if we do all of it, it takes a lot of time and requires a lot of equipment and personnel and many expensive drugs. And it requires training of physicists, of scientists, and doctors of medicine.

Nobody is to blame, but these costs have to be met somehow if we want to reap the blessings of medical research in the relief of human suffering.

Our problem is to bring medical and health services to people at a price they can afford to pay. I have invited the cooperation of the medical profession in solving this problem. But it is not a job for the medical profession alone. It is a job for all of us.

We are now partially solving this problem for many people through voluntary medical and hospital plans. But for many, many more of our citizens the problem is not solved. Many tenant farmers and low-income workers and older people do not have the money to obtain health services to an extent even remotely approximating their needs.

Over all the land, there are examples such as these. And I say to you, "What shall we do about it?" This great free enterprise system of ours has made it possible for more Americans to have more things--more of the good things of life--than any people anywhere on earth, or anywhere in the history of the world. Can it now also make it possible for every American to protect his health? I would not call such a goal "socialism." I would call it a goal of enterprise--American free enterprise.

Meeting the health needs of our people is one of the most important ways we can make our American promises come true. It also is one of the mainstays of national defense. Only the strong can survive and only the healthy can be strong.

This is why, last December, I appointed a Commission on the Health Needs of the Nation. I asked this group of prominent professional leaders and lay citizens to survey the situation and then make positive recommendations for action that would bring our people better health. That Commission now has been hard at work for 6 months. It is gathering a lot of highly important facts. It is going to the grassroots of our health problems. It has been holding regular meetings throughout the country and finding out what the health needs of our people are, and to what extent they are being supplied.

I have not in any way sought to control the work of this Commission. I do not know what it will recommend. But I have great confidence in its members, and I am sure that the report it will file in December will help us move forward toward the thing we all want better health for everyone in the country.

Before we can conquer any obstacle, we must have the will to conquer it. I have a profound faith that the people of this great Nation who have willed so many miracles in modern times also have an inflexible resolve to conquer our everlasting mortal enemies--disease and untimely death.

We have made great progress toward that goal. We are making progress now. hope that in the years ahead we can all march along side by side to take full advantage of our opportunities to make a better and healthier United States of America.

NOTE: The President spoke at 1:43 p.m. at Convention Hall in Philadelphia. During his remarks he referred to Fred A. McNamara, Chief, Hospital Branch, Bureau of the Budget, and Mayor Joseph S. Clark, Jr., of Philadelphia.

For the President's statement on the report released in December, see Item 352.