Address at the Dinner of the National Fund for Medical Education.

Mr. Chairman, President Hoover, Mr. Sloan, Cardinal Spellman, Bishop Donegan, Ladies and Gentlemen of this distinguished gathering:

I hope you will permit me one word of explanation to a part of the audience, the doctors here present. Having only today received the distinction of being named an honorary member of the College of Surgeons, I want to explain to the colleagues of my newest profession, out of deference to the great number of laymen present, I shall not talk technically or professionally.

I am here this evening in fulfillment of a promise I made last summer to speak for the National Fund for Medical Education. I wanted to come here to this meeting because I so earnestly believe in the serious causes to which the Medical Fund is dedicated, and the importance of private support of the effort.

There are many other serious causes in the minds of our fellow citizens tonight. They are also very much in my mind and heart. I should have liked, under other circumstances, to discuss them with you.

They include such things as the continuing endeavor and progress of our people in fields of scientific achievement--and methods of attaining even greater achievements, our responsibilities and our opportunities abroad, the strength and great capacity of our domestic economy, the character and power of our defense programs, the right of our people to confidence in these strengths--these are some of the subjects about which, during the ensuing weeks, I shall seek opportunities to talk with the American people, telling them of my beliefs and my determinations in these matters. I have unshakable faith in the capacity of informed, free citizens to solve every problem involved.

If in those talks I may be able to set out in proper perspective the truth and facts in these matters, no time consumed will be too much, no personal inconvenience will have any weight.

In coming to New York tonight to speak to those who share my interest in the National Fund for Medical Education, I feel something like a traveler returning home.

For it was while at Columbia University that I was privileged in 1948 to join many other citizens, some present here tonight, in beginning the organization of the National Fund. I recall the deep interest we then felt in establishing a national mechanism which, in the American way of voluntary citizen effort, could help to strengthen education in the medical schools of the United States.

We were aware of and stirred by our country's critical need for more trained physicians. We were equally aware of the dangers to our form of government that would grow out of citizen neglect of that need in any misguided attempt to leave its satisfaction wholly to government.

And so this evening, my friends, my talk will concern itself mainly with that phase of the work which presents responsibility and opportunity to the private citizen, including in the term "private citizen" also our corporations.

I can also recall, when there was extended to our guest of honor, Mr. Sloan, an invitation to become one of the first permanent trustees of the National Fund, the unhesitating and positive "yes" of his acceptance.

So it is a satisfaction to have a part tonight in recognizing the leadership which Mr. Sloan, trained and experienced in industry, brought to philanthropy. He was among those pioneers who believed, far back, that the corporations of America derive from our colleges, our technical institutes, and our medical schools, a benefit which is ample to sustain--if not oblige--contributions toward their continued and effective service to the American people.

Mr. Sloan has received tonight the Lahey Memorial Award for "outstanding leadership in medical education by a layman." I am sure that in Mr. Sloan's case the Award was voted by acclamation. Certainly it is unanimously approved by the members of this audience.

The wise philosophy of corporate support for higher education has flourished in the last decade. In 1948 corporation contributions to education of all sorts were below 25 million dollars. In the year 1956, they exceeded 100 million dollars.

The American corporation is showing increasingly that it is a good citizen. Industry is accepting the support of higher learning as the normal responsibility of a successful business, because it senses a fundamental truth, too long veiled: that, by contributions to the strengthening of our educational resources, each giving corporation makes a sound investment in its own as well as in our nation's future.

Few investments of this kind could be more worth while than in medical education.

From our medical teaching institutions come every year the future guardians of our people's physical and mental health. A healthy citizenry is the first defense line of the Republic. A healthy citizenry is capable, in peace-time, of expanding our economy; in times of critical tension, of carrying on without cracking or growing hysterical; in times of conflict, of showing the endurance and stamina upon which victories are built.

The rapid accumulation of new medical knowledge is flooding in like a tide in the Bay of Fundy. There is on all sides a mounting demand for health services by our communities. Under these demands, the medical schools in America today face inherited responsibilities beyond what they are financially able to meet. The medical progress of which we are so justly proud has involved these teaching institutions in a struggle for solvency and survival.

The constantly widening scope and complexity of medical education has, within the space of a few decades, quadrupled the cost of producing a qualified doctor. Tuition now pays but one-fifth of the student's total education cost.

