phasing it out but not eliminating it and would like to see you do it in steps. We are in about the third year now. I think there has been fair warning to the community that we are ready to phase it out.

COLLEGE EQUIPMENT GRANTS

Secretary RICHARDSON. College equipment grants is another one of the programs which deals with a particular kind of physical property, and we think of it as lower priority than other areas. I think this is a good example of the kind of hardening of the categories I referred to carlier where we would like, given a choice to operate through a broader authority giving the institutions wider opportunity to reflect their own priorities.

PUBLIC LIBRARIES

Public library services and public library construction represent, in the second instance, another example of the lower priority we believe should be attached to construction grants.

Carryover funds will in any case permit a little over $6 million in obligations for that program in 1973, the same as 1972.

For the services, the $16 million reduction is a reduction from $49 million in 1972 which we think is justified by the fact that there is increased State and local spending in this area; and, this permits a diminished Federal role.

WORK INCENTIVE PROGRAM

Under work incentive, the last item on the list, what is involved here is that the jurisdictions administering welfare programs have been slower in referring people under the WIN to jobs and finding eligible people and training them.

There is a carryover of funds for this program from 1972 that will permit an actual increased number of trainees in 1973 than in 1972, but because of the carryover we can reduce the request for new authority.

Mr. CARDWELL. $76 million is the amount of carryover.
Mr. FLOOD. A tidy sum.

HEART DISEASE

Since the President declared war on cancer there has been a great deal of talk about making the same kind of attack on heart disease. I went to New York to receive-you were the principal speaker that night you recall-an award from the National Cancer Society as the man of the year or something like that. You spoke there with your usual eloquence. The very next day pounding on my door were the Heart people as you can imagine. There has been a great deal of talk about making the same kind of attack on heart disease since so many more people die from heart disease than die of cancer.

However, the 1973 budgets for the National Heart and Lung Institute does not show a very large increase. What are you going to do about heart disease?

Secretary RICHARDSON. There is some increase, not a dramatic.

one

Mr. FLOOD. I said not a very large increase. Cancer was dramatic and very large.

Secretary RICHARDSON. The President did in his State of the Union message say that he would create a panel to advise him on the question of what additional emphasis should be given to research in heart and lung disease, heart disease particularly, given the fact that more people die of cardiovascular diseases than any other single cause.

I think our view in the meanwhile is that we are moving forward with a fairly substantial increase, about $22 million, pending our receiving this advice.

The President said, "I will shortly assign a panel of distinguished experts to help us determine why heart disease is so prevalent and so menacing and what we can do about it. I will also recommend an expanded budget for the National Heart and Lung Institute. The young father struck down by a heart attack in the prime of life, the productive citizen crippled by a stroke, an older person tortured by breathing disturbing his later years-these are tragedies which can be reduced in number and we must do all that is possible to reduce them."

Mr. FLOOD. You don't feel you are casually dismissing heart disease in view of its record for mortality vis-a-vis cancer?

Secretary RICHARDSON. No; we don't feel so. The cancer was identified for a special attack by the President and by the Congress on the basis primarily that there appeared to be, on a number of fronts, work that had reached a point which offered a hope.

Mr. FLOOD. A breakthrough point.

Secretary RICHARDSON. "Breakthrough." And whether a comparable infusion of additional funds for heart and lung disease could also make a significant difference or whether we are moving in essentially the right direction is I think the kind of question the President hopes to get advice on from this panel.

SIZE OF INCREASE FOR REST OF NIH

Mr. FLOOD. Now for all of the institutes other than cancer and heart you are requesting an increase of less than $25 million. That is roughly 212 percent. Isn't it true that this will not even cover the cost increases out there. So really you are going backward as far as these very important institutes are concerned.

Secretary RICHARDSON. We believe we do have enough funds. Mr. Chairman, to fund the cost of continuing grants.

Mr. FLOOD. Isn't that nice.

Secretary RICHARDSON. And to provide for new initiatives in a number of areas which we think are most important.

Mr. FLOOD. Let me ask you this: If it is so that this figure of $25 million increase is roughly 22 percent, how can that be so? You can't meet the increased costs of doing business. We have been through this year after year. Different people make different estimates, but I don't recall that anyone has estimated that less than a 6-percent increase is necessary just to continue research and research training at the same level.

Secretary RICHARDSON. Mr. Chairman, if you assume, roughly speaking, that the average duration of each grant is 3 years, and that most of the appropriation to each institute goes out in the form of support of research grants, that means then in any given year twothirds of the money is used in cost of continuing grants and the other third is available for new grants.

So what it means in effect there may be for these institutes that are not getting more than the 22 percent increase some contraction in the number of new grants they can fund, but it does not mean a cutback on ongoing work. What we have had to do basically is to choose among competing priorities. There is a relatively much larger amount going into health manpower training and education; and, the need for new professionals, particularly primary care physicians, is we think, given competing choices and given the fact that it is selected areas, including cancer and heart disease, research on human development

Mr. FLOOD. You are going about it very calmly. You are not manning the barricades, you are not charging and attacking this enemy on which rhetoric has been flowing about all of these bad diseases and the need for more research and development.

REDUCTION FOR NATIONAL EYE INSTITUTE

For instance, we went through the pains of childbirth here to create the National Eye Institute, and we finally did. Now I find out in 1972 the National Eye Institute is $37.255 million. This is a very important thing. Now for 1973 it is $37.201 million, actually a reduction. How do you explain that?

