Remarks Before the Annual Convention of the National Medical Association, Houston, Texas.

THANK YOU very much, Dr. Swan. Thank all of you, for wanting me to come here and visit with you this afternoon. Mayor Welch, Mayor Washington, Dr. Whitticoe, Dr. Armstrong, Dr. Robinson, and Dr. Spellman, my dear friends, ladies and gentlemen:

America, I believe, is essentially healthy. America is, I believe, getting healthier, because we have shown that our remedies are taking hold and, because we have done that, we must today gird ourselves to work even harder to reach those goals.

It was three decades ago in the heart of a great national depression that Franklin D. Roosevelt inspired a nation with four freedoms and the need is very much the same today as it was then.

Jobs, homes, health, education--four simple words that can mean everything in a person's life.

Jobs, health, education, and homes--all without discrimination.

Now, just put very simply so you won't forget everything I say, that is what things are all about these days.

So I am going to talk to you today about these five freedoms, the new freedoms that we are trying to win for our people in our time--jobs, homes, education, and health, all without discrimination for all people.

Now, let's talk about the first, the freedom to earn a decent living from a full-time job. For most Americans, that freedom today is secure. Because 80 million of our people today are working on good jobs at good pay, and that is something that we have never been able to truthfully say before anywhere, any time.

The median income--that is the income of the family right in the middle--has today reached over $8,000 per year, for the first time in all of our history, this year.

For our retired, our social security benefits this year were increased by the largest amount since this program was brought into being by President Roosevelt a third of a century ago. The largest increase in all of our history this year.

Six million citizens, as Dr. Swan referred to a moment ago, have come out of poverty, have lifted themselves up with our help by their own bootstraps--6 million of them in the last 2 years alone.

Now while the freedom to earn a decent living is secure for most Americans, it is not secure for all Americans.

Our job then must be to see that every citizen can earn enough to live in decency-through minimum wages, through higher social security for the poorest and the aged, through job training for all who cannot work but who are willing to prepare themselves to work.

The second freedom is the freedom to own a decent home. As I said in the beginning, our people don't ask much. They are not a grasping, selfish, greedy few. The average father and mother are not asking for much when they ask for a job to work at, a roof over the heads of their family, for their children-food for their stomachs and clothes for their body, education for their minds and health for their system; all without discrimination.

That is not much to ask for. That is a great deal to work for. It is a lot that we have yet to get, but we are on our way.

Every mother in this land wants, more than she wants anything else, except for the health of her children, a home of her own. Haven't you found that to be true?

That was true of my mother, that was true of my wife, and that is true of my daughters, and I have had some experience with women.

Two weeks ago, with Secretary Weaver, over in front of that magnificent new housing building that houses the new Housing and Urban Development Department, I signed, in the presence of 5,000 citizens, a bill that every person in this country ought to know about.

There are more sensational things happening every day though, and there are more controversies raging and they get more attention sometimes. But this is the most far-reaching housing bill ever passed by any Congress in almost 200 years.

It will help us build in the next 3 years and help you get in the next 3 years, if you don't already have a home, as many decent homes for the poor as we have built in the previous 10 years put together.

The third freedom that I want to talk about, besides jobs and homes, is the freedom for every boy and girl born in America, of whatever race and creed or religion or section, to have a chance to get all the education that he or she can absorb.

That freedom of education is today being secured in the classrooms and the schools all across our country.

At this moment, for example, over one million young men and young women-black and white--are being helped through college by some kind of Federal loan, grant, or scholarship that we have passed and put on the statute books in the last few years under a program known sometimes as the Great Society. That is more than one out of every five young men and women in college in this entire country.

The fourth new freedom is freedom from discrimination. Three landmark civil rights laws have been passed in the last 5 years. Today the injustice of American life--in voting, in accommodations, in jobs, in housing-is diminishing every day. And one good day, in the not too distant future, the ancient stain of injustice is going to be banished from our beloved land forever.

A good job, a decent home, a good education, and justice for all--these are the new freedoms that we are working for today, that President Roosevelt eloquently referred to in his time. They are four spokes of a great wheel.

And the fifth spoke, the great freedom, is the right of every American to as healthy a life as modern medicine can provide.

Now, this is a field where you men and women of the National Medical Association have a very special expertise. The past 5 years have been a time of quiet, sometimes unnoticed, progress toward the defeat of illness.

The Federal Government has more than doubled its annual health investment under this administration--to the point where today we are spending $16 billion a year on health. When I went to Washington we were spending $5 billion on the entire Federal budget. But that investment is paying all of us rich dividends.