Accordingly, there is--today--a great gap to close; the gap between the ceiling of medical school receipts from all sources and the racing increase in costs of teaching, research, and medical care. But the gap which the United States will face tomorrow will be still wider and deeper.

Our Nation is on the threshold of unprecedented population growth. I am told by the Bureau of the Census that in 1975 just 18 years ahead--it is reasonable to assume that there will be 228 million of us Americans.

These 56 million additional Americans will need a great many more things than we are now able to produce. And no need will be more essential to them than the doctors who care for their health. Our 83 medical schools today are turning out scarcely enough physicians to care for America's present population of 172 million, to safeguard the health of our young men in the Armed Services, and to keep abreast of the forward sweep of medical research and knowledge.

Toward closing today's gap between the annual needs of medical schools and their annual resources, the National Fund for Medical Education has made a start. Its goal from inception has been to fortify and sustain all our existing medical teaching institutions--both those which depend on voluntary support and the other half which receive tax subsidies from the States.

Since 1951, the Fund has provided to our medical schools over 12 million dollars in unrestricted moneys. Each year, as the word has spread, the Fund has received larger gifts from more givers, and has been able to make larger allocations. Recently I learned that a Foundation gave to the Fund ten million dollars for use, on a matching basis, to attract new unrestricted gifts-one added dollar for every new dollar raised by the Fund beyond its present effort. This is great news.

But the total need of America's present medical schools is far above what the National Fund has yet been able to do. Reports are that America's 83 approved schools still require 10 million dollars a year in excess of all present resources to balance their fiscal budgets--and many more dollars to meet their existing academic deficits. Adding to the magnitude of this problem, it is clear that, in the near future--if the United States is to provide enough doctors to meet a population increase of one third by 1975--many new schools of medicine must soon be put into operation.

The question is, how to go about satisfying so great a need?

Of one thing I am sure, this problem of financing medical education must be met as we meet so many other problems: through the leadership of citizens who are aroused to a crucial need and who will arouse others.

The resources are available. Ours is a 440 billion dollar country today. Our incomes, even after taxes, never totalled so great a sum as they now do. The only question is this: will enough citizens become concerned enough? Will enough citizens think a little more deeply about what they do with what they earn? Will they understand what is truly involved?

Certainly there are ways in which government--local, State, and Federal--can properly help. Many states now contribute support to medical schools as integral parts of their State Universities. There are Federal matching funds for certain phases of medical training, research, and construction of research facilities. But historically and, I believe, for our own spiritual and political good, the support of medical education is a mission demanding broad private effort. For government to take over all responsibility in this critical field would signal the onset of a grave infection of our nation's spirit.

I speak of this because all of us can sense a disturbing disposition on the part of many groups throughout our land to seek solutions to their problems from sources outside themselves. Because life today is more complex and interdependent than ever before, we seem, in every difficulty always more ready to lean on government than upon ourselves.

Such an approach to our individual and group problems can never retain the health and vigor of America. Rather we must believe in and practice an approach rounded on individual initiative, individual self-reliance and resourcefulness, individual confidence, and individual volunteer effort. In this role, the American citizen is not a spectator, or a dependent, but he is an active and vigorous participant. And participant he must be if we are to remain a free society.

And my friends, if he is to be an effective participant in this group effort, or any other similar group effort, he must be informed. He must understand. I believe it to be today the gravest duty of every citizen to inform himself on the great problems of our time so that he may contribute properly, not only of his substance but of his spirit, of his intellectual capacity, to their solution. Because our whole form of government depends upon the existence of a trained, informed mass of people giving their collective decision in our great problems, those decisions are not wrong.

In the world conflict between those who believe in the supremacy of the State and those who believe in the supreme worth of man, freedom's victory clearly requires vitality in the individual citizen--and vitality in the voluntary associations in which he chooses to join for common purposes.

Indeed, a definition of human liberty that I like very much is one that came from a Frenchman: "Liberty is nothing but the opportunity for self-discipline." Meaning that liberty gives us the opportunity to perform our group problems by voluntary effort and not through regimentation.

