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Clark, Hon. Dick, a U.S. Senator from the State of Iowa---

Van Hoek, Robert, M.D., Acting Administrator, Health Services Adminis-

tration, DHEW; accompanied by Kenneth M. Endicott, M.D., Adminis-

trator, Health Resources Administration, DHEW; Edward D. Martin,

M.D., associate director, Bureau of Community Health Services, Health

Services Administration. DHEW; and David A. Kindig, M.D., Deputy

Director, Bureau of Health Manpower, Health Resources Administra-

tion, DHEW, a panel_----

Randolph, Hon. Jennings, a U.S. Senator from the State of West Virginia__

Van Guider, John, M.D., resident, West Virginia University Medical

Center, accompanied by Ronnie Burke, Ph. D., Glenville State College;

Rev. Richard Bowyer, chairman, West Virginia Committee for the

Health Security Act; and Jean Nutter, Doddridge County Office on

aging, a panel_---

Walsh, Jack, supervisor, San Diego County, Calif., on behalf of the Na-

tional Association of Counties; Sister Mary Margaret Pignone, Na-

tional Catholic Rural Life Conference; William E. Murray, National

Rural Electric Cooperative Association; Richard J. Margolis, Rural

America, Inc.; Stephen C. Caulfield, assistant director, regional opera-

tions, United Mine Workers of America Health and Retiremrent Funds;

accompanied by Lorin E. Kerr, M.D., director, Department of Occupa-

tional Health, Unitied Mine Workers of America; Ruth Kobell, National

Farmers Union, a panel..

Fenstermaker, Carl, Assistant Director, General Accounting Office ( accom-

panied by Frank Etze, General Accounting Office, and Donald M. Mc-

Cartney, Consad, Inc---

Van Gilder, John, M.D., resident, West Virginia University Medical Center; accompanied by Ronnie Burke, PH.D., Glenville State College; Rev. Richard Bowyer, chairman, West Virginia Committee for the Health Security Act; and Jean Nutter, Doddridge County Office on Aging, a panel.

Biographical sketches of__

Van Hoek, Robert, M.D., Acting Administrator, Health Services Administration, DHEW; accompanied by Kenneth M. Endicott, M.D., Administrator, Health Resources Administration, DHEW; Edward D. Martin, M.D., Associate Director, Bureau of Community Health Services, Health Services Administration. DHEW; and David A. Kindig, M.D., Deputy Director, Bureau of Health Manpower, Health Resources Administration, DHEW, a panel--

Prepared statement.

Walsh, Jack, supervisor, San Diego County, Calif., on behalf of the National Association of Counties; Sister Mary Margaret Pignone, National Catholic Rural Life Conference; William E. Murray, National Rural Electric Cooperative Association; Richard J. Margolis, Rural America, Inc.; Stephen C. Caulfield, assistant director, regional operations, United Mine Workers of America Health and Retirement Funds; accompanied by Lorin E. Kerr, M.D., director, Department of Occupational Health, United Mine Workers of America; Ruth Kobell, National Farmers Union, a panel__

Prepared statement---

West Virginia Committee for the Health Security Act, Rev. Richard Bowyer, chairman, prepared statement__

ADDITIONAL INFORMATION

Articles, publications, etc. :

Health Care Conditions Called Deplorable in State, by Margot L. Willis, from the Times-West Virginian, April 25, 1975__.

Rural Health Program, by George Vranesh, developed by the United Mine Workers of America___.

APPENDIX

"Health Care Financing in Rural America," by Beverlee A. Myers, deputy commissioner, First National Conference on Rural America, April 15,

1975

"Health Needs and Services of the Rural Poor," by Milton I. Roemer, professor of public health, University of California at Los Angeles_-_. "Health Sevices and Rural America," from the Rural Housing Alliance and Rural America, Inc., published for First National Conference on Rural America, March 1975__.

Kennedy, Hon. Edward M., chairman, Subcommittee on Health, and Hon. Dick Clark, chairman, Subcommittee on Rural Development, from Charles L. Frazier, director, Washington staff, National Farmers Organization, Washington, D.C., July 31, 1975, communication of.. "Meeting the Needs of Rural People for Health and Medical Care," by Prof. Rashi Fein, Harvard Medical School, Boston, Mass., April 15, 1975_ "Notes on the Health of Rural America," by Richard J. Margolis, from the Rural Housing Alliance and Rural America, Inc_-_

"Rural Health and Medical Care: Health Personnel," by Milton I. Roemer, M.D., professor of Health Services Administration, UCLA School of Public Health___

"Rural Health and Medical Care-How Did We Get Here With Some Brief Comments on How We Get Out," from the First National Conference on Rural America, Reprint No. 16--.

"Underdevelopment of Health in Rural America-Causes, Consequences, and Solutions," by Vicente Navarro, the Johns Hopkins University, April

HEALTH MANPOWER LEGISLATION, 1975

Health Manpower and Loan Forgiveness in Rural Areas

THURSDAY, JULY 31, 1975

U.S. SENATE,

SUBCOMMITTEE ON HEALTH OF THE

COMMITTEE ON LABOR AND PUBLIC WELFARE,

AND THE SUBCOMMITTEE ON RURAL DEVELOPMENT
OF THE COMMITTEE ON AGRICULTURE,

Washington, D.C.

The subcommittees met, pursuant to notice, at 10:10 a.m., in room 5110, Dirksen Senate Office Building, Senator Edward M. Kennedy (Chairman of the Subcommittee on Health), presiding.

Present: Senators Kennedy, Clark, Leahy, Randolph, and Stafford. Committee staff present: LeRoy Goldman, professional staff member, and Jay B. Cutler, minority counsel.

Senator KENNEDY. We will come to order. This morning we open hearings of the Subcommittee on Health of the Committee on Labor and Public Welfare and the Subcommittee on Rural Development of the Committee on Agriculture on "Health Manpower in Rural Areas." These hearings will be cochaired by the distinguished Senator from Iowa, Senator Clark, who has been long interested in the provision of health care in rural America. Senator Clark, the chairman of the Subcommittee on Rural Development, has been extremely interested in the general problem of manpower in rural communities of this ountry.

I had the opportunity to visit a number of rural communities in the home State of the distinguished Senator from Iowa a number of years ago. There we met with a number of the citizens who had gone to extraordinary lengths to attract doctors into the rural communities. They had built clinics, put advertisements in newspapers, even national publications such as Time and Newsweek, and done many other things in order to attract doctors to provide the important health care services to people living in their rural areas.

The one thing that is perfectly clear is that in most rural parts of the country it is more and more difficult to find a doctor. This is not only true in the rural communities of this country; it is also true in many urban neighborhoods, particularly in the innercity.

Against this background, the American taxpayer is contributing very substantial amounts to train health manpower in this country. The Federal Government spends close to a half a billion dollars a year

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