By virtually every yardstick, we are a much healthier people today than we were a generation ago--or than we were 10 years ago--or than we were 5 years ago. Now here are some of the facts:

--In the last 20 years life expectancy for the average American has already increased 7 years. How can we put a value on that? How much does it mean for the average person to live 7 years longer?

--In just a few years, mass vaccination programs have completely wiped out polio and dramatically reduced the danger caused by measles.

--In the past 5 years, the infant death rate has been cut by 13 percent. Today as I speak to you, with your help and with the help of all good Americans, we are at a record low in the history of the United States of America; 12,400 babies will live this year who would have died when I came into office in 1963. One out of every two infants who would have died in 1940--one out of every two that would have died-will live today.

--Because of new drugs and because of new treatment techniques, 80,000 fewer mental patients are today confined to hospitals than 5 years ago.

--In just 1 year--1967--we witnessed three spectacular medical breakthroughs: Life was created in a California test tube. A Minnesota-trained doctor who studied in the federally sponsored NIH [National Institutes of Health] performed the first heart transplant. A new vaccine was developed that can completely eliminate measles. Now these are some of the remarkable achievements that you have made, that the American people have made. Each gain and each statistic, somehow, seems to me to represent a personal victory for all of us--because a citizen who is restored to useful work or a child who is saved from premature death or a breadwinner rescued from disability-that is a worthy job for all of us to participate in.

And equally important, each statistic represents a gain for your country, a break in the old cycle which always destined the poor to be sick and always destined the sick to be poor.

But my friends, the largest breakthrough of all, the greatest triumph of our time can be summed up in one short, sweet, little word: Medicare.

We prayed for it. We sang for it. We talked for it. But now we finally got around to passing it and putting it into effect.

Some argued that it would never work. Some predicted that medicine in this country would be regimented and ruined. Do you remember those voices?

I remember one particular critic who said that on the first day of Medicare, "A line of patients will stretch all the way from Chicago to Kansas City."

But these prophets of doom about Medicare were just as wrong as they were about social security.

I want to give you some of these facts about Medicare. They speak of its success as we begin the third year.

--Twenty million of our best Americans are right now protected by that program. That means 20 million happy grandpas and grandmas as well as 20 million happy sons-in-law.

--$8 billion 400 million has been paid out in hospital and medical services.

--200,000 doctors, 120 insurance organizations, and 7,000 hospitals are all involved in this gigantic venture.

--And they are all providing medical treatment to all citizens of all races.

So Medicare is working its wonders. It is saving lives. It is replacing fear and anguish with confidence and with serenity. And our older citizens are now getting medical care, not as charity cases any more, not on hand-outs from their sons-in-law, but as insured, equal patients. In short, Medicare is an expression of fundamental humanity. In short, Medicare is a triumph of rightness. Now, we must seek new ways to improve and to expand medical care.

I had a friend who came over from a rural section of this area of the United States, not from this State. He was riding around with me about sunset a few days ago. He said, "Mr. President, the most wonderful thing that we have done in this whole country in all my lifetime is Medicare.

"But," he said, "I want to beg of you and plead of you, as the leader of our Nation, please ask all of our people not to let it become a racket, because it is too good a thing to be abused." It is too good a thing to chisel. It is too good a thing to bring in scandal and disgrace. It is too good a thing to fudge on.

So I appeal to you good doctors, and your wives, and to your nurses, and to the hospitals, and to the insurance organizations-tell it as it is.

Now, we just must make it more efficient. There is no room for waste in Medicare. Last March I asked Congress to let us put into practice the results of our experiments to provide incentives for efficiency. But that was last March and nothing has happened since. That bill is still stalled in the Congress.

I urged Congress to act on this vital measure last March. And I urge it again today to act as soon as it returns from the political conventions.

Second, I came here this afternoon, not only to see these happy and smiling and trusting faces, but I came here because I wanted your help for this good program. I want you to try to help us reduce its rising costs.

So, I appeal to the entire medical profession in this country to exercise restraint in their fees and in their charges. Doctors, hospital administrators, and insurance carriers all know that demand for medical services is going up. And they all know that, while the demand is going up, the supply for medical services is going down.

This pressure--when demand exceeds supply--always results in higher costs. And this trend must be stopped if we are to save every insured American under Medicare in this country.

Now mainly, because we have seen that Medicare for the elderly is a success, we must now turn our thoughts to another important group of Americans who greatly need our help.