In the Preamble to the Constitution, the Founding Fathers set down a basic purpose "to promote the general welfare." But this phrase did not stand alone. The very next purpose stated is "to secure the blessings of liberty to ourselves and to our posterity." We secure these blessings of liberty when we remain faithful to the concept that ours is a government of limited powers and the accent in our society is on individual freedom and initiative. We are loyal to those principles when we as citizens are active in their service.

Undoubtedly some of the last quarter century growth of the role of the Federal government in our economy has been inescapable. This growth is the result, in part, of depression, wars, and a continuing state of tension in the world. It is the result also of the undeniable need for basic protection against economic forces over which the individual--the farmer, the wage-earner, the retired worker, the housewife has no direct control.

The necessary and constructive use of government, however, must not lead to a doctrinaire and expedient reliance upon government. Freedom's permanent spiritual and intellectual values will always transcend any momentary material advantage resulting from regimentation. Moreover, in determining government's proper role, we must cast aside any morbid pessimism about the capacity of our private enterprise system to generate and maintain high levels of employment, production and incomes.

Indeed, if I may have the privilege of interrupting myself again, I was delighted in the short exchange of our guest of honor, Mr. Sloan, this evening, to hear him say, "Why are people so pessimistic about our economy?" The greatest thing that man has produced. I know that there are a good many people here that served in the war, and I don't believe that there's a single one of them that ever saw a victory won by growing pessimistic and putting your chin on your chest. You have to get it up.

Now, happily, very recent years have seen a distinct shift toward renewed reliance on the initiative and enterprise of a free people. There is today, I earnestly believe, a reviving confidence in our kind of economy--a faith that it can generate jobs and incomes and a rising standard of living for all our people. There is a surging belief that freedom actually works in our generation as it did for those who preceded us.

With this resurgence of our belief in freedom, we have become more critically insistent not only that the necessity and value of governmental activities be clearly demonstrated, but that these activities be conducted at a level as close as possible to the people. Acting on this conviction, an expert task force, representing the Governors' Conference and the Federal Administration, is now at work on some practical steps that can be taken.

Let a way be found to transfer Federal activities to the States-with appropriate tax resources--in fields where Federal intervention has already served its original purpose of enlisting State or local effort, or where the desirability of Federal intervention has never been convincingly established. We are determined to make progress in this direction. You can help make sure that we do.

You can help in another way. You can help reduce or defeat the demands by each of us upon the government. The purpose for which we gather here tonight is an excellent example of the opportunities for citizen leadership. There are dozens more. I see these opportunities constantly as proposals for new or expanded Federal programs are suggested to me. In preparing the budget for 1958, the budget which went to the Congress last January and under which we are now living, there was eliminated over 3 billion dollars' worth of proposals for non-military spending. Many of these ideas had merit. But it was my judgment that they should either be undertaken privately or by other levels of government or in the case of some existing Federal programs--at a slower pace.

Now today, when the costs of defense and of waging peace must be so great, the risks of collecting larger and larger sums through taxation for other governmental activities are especially ominous. It infringes further on the freedom of our people to spend or save out of their incomes as they see fit. While no sensible man should arbitrarily refuse to be convinced in a case where governmental help is truly needed and serves a constructive purpose for the benefit of the nation as a whole, we can and we should insist on cogent proof.

Most of these things I have been saying are obvious--they are self-evident. How many Americans find them so? Too often we are encountering the mischievous idea that all men can be made happy by some men, through government, compelling all other men.

The individual of this type would help others by making himself--or government--the all-wise authority to determine what is good for others and in what measure they should have it, and make of himself, or government, the only means through which they may attain it.

Our great opportunity, it seems to me, can be this: in a complex and dangerous time we can be active members in the great company of the defenders of liberty. It will require much of us; but to us much has been given. We can with confidence believe in the proposition--and act upon it--that free activities of individuals and businesses operating in a competitive environment will lead to the best and steadiest advance in our standard of living.

But a high living standard is only one--and by no means the most important--of the criteria by which our society is to be judged. We who are advocates of freedom must recognize the other criteria--the state of our morality, charity, culture, health, learning, and the law. We must be alive to the impulses of our time and imaginative in meeting the needs generated by these impulses in ways that do not sacrifice our traditional values of personal liberty and initiative.

You who are here tonight have sensed this critical fact. You are moving to meet a vital need of our day in a way which will exercise your faith in freedom and, in so doing you will insure its vigor for another day.

Thank you very much indeed.