Remarks in Response to the Report of the National Commission on Community Health Services.

Mr. Folsom, Secretary Gardner and distinguished members of the Committee, ladies and gentlemen:

I welcome you--and I welcome your report, whose purpose is the same as mine: that is, to make good health for every citizen not only our Nation's promise but its possession.

I am particularly indebted to you, Secretary Folsom, for your fine contributions to public service in this country. You have always been available, you have always been willing, and you have always been constructive in your work for the people of this Nation.

I would like to say to you, and through you to the members of your commission, that you have performed a vital and a needed service in serving on this National Commission on Community Health Services. While I can assure you we will not embrace all your recommendations and we will not fund them all immediately, they are exciting, they do face up to the problems that we must in time face up to, and, as a matter of fact, as you spoke you were discussing some that I had been going over this morning with some of my counselors here in the Federal Government.

Yesterday our Consumer Price Index was up, and one reason it was up was because of the increase in services. One of the increases in services was in our medical costs, and one of our medical costs was in our hospital costs. One of our hospital costs is that, traditionally, people who serve us in our hospitals get pretty low wages, and when the labor market tightens up, employment gets scarce. Why, they either leave the hospital and go to something else--and it is very difficult to replace them. You have to replace them with higher wages--so that gets into extra costs.

Now, there's not anything you can really do about reducing expenditures that will change that situation much. A tax bill won't even change that situation much. A control bill won't change that situation much. So any of the alternatives we have, really doesn't get at that.

What it actually means is that we are going to have to have more people trained in this field and we are going to have to have more facilities in this field, and there are just more people using these fields.

We have more medicine and better medicine; we have more hospitals and better hospitals; we have more health care and better health care--but we don't have enough.

And our goal is up there--it's got to be. We've got to keep our eyes on the stars and our feet on the ground, and it's pretty hard to do that and still keep your equilibrium around here.

Some people want us to go further faster.

Our budget this year is $113 billion; our budget last year was $99 billion--that's a rather substantial increase. Some of it is Vietnam, but in the 2 1/2 years since I became President, our appropriations for education have gone from 4.75 billion--and you have been greatly interested in this field-from 4 and 3 quarters billion to 10 billion 200 million. Now that is more than double in 2 years.

It took us a long time to ever get $4 billion-when President Kennedy took over it was about $1 billion. And then we got up to 4 billion plus, and now we've got it from 4 to 10. That's a pretty big jump.

Now, some people think that jumped pretty fast, that we don't have the trained personnel, we don't have the proper organization. We don't have the--Secretary Gardner has had to do a lot of reshuffling, reworking, reorganizing, to get people that can handle that much money and handle it wisely and plan it wisely and get a dollar's worth of value out of a dollar spent.

In the field of health we were spending about $5 billion a year when I became President 2 1/2 years ago. This year we will have over 10, so we've doubled it in a little over 2 years.

In education we've doubled it; in health we've doubled it. We'll spend over $10 billion more this year in health and education-just two items--than we did when I became President 2 1/2 years ago.

So--and poverty--we were spending none, classified as such. Now this year our appropriation will be almost $2 billion in those fields. So when you add that on to education, health, and so forth, you get in excess of a $10 billion figure.

Now all of those things are going to have to be added to, are going to have to be improved, are going to have to be enlarged, as the years go on. And we have the resources to do it. We must be sure that we do it in the right way, with the proper personnel, with the proper planning, with the proper management, with the proper standards, with the proper relationship between the Federal and the State and the local units.

Now we're trying to do that. I spent a long time yesterday trying to work on a commission of scholars and elected officials and others to get this relationship thing straightened out. I spent a good deal of my day working with Secretary Gardner and others on trying to get the personnel of these things straightened out.

And the very things that you talk about in your report must become a part of our goal for the years to come.

But I don't want to suffer any illusions that we are going to realize them all immediately, because it's going to take time and we're going to have to prepare the way. We must learn to walk before we run.

Now, we have entered an age in which these miracles are commonplace. Already our doctors are doing unthinkable things. You're reading about it on the ticker--I just went to check before I walked in here-about the very unusual thing that happened down in Houston yesterday. Our doctors are probing the interior of arteries with tiny lights and cameras.

Through electronic sensors in an astronaut's couch, scientists can monitor the physical condition of space explorers. And a waiting-room chair may soon report a patient's pulse and blood pressure before he enters a doctor's office. (My fellow gets mine before I get out of bed every morning, but I'm sure that he will welcome the day when he can get it in the reception room instead of having to come in there.)

But as I said, less than 24 hours ago in an operating room in Houston, Dr. DeBakey and others had a dramatic breakthrough-a surgeon implanted an electrically-powered artificial heart in a human patient.

All this knowledge would profit us little, though, unless we use it for the good of every citizen in every community. Our age, rich as it is with miracles, is still an age where too many families must travel too far and pay too much to receive treatment. Our health services are not organized to get the full benefit of our health manpower. We are trying to do that, as I told you, with our Commission--and under the dynamic leadership of one of the ablest Cabinet officers to ever serve in this town, Dr. Gardner.

The responsibility for providing the best services in every community can't be met just here in Washington, though. It is going to take time and talent; it is going to take State leaders; it is going to take community leaders; it is going to take neighborhood leaders. And how we can coordinate all this leadership and keep them working together in a consensus, so to speak, is a problem we still have.

Now, you have taken the leadership of this Committee and you have produced a report, and you have agreed. And I welcome it and I thank you.

You have concentrated not so much on just Federal efforts but on the whole broad range--State and community planning.

You have underscored an important national goal, and that is to make health available to all the people. I am sufficiently progressive that I want to see it made available to all the people of the world--not just here. I want to set an example here that they can emulate elsewhere. I think that we have made great progress. In HEW alone, our health expenditures have grown from less than $1 billion in 1961 to a billion 4 in 1963; up to 6.9 for 1967. Now, that's 8 times as much in only 6 years. And when we bring our Medicare in there, and so forth, you can see we run over the 10 billion figure.

Your report makes an important contribution to our efforts and I can assure you that we will study it carefully. We won't agree with you on all the 98 major recommendations, we won't get them implemented, even in our time allotted us. We can make a drastic mistake by going too far too fast without proper preparation.

I am trying to pull all these things together, and I can guarantee you, and through you, your Committee, that these recommendations are going to receive the "carefullest study," as Secretary Hull used to say--the most serious consideration. And I trust that a great many of them will be implemented and funded and that the citizens for whom they were prepared will reap the rich result for which they were intended.

I don't think you men know--and I want this ceremony to emphasize it again--just how very much your contribution of your time and your prestige and your effort to studies of this kind means to your President and to your country.

We have made revolutionary advances in this country in many fields in a matter of months--30 months: in conservation, in food production and distribution, in medicine, in health, in hospitals, in education-in all these things. And almost without exception they have been the results of task forces, they have been the results of studies, they have been the results of commissions, where men and women who made up this effort have outlined a long-range plan in a democratic way for their fellow citizens. And it has relieved my burden immeasurably.

And I am so happy that the President of this country can still call on any citizen in this country, Republican or Democrat--particularly Republicans, because Democrats may want to be postmasters (we have a leverage over them)--but call on men to come in here and serve not their party but serve their country. And whatever is good for their country is really good for their party and for themselves in the final analysis.

So one of the greatest rewards that comes to me, and one of the most satisfying things that comes to a President, is the knowledge that men like you and those associated with you in this endeavor would spend the midnight oil that you spent trying to find better health for all the people of this land.

Thank you.