Today in this prosperous land, in this year of our Lord 1968, there are children, little children, who never see a doctor. There are children who are crippled for life by diseases that could be prevented. That is almost a national scandal. We do have the power to prevent it.

If I had my wish today, I would want every mother, as soon as she realized that she is to be a mother, to have the chance to have a good professional doctor advise her and examine her and to provide her with counsel and prenatal care from that first day, until that little one is 1 year old.

Hundreds of thousands of lives would be saved, not only the child who is lost at childbirth or crippled at childbirth or handicapped at childbirth or the mother's life that is lost, but the lives of those who must go along and wait on them all of their lifetime. It is absolutely disgraceful that the richest nation in the world, the most powerful nation in the world, would rank 15th in infant mortality. That is a statistic we want to do away with.

Now, you can call this plan that I proposed to the Congress and that I am going to propose to the people in the years ahead even more often--you can call it by whatever name you wish. Some call it Medicare, some . call it children's aid, and some call it "kiddiecare," but I know what you know and that is the richest, most powerful nation in the world ought to see that every child born into it is born as healthy as medical science will permit. And we know that it is not happening now, don't we?

Now, you think that your President doesn't know what is going on in this country. You have heard me talk about some of the good things. I think it is necessary in this day and time when all we read about and all we see and about all we can get published is some criticism or something sensational.

I think it is good that we lay a predicate and a foundation to show that we do have the capacity to move. And even though they charge us with saying that you have never had it so good, I think it is important that we do point out that we have had it good in a good many fields. That is the reason for laying a predicate to show what our goals must be in the future and the big job that is still ahead.

Winston Churchill, the great Prime Minister of Great Britain, has this story told about him which I often use and--if you haven't heard it many times--I want to repeat it to you again today.

In the dark, trying days of the last of World War II, a little lady who had very good intentions, who was leading a temperance group movement brought her committee in to call upon the Prime Minister to complain about the Prime Minister's drinking habits.

She said, "Mr. Prime Minister, I am told that if all the brandy and the alcohol that you have drunk during World War II could be poured in this room now it would come up to about here." It was a pretty big room, too.

The Prime Minister thoughtfully looked at the floor and then he looked at the ceiling and then he said, "My dear little lady, so little have I done, so much I have yet to do."

So, as we meet here on this glorious day in August, we can all summarize what I have said these first few minutes by pointing out, so little have we had a chance to do, but so much we have yet to do.

Now, what are some of the things we have yet to do? It is true that the life span of Americans has been dramatically increased for both whites and blacks, but this is something we have yet to do. I want you to remember this: A Negro, on the average, dies nearly 7 years earlier than his white fellow citizen. That is not right.

It is true that infant mortality of which I just spoke has been sharply reduced in our country, but it is still not as low as it should be for either black or white babies.

In 1965, as I told you, America ranked 15th in infant mortality among the most advanced nations of the world. A Negro baby is still twice as likely to die in his first year as a white baby. That is not right.

It is true that good health care is more widely available than has ever been before in America. And you know that, don't you? But do you know that a Negro child is 10 times more likely than a white child to be born away from the safety of a hospital? That is 10 to 1.

It is true that we are fast conquering the killer diseases--for both black and white. But how much we have yet to do. TB, pneumonia, strokes, and other diseases are twice as likely to kill blacks as they are to kill whites. I wonder why.

Now, what must you and I do if we really mean what we say when we say we want to guarantee every American his right to decent health care?

Well, first, we must nourish and expand the programs that we have already begun-the programs which offer hope for ending discrimination and disability, disease and needless death in America. Then we must continue to build and develop and to secure the four freedoms that I talked about-jobs, health, education, and freedom from discrimination.

Second, if we are to make decent health care a reality for all Americans, we must have the manpower to do it.

Dollars, dollars, dollars everywhere, like water, water everywhere, but not a drop to drink. Dollars--even the most generous appropriations-are useless unless we have the human imagination and the strength and the energy to use them.

American citizens--especially black citizens-need health care--more and better health care. That just means one thing, my fellow citizens, that means more doctors, more nurses, and more trained health aides. That means more of them have to go to school and the universities have to graduate more.

Consider this fact: Among white citizens one American in 670 becomes a doctor, but among Negroes one in 670? No, one in 5,000.

So if we are going to have whites taking care of whites and blacks taking care of blacks, one white doctor can take care of 670, but one black doctor has to take care of 5,000. That just is not right. That is a tragedy. That is a complete, absolute indictment of our entire educational system and I am going to say so here today.

