Address at the Dedication of the National Institutes of Health Clinical Center.

Mr. Ewing, distinguished guests, ladies and gentlemen:

We are here today to lay the cornerstone of a building which will be devoted to the service of mankind. The men and women who work in this clinical research center will be striving to save human lives and to prevent human suffering. This is a noble purpose.

As a people, we have constantly sought better health and longer lives for our citizens. We have done so not merely because human strength and human intelligence are great national assets. Far more important, we believe that there is something sacred about every human soul that God has put on this earth.

We believe in the rights of the individual. We acknowledge his supremacy over the state. This is the great mark of distinction between our democracy and the totalitarian dictatorships. In the totalitarian countries little value is placed on human life. People are herded into slave labor camps by the millions, and are allowed to die like flies from starvation, disease, or hardship.

In our country the Government exists to serve the people. Our Government is one of the instruments through which the people achieve freedom, happiness, and the good things of life.

This is true in the field of health as in other parts of our national life. Advances in medical knowledge and medical care in our country have come about through the combined efforts of private individuals and institutions and local, State, and Federal agencies.

This clinical research center will advance the work that is being done by all of us to achieve better health. I am especially glad to participate in these ceremonies, because I believe so strongly in the importance of medical progress. And I know what amazing advances can be made, because I know what has happened in my own lifetime.

At the turn of the century the average American could expect to live only 49 years. The two biggest killers, pneumonia and tuberculosis, exacted a frightful toll. Diphtheria and typhoid ran wild. We were losing 130 of every thousand babies before they were a year old. Our maternal death rate was very high--more than six mothers died in childbirth for every thousand babies born. In World War I, 141 American soldiers out of every 10,000 were cut down by disease--more than were killed by the enemy bullets. Today, many of these scourges have been almost completely eliminated. The death rate from tuberculosis, pneumonia, and other infectious diseases is at the lowest point in medical history. We have reduced infant mortality by more than two-thirds. Our maternal death rate is now less than 1 mother per 1,000 births. The death rate from disease in our Armed Forces in World War II was only about 6 in every 10,000, as compared with 141 in 10,000 in the First World

War.

Most remarkable of all, we have extended the average life 18 years in this short half century. The average American baby born this year can expect to live 67 years--until the year 2018. And I was 67 last month-too bad !

Medical science has won victory after victory over the deadliest diseases of a generation ago. During the first half of the 20th century, it is safe to say that we successfully conquered the infectious diseases. Now, in the second half of the century, we are facing an even greater challenge--the battle against chronic diseases.

Over 1 million Americans died last year from cancer, heart trouble, diabetes, and other chronic illnesses. As the life span of our people has grown longer, the mortality from these illnesses has risen. Last year the death rate from heart disease was the highest ever recorded for any single human ailment, and it was 20 percent higher than 10 years ago. Fifteen percent more people died of cancer last year than they did 10 years ago.

The most heart-rending of the chronic afflictions, and perhaps the most serious, is mental illness. Over 600,000 hospital beds-about 50 percent of the hospital beds in this country--are occupied by the mentally ill.

All these chronic illnesses take a tremendous human toll. It is estimated that more than 25 million Americans suffer to some degree from chronic diseases.

Modern medicine must find ways of detecting these diseases in their early stages and of stopping their destructive force. That will be the major work of this clinical research center. There could be no more useful expenditure of the taxpayers' funds.

The center will be operated by the Public Health Service of the Federal Security Agency. It will be the home of one of the greatest groups of scientists ever gathered together for basic and applied medical research •

Basic research has been at the core of the great advances in medicine during the last half-century, and the scientists of the Public Health Service have been in the forefront of this research.

Scientists of the Public Health Service were the first to discover that pellagra was caused by a dietary deficiency, and they devised the means for its prevention and cure. They found the cause of Rocky Mountain spotted fever and how to vaccinate against it. They developed the use of fluorides for the protection of teeth, opening the way to the major reduction of dental decay.

Public health research workers right here at Bethesda developed a vaccine against typhus. Their vaccine has kept our forces in Korea free from typhus, while the North Korean and Chinese Communists have suffered seriously from that disease.

