TASK FORCE REPORT ON 
Federal Medical 
Services 
Supplement to 
[ Appendix O ] 
PREPARED FOR 
THE COMMISSION ON ORGANIZATION 
OF THE EXECUTIVE BRANCH 
OF THE GOVERNMENT 
March 1949 Federal Medical Services 
A REPORT WITH RECOMMENDATIONS 
PREPARED FOR 
THE COMMISSION ON ORGANIZATION OF THE 
EXECUTIVE BRANCH OF THE GOVERNMENT 
by 
The Chairman of the Committee on Federal Medical Services 
Acting for the Committee For sale by the Superintendent of Documents, U. S. Government Printing Office, Washington 25, D. C. 
Price 10 cents (paper) Letter of Transmittal 
Washington, D. C. 
5 March, 1949. 
Dear Sirs: In accordance with Public Law 162, approved July 7, 
194T, the Commission on Organization of the Executive Branch of 
the Government submits to the Congress herewith a supplemental 
report on the Medical Services of the Federal Government. 
The Commission's own report on Federal Medical Services is sub- 
mitted to the Congress separately. 
Faithfully, 
C hairman. 
The Honorable 
The President of the Senate. 
The Honorable 
The Speaker of the House of Representatives. Supplemental Report on 
AN INDEPENDENT MEDICAL AGENCY 
Proposal to set up a United Medical Service organization 
as an independent administration reporting to the Presi- 
dent, instead of as a bureau of a department of health, 
education and security. 
As our committee had been instructed to assume that any consoli- 
dated health organization would be a part of a new cabinet-level 
department embracing health, education and security, which the 
Commission would recommend, our main report contained on page I 
the following statement: “The above instructions excluded from our 
consideration the question as to whether a separate cabinet department 
would be established for health alone, as urged by professional groups. 
However, should this be done, the organization which we are pro- 
posing would be adapted to such plan with only a few changes in 
nomenclature.” 
Thus, we answered in the affirmative the question as to whether the 
organization, which we originally designated as the National Bureau 
of Health, could function as an independent department or agency. 
It remains to consider whether such an alternative would be pref- 
erable. This question has been fully considered by our committee, 
and we have reached the conclusion that such an independent organi- 
zation would be preferable to placing this function in a larger depart- 
ment, as the Commission originally proposed. 
In favoring this, we recognize that such an organization would 
create some additional problems. For example, the administration of 
health and welfare require close coordination in certain areas. Their 
separation would require an adjustment of the dual functions of the 
Children’s Bureau and of the Office of Vocational Rehabilitation. 
These, however, can be solved without undue difficulty. 
The advantages of an independent agency are: 
a. The health agency, if submerged within a multipurpose depart- 
ment, would be more likely to find its health functions impeded by 
collateral considerations pertaining to welfare and insurance. 
b. Appropriations for health should, if possible, be clearly identified 
as such and not confused with those for social security, welfare or other 
social programs. 
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826986—i9 c. Other departments, such as the armed forces, using the medical 
service agency would be concerned only with its health functions as 
such and would thus be protected from any collateral and irrelevant 
considerations having to do with welfare, social security, etc. 
d. The special personnel policies which we have recommended in 
our main report (sec. XI) could be established with much greater 
freedom and better success for an independent agency than they could 
be for one of three bureaus standing side by side in a single depart- 
ment. The new plan would, therefore, greatly facilitate obtaining 
personnel of the highest quality for the key positions. Under the 
previous plan, this was a problem which occasioned serious concern 
in our minds because of the contrast between the great responsibilities 
of the director general and the heads of his three main divisions (espe- 
cially the Medical Care Division) and the relatively limited govern- 
mental position and pay of the head of a Bureau and the chiefs of its 
subordinate divisions. We believe, therefore, that the new proposal 
would go far to solve this problem which we regard as the most serious 
affecting the original plan. 
e. The head of such an independent agency should be assisted by an 
advisory committee, representing the several departments and agencies 
which would be the principal users of medical services, such as the 
Medical Departments of the Army, Navy, and Air Force, the new 
proposed Department of Welfare, and the Veterans’ Administration. 
With the agency independent, it would be more flexible to adapt its 
services, with the assistance of such advisory committee, to the needs 
of the several interested departments and agencies in its medical care 
facilities, in the training and staffing of professional and technical 
personnel, in its public health functions, and in other ways. 
In considering the establishment of such an independent health 
agency, our committee again calls attention to a most important con- 
sideration pointed out in chapter III (p. 26) of our main report. 
The agency should be headed by a professional career director general. 
Under the new plan he should report directly to the President, and 
should, in the nonmilitary Federal medical organization, be the high- 
est ranking physician in the Government. The supreme medical im- 
portance of the position of the Director General should command, 
irrespective of all other considerations, the ablest medical and health 
administrator whose services can be obtained by the Government. 
For these reasons, the committee views the present proposal for an 
independent organization as a significant improvement over the pre- 
viously submitted plan. 
For the Medical Services Committee: 
Tracy S. Voorhees, 
Chairman. 
February 8, 1949. 
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