Secretary RICHARDSON. That particular decrease is actually due to a need for fewer funds to pay HEW employees because of the employment reduction we are making this year, not to a decrease in the program of the Institute. What is important is that we are talking about a very high overall level of the funding of biomedical research and we are talking also about giving a new thrust of emphasis in selected areas. Simultaneously we are concerned with the availability of manpower for the actual direct provision of health services and I think what we are saying really is, as a matter of judgment, we believe that in some of these areas of medical research to add more money would not, in the present circumstances, offer any significant assurance of greater results.

What we are limited by in every case is the availability of people who are doing significant work in a given field.

INCREASE IN 2-YEAR PERIOD

Mr. CARDWELL. Mr. Chairman, I think if you look in the growth of the National Institute's regular research and training program for all of the institutes for the last 2 years you will find a dramatic increase. They have gone up $383 million.

Mr. FLOOD. This is so.

Mr. CARDWELL. The original question to the Secretary for the 22percent increase other than heart and cancer

Mr. FLOOD. You have been here and you have heard these estimates of 6-, 10-, even 15-percent increases being necessary just to stay even. Now we have 212 percent. What would you say if you were sitting here on this side of the table?

Mr. CARDWELL. I would try to give the answer I am going to try to give now. Those institutes excluding heart and cancer over a period of two budgets starting 1971 through 1973 have gone up 17 percent, $128 million. The National Institutes of Health together have gone up $383 million. And we have made selections as the Secretary has pointed out and tried to give emphasis to those institutes that have the greatest potential for payoff and that is where we have concentrated the increases. I think it is quite a respectable program.

As we pointed out yesterday, the research grants alone will have gone up $61 million in the 1973 budget up to a total of $854 million just for research grants to outside institutions.

Mr. MILLER. May I take my shot at it too, Mr. Chairman?

Mr. FLOOD. Never volunteer.

COST-OF-LIVING INCREASES

Mr. MILLER. I have to disregard that advice now and then. The cost-of-living argument does bug me a bit because we take a total figure and compare it and say the cost of medical research has gone up by 10 percent but your budget only goes up 22 percent. In fact, as the Secretary said, this budget covers the increase in costs of living because first we compute how much the costs are of the research we have already committed for 1, 2, 3, 4, or 5 years. If the cost has gone up 10 percent, we cover that cost. We cover the increased costs of doing business.

Mr. FLOOD. You are the budget director; aren't you?

Mr. MILLER. Yes.

Mr. FLOOD. You sound like it; yes.

Mr. MILLER. We may not have quite as much new research but we cover whatever the costs are of the new starts we fund and cover them for 3, 4, or 5 years. The real issue is do we need as much new business as we previously had. That is the only place where there can be any contention.

EDUCATION INCREASES

Mr. FLOOD. Of course you are in favor of motherhood and against sin and all of these things in which I hasten to join you. But now we come to education, with a capital E. The total Office of Education budget for 1973 is an increase of $145 million or less than 3 percent. That, also, will not cover the increases we know will come in the cost of doing business in this area.

ANALYSIS OF NET INCREASE

Mr. CARDWELL. There again I think we are working against some net figures. There are several items of significant reduction in the budget, one of which, for example, is the one-time item that we are requesting this year to put part of the higher education student assistance on a forward funded basis. That subtracts $166 million from the

gross increase that is in for education. There is the item of $288 million that represents our proposed legislation on higher education student assistance to eliminate the direct loan program. That does not represent a reduction in program levels. It is just a difference in financing.

Mr. FLOOD. You don't slay many dragons in this wilderness of education with that, do you? You maintain the status quo nicely.

Mr. CARDWELL. In fact you have an increase of $861 million in Federal programs administered by the Office of Education, not including the National Institute of Education or the National Foundation for Higher Education.

Mr. FLOOD. I know about that.

Mr. CARDWELL. It is a big increase.

Mr. FLOOD. I was talking about the total, net increase for the Office of Education, which is $145 million.

Secretary RICHARDSON. It is a full $1.1 billion in total increases for all education programs. There are total decreases of $826 million, some of which, as Mr. Cardwell has explained, do not represent pragmatic decreases. So the overall net increases in terms of our capacity to carry forward on educational activities on a larger scale is very substantial.

Mr. FLOOD. Yet voila! Here it is-3 percent.

NECESSITY OF BALANCING INCREASES AND REDUCTIONS

Secretary RICHARDSON. Mr. Chairman, I beg respectfully to call attention to the fact that, to derive a figure which represents the balance of a series of increases and reductions, doesn't really tell you anything about the funding of any given program. Some of the reductions, as Mr. Cardwell pointed out, are reductions resultant primarily from what are essentially bookkeeping measures.

In the case of actual programs we are either providing enough to meet year-to-year cost increases with some large increases under two headings, one the emergency school assistance program which is now pending before the Senate, having passed both branches in one form or another, for $500 million, and a $224 million figure which covers the activities that would be embraced within the special revenue-sharing program. There are a whole series of increases in other individual line items as well as provision for such new activities as the National Foundation for Higher Education, an increase of $97 million, and a $35 million increase for the National Institute of Education over and above the programs that would be transferred to it.

Mr. FLOOD. I seem to be wearing the wrong hat here as chairman of this appropriations subcommittee. We seem to be on the wrong side of the table here. We, historically, are supposed to accuse you of having fat in your budget and asking for far too much money. Now all of a sudden I find myself pursuing this line. What in the world is going on?

DETAILED EXPLANATION OF EDUCATION INCREASE

Will you put in the record a table and narrative explanation to document what you have just been talking about-that there is a substantial program increase in the Office of Education budget even though the total shows only a net increase of $145 million?