The fine record of the Public Health Service research workers promises well for the future. This magnificent building will give them many new opportunities to forge ahead in the field of medical discovery. I am particularly glad that one of the wings of the building has been especially designed for work with radioactive materials--to put to peaceful and constructive use our increasing knowledge of atomic energy. I am just as sure as I stand here that we are going to discover uses for this great force that we have released that will be for the welfare of mankind, instead of for its destruction. And that is what I am looking forward to.

This clinical research center will not be an isolated enterprise. Research scientists from medical schools, private hospitals, and other private institutions will come here to share in the work. And the Federal Government will continue to make grants-in-aid for medical research in other places. In 1950 the Public Health Service made more than 1,500 research grants totaling about $14 million. These grants went to universities, hospitals, and medical schools in every part of the United States.

In the last few years Government assistance to medical research has been greatly expanded. At one time there was a great hue and cry by the viewers-with-alarm that Federal assistance would threaten freedom of research. That is a very, very familiar statement that goes on all the time. That wasn't true, of course. The fact is that the presidents of some of our leading universities have gone on record to the effect that Federal assistance has broadened both the scope and the freedom of medical research. Their experience with these research grants is proof that Government aid does not mean Government control.

Today there is a growing awareness that medical research needs support from the Federal Government, from State and local governments, and from industry, endowment funds, and private contributions. It will take support from all these sources to give us the rapid progress we need.

At the same time that we are moving forward with medical research, we must drive ahead to translate the new knowledge gained by research into better medical care for more people. Here we have run into difficult problems, but we are making progress.

We have made great strides in the field of public health. The Federal, State, and local governments have formed an effective partnership. In 1950, $231 million was spent for State and local public health services. Forty-five million dollars of this was provided by the Federal Government, $96 million by State governments, and $90 million by local governments.

These funds were used by public health doctors and nurses who are in the front lines of the fight against disease--X-raying to find tuberculosis, inoculating against diphtheria and typhoid, treating venereal disease, guarding the purity of water and milk supplies, organizing health services for civil defense, and performing a host of other services to protect the health of the American family.

Yet, our present local public health system is woefully inadequate to meet its responsibilities. Thirty-two million Americans live in areas which are not served by full-time public health workers.

I am happy that the United States Senate at its present session has passed legislation to help strengthen and expand the Nation's local public health units in our cities and counties. I hope that the Congress will complete action quickly on this legislation. Stronger local public health units are essential to better health in this great country.

We are now making good progress in meeting our needs for hospitals and health centers. The projects already approved under the national hospital program, started in 1946, will give us 65,000 additional hospital beds and 240 new health centers, with the Federal Government contributing about one-third of the cost. These hospitals are being built where they are needed most. Most of them are small hospitals of 50 beds or less, and most of them are located in towns of 10,000 people or less.

Hospital and research centers are worthless, however, without trained medical personnel to staff them. In recent years the education of students in the medical, dental, nursing, and allied professions has not kept pace with the increase in population. These shortages are crippling hospital services all over the country. Less than a month ago, every Washington newspaper carried front page stories on the closing of many hospital beds in this area because of a critical health personnel shortage.

These shortages are being aggravated by the needs of our Armed Forces. Our military medical men are doing a magnificent job in saving lives on the Korean front, but we have had to dip deeply into our medical strength over here to accomplish this.

In order to supply more doctors and nurses, we will have to strengthen and expand our schools. In spite of the best efforts of the medical schools, they have had to turn away thousands of applicants each year. The income of the medical schools has not risen to meet the rising costs of medical education. They are today in the most precarious financial condition in their history. President Hoover, as honorary chairman of the National Fund for Medical Education, pointed out recently that the financial condition of our medical schools is so acute that few can continue even their present programs without large-scale financial aid.

Legislation to remedy this situation is now before the Congress. This legislation will provide emergency Federal aid for 5 years to tide the schools over the present crisis. The overwhelming majority of the medical school deans support this legislation. It is not intended to replace private sources of support. On the contrary, I am sure it will broaden this support in the same way in which both public and private sources, joined together, have broadened the base and scope of medical research. I hope that the Congress will act on this legislation soon.

