TRENDS
By JOHN P. HUBBARD, M.D., Contributing Editor
This and subsequent descriptions of events and trends are intended to be unbiased and factual, pre-senting both sides of controversial matters so that conclusions may be formed from ‘ritical appraisal
of things as they are. These statements do not necessarily reflect the opinion of the writer nor are they to be interpreted as official opinion of the Academy.
EMIC
AGAIN?
I
THERE to be another EMIC program ? This question is heard again in Washington, in various state health departments, in gatherings of interested persons, and amongthose physicians primarily concerned : pediatricians, obstetricians and general
practi-tioners.
It is not our purpose to argue for or against an EMIC rebirth, but rather to report
the status of the proposals which have already appeared, bearing in mind that the scene
may have shifted much or little between the present date (May 28) and the appearance
of this column.
As the tempo of the Korean War and war mobilization increased during the early
months of this year, it was hardly surprising that consideration should again be given
to medical care for the wives and infants of service men. In February there were
in-formal discussions between the Children’s Bureau staff and the AMA. In early March,
the Committee on Maternal and Child Care of the AMA Council on Medical Services
met and discussed the possibility of revival of EMIC. Those attending this meeting
in-cluded Dr. Lull and others from the AMA, Miss Lenroot, Dr. Blain and Dr. Daley from
the Children’s Bureau and Drs. Barba, Webb and Christopherson from the Academy. A
questionnaire to elicit comments on the EMIC had been sent out to District and State
Chairmen of the Academy, to all State Medical Societies, to individual pediatricians and
obstetricians and to others who had been vocal about the old EMIC. In the general
dis-cussion it was brought out that the Child Welfare Committee of the American Legion
had passed a resolution, which was adopted by the Assembly, recommending a revival
of EMIC with modifications to avoid the former difficulties and objections.
Also in early March, when the Executive Committee of the Association of State and
Territorial Health Officers met with the Children’s Bureau in Washington, the
Com-mittee determined at that time that there was not sufficient evidence of need to justify
the support, promotion or introduction of legislation for this purpose. However, it was
thought advisable, because of the difficulties and strained relations incurred by EMIC
during World War II, to review the policies and procedures of administration which
would be required in such a program if legislation of this nature were to be introduced.
Thus, by planning ahead, it was hoped to avoid many of the former irritations which
came from hasty arrangements.
On March 20, Representative Flood of Pennsylvania introduced HR. 3349 which
proposes a program quite different from that in effect during World War II. This bill
provides that the wife of any member of the Armed Forces should be allowed $100 for
the expenses incurred in childbirth, if such expenses are found to constitute an undue
financial hardship. The old EMIC was administered by the Children’s Bureau ; according
TRENDS 151
to the Flood bill payments would be made by the Secretary of the service in which the
husband is serving. Formerly, a flat fee not to exceed $50 was paid to physicians for
ex-penses of childbirth, including delivery, prenatal and postnatal care, and the payment of
hospital expenses ; here an amount of $100 is proposed, payable directly to the wife of
the service man.
On April 2, Senator Humphrey of Minnesota introduced S. 1 245 which would
estab-lish a program similar to the plan in existence during World War II. The Children’s
Bureau would be authorized to make grants to states in accordance with the financial need
of each state, as determined by the administrator. This bill does not attempt to establish
fees for physicians or rates of payment to hospitals, such matters being left to the
judge-ment of the administrator in the writing of regulations. In the Humphrey bill it is
pro-posed that the wives and children of all enlisted members of the Armed Forces would
be eligible to receive benefits, whereas the old EMIC plan gave benefits only to the
de-pendents of enlisted personnel in the lowest four pay-grades.
At the state level, at least one state has gone on record for an EMIC program. At
the time Senator Humphrey introduced S. 1245, his fellow Minnesotan, Senator Thye,
filed a joint resolution of his state legislature requesting “immediate” enactment of
EMIC legislation to relieve “suffering and hardship (that) has been experienced by
pregnant wives . . . owing to the absence of their husbands from home.”
On April 4, a special conference was called by the Children’s Bureau for the purpose
of discussing ideas as to how EMIC should be developed if pressure for it gathers
momentum. This meeting was attended by representatives of the AMA and the Academy
and included also others from the ranks of the pediatricians and obstetricians. One of the
suggestions which arose from this conference was that the medical profession have a
more prominent role in the administration of the plan than existed under the old EMIC.
The Children’s Bureau concurred in this suggestion, stating: “It was recognized that
ad-visory consultation with medical and hospital groups would be particularly important.”
The present attitude of the AMA is reported in a Bulletin dated May 1, 195 1, from
the Washington office which states “At its most recent meeting, A.M.A.’s Board of
Trustees and Legislative Committee voted to oppose both bills (H.R. 3349 and S. 1245),
a major contention being that they are not necessary at this time. In commenting upon
the attitude of the A.M.A. Committee on Maternal and Child Care, Dr. Lull, in his
Secretary’s Letter of April 30, states that “Committee Chairman W. L. Crawford says
he believes the evidence at hand so far indicates that no wide spread emergency exists at
the present time for setting up a special maternal and infant care program for wives and
dependents of service men. He adds that as nearly as the committee can determine, there
have been only a few requests or pressures for a nationwide reenactment of such a
program. The few requests that have been received usually can be traced to individual
instances arising near military installations where the influx of service men and their
families has resulted in abnormal conditions. Special considerations and planning, Dr.
Crawford believes, will have to be given to these particular areas.”
152 JOHN P. HUBBARD
health bills of national significance. Covering as it would only the wives and infants of
men in uniform, this legislation when whipped satisfactorily into shape may be expected
to be justified and passed as an essential cog in strengthening and development of the
military services.”
A more recent development was the introduction into the House of a bill (H.R. 4176),
identical to the Senate bill (S. 1 245
)
. This House bill was introduced by RepresentativeMitchell on May 21. An interesting note was the fact that it was not referred to the
House Interstate and Foreign Commerce Committee, to which health bills are generally
referred, but it was sent to the Armed Services Committee. This action links the measure