We must recruit more talented Negro students for the medical professions. We must assist more institutions to educate more Negro doctors, Negro dentists, Negro nurses, and Negro technicians.

We must persuade American universities to stretch and expand their resources to give special attention to training Negroes to take their rightful place in the health professions.

I hope the National Medical Association will put this matter high on its agenda for the coming year--and for the years ahead.

There is a model of a housing project that we have conceived and dreamed of and talked about in the Cabinet Room of the White House with Dr. Swan and others.

I want to conclude and just summarize some of the things that we have yet to do and some of the things that we have done.

in 1960, we had a little over 300,000 Negroes in professional and technical jobs. This year we have about 600,000. We have doubled it.

In 1962, the year before I became President, we had 13 percent of the Negro families who were earning $8,000 a year or more. I had not met many of them, but they claimed they had. They were in other sections, I am sure. Last year the percentage was not 13 percent, but it had already more than doubled to 27 percent. If you take the South out of it you can have an extra 10 points and say 37 percent.

In 1960, 36 percent of the Negro men graduated from high school. Today more than 60 percent are graduating. And it is still going up like that.

In 1964, the first poverty law was passed by the Congress. We had talked about it. We had written about it. And we had campaigned about it. But in the past 2 years, more Negroes have risen above poverty than in all the previous 6 years combined.

In 1965, 46 percent of the nonwhites were below the poverty line. Well, this was reduced 11 percentage points in the past 2 years. Today we are moving out of poverty in the Negro groups--more than 1 million per year.

So little have we done--so much yet have we to do.

I met the other night with the Negro lawyers of this Nation, the great ones. I was introduced by a member of the Washington City Council. I don't want to get into politics, but he is a Republican member of the Washington City Council. I had appointed him to that City Council. I had to appoint some Republicans. We have a system where both parties--you know--must have representatives.

Those lawyers had not summarized lately what we had done together. But Mr. Thompson made a reference to it, as Dr. Swan did today. It is something I am very proud of. It is something that I hope you know about. It is something that you can be very proud of, too.

The first mayor of any major city in America, a Negro mayor of the National Capital, Washington, D.C., is Mr. Walter Washington. He honors us with his presence today. The capital of the free world, the Capital of the United States not only has a Negro mayor, but it has a majority of Negro councilmen on that City Council.

In the last few years conditions have been such that we named the first Negro lady to be an ambassador to represent the president abroad.

Yesterday we swore in the first Negro lady to be a high official in the State Department, Miss Barbara Watson. She was sworn in by her Negro brother, her black brother, a judge whom we also appointed. And we have appointed more black judges than all of the other 35 Presidents put together.

We put the first Negro in the history of this country on the Federal Reserve Board.

We put the first Negro in the history of this country in the "Little Cabinet." We put the first black man in the history of this country in the "Big Cabinet."

We put the first black man in the history of this country on the Supreme Court.

Now, we are not entitled to any special credit for all of these things. I could go on all afternoon discussing firsts with you. But it is some indication, I think, that we are moving.

We have a lot of trouble among us. I was reading the other night about the dozens and the hundreds who were killed in New York City--shot down on the streets 100 years ago in another turbulent period.

For the first time I really realized and had it brought home to me again that as you emerge and as you make progress, as you open the wounds and the sores out to the sunlight here and the wind goes against it, the tender spots break out. Seeking freedom is not always a pleasant task.

I hope that we will make it so in this country that we don't have to violate laws and we don't have to be guilty of breaking the peace and we don't have to endanger health and life for us to get justice.

Because no man--not even the President-has the right to say what law he will abide by or what law he will not abide by in this country. But every law ought to be fair and equal for everybody--from the President to the street sweeper or vice versa.

We are marching and moving and going in that direction.

So, to you men who are more fortunate than most of your fellow black men, and you women, too, you doctors, as I said to the lawyers the other night, you must be your brother's keeper. You must provide the leadership. You must provide the brain and the vision and the courage and you may have to pitch in a few dollars now and then to do it.

Because the time is not far away when we are going to make sure that every boy and girl born into this land has a chance to start life with good health; that when he becomes old enough to work he will have a chance to get a good job; that he will have an opportunity to own a good home and that he have all of these things--jobs, health, education, and homes--without discrimination, without regard to what section he lives in, without regard to what the color of his skin is, and without regard to how he worships his God.

Thank you and goodby.