Finally, we have the problem of meeting the cost of medical care. The research discoveries which will be made at this clinical center and elsewhere must not be confined to a chosen few, simply because the rest of us cannot afford to use them.

At the present time most people find it very difficult to pay for medical care. I have been very glad to see the growth of the many private health insurance plans over the last several years. But the plain fact is that they do not meet the problem. They are not reaching the overwhelming majority of low and middle income families.

Less than 4 million Americans have reasonably complete medical care insurance, and 75 million have no health insurance at all. Skyrocketing medical costs are pushing millions of Americans into the medically indigent class.

Since 1945 I have been proposing to meet this problem by national health insurance. This proposal has generated a great deal of controversy. I still believe it is sound, and that the Nation would be greatly strengthened by its adoption.

I want to make it clear, however, that I am not clinging to any particular plan. What I want is a good workable plan that will enable all Americans to pay for the medical care they need. And I will say here and now that if the people who have been blocking health insurance for 5 years will come up with a better proposal--or even one that is almost as good--I'll go along with them. I want to get the job done, and I am not concerned in the slightest with pride of authorship.

But I am concerned with results. Medical care is for the people and not just for the doctors--and the rich. Our objective must be to make the best modern medical care available to more and more people. I intend to keep right on working for that as long as I am President of the United States, and also after I get through being the President of the United States.

I have been speaking of the medical needs of our own country. We should never forget, however, the extremely fortunate position we are in compared to the rest of the world.

Throughout the world almost half the people--more than 1 billion men, women, and children--are victims of preventable disease. Millions of them are weakened by malaria. Millions die each year from tuberculosis. Three babies out of every ten die in infancy.

In many parts of the world the average life expectancy is under 30 years. That was our expectancy in 1890. This means that the average farmer or industrial worker in these countries has but a few years of limited productivity before death.

Obviously, people with such handicaps face immense difficulty in striving for economic and social progress. It is urgently necessary that we help them to learn and put into effect modern medical knowledge and public health methods. This is one of the most important parts of the work we must do under the point 4 program.

We know what can be done. In Western Europe, when World War II ended, disease was rampant and epidemics threatened wide areas. Experts said that 20 years' effort in public health had been lost as a result of the war.

Now in 3 years, with our help, the tide was turned. By 1948, death rates in Western Europe were the lowest ever recorded. Tuberculosis, which had spread to an alarming extent, was reduced to a lower level than ever before. Malaria was nearly wiped out as far east as Greece. Typhus and smallpox were gone. The public health work in Europe was more completely successful than the efforts made in any other field of postwar rehabilitation.

Of course, this was done in Europe, where there was a large group of medically trained specialists. We cannot expect such quick results in the underdeveloped areas of the world. They are desperately short of doctors and nurses and health facilities of all kinds. In parts of Iran, for example, there is only one doctor for each 80,000 people. It will take time to remedy these conditions. But progress is being made.

More health technicians are being trained. Last year, thousands of professional health workers came to the United States for training-they came from the Philippines, Latin America, and many other areas all around the world.

We are also sending our specialists abroad. For example, last year, a team of our public health officers flew to Indochina and helped the people there plan a campaign against malaria and other serious diseases. Another team spent 10 weeks in Iran, showing village physicians and government medical officers how to vaccinate and use DDT.

This public health work is the key to improving conditions in the underdeveloped areas. No funds we can spend will bring richer rewards in human progress and in strength for peace. This is recognized by other countries as well as our own, and splendid work is being done in this field by the World Health Organization.

The United States was one of the founding members of the World Health Organization. It is a source of deep satisfaction to me that Surgeon General Scheele of the Public Health Service was elected to the presidency of its annual assembly in Geneva just a month ago.

As we lay the cornerstone of this clinical center, I see in this structure a symbol of what is finest in our way of life.

The work that is done here in Bethesda will bring life and health to all mankind. This center is a specific and exciting expression of man's humanity to man. It will save the lives and alleviate the suffering of our own children and grandchildren. But, more than that, it will serve men of all religions, all races, and all nations--everywhere in the world.

May it serve for many generations as a monument to our desire for human health and happiness in a world at peace.