Additional material submitted for the record by-Continued

Beigel, Allan, M.D., director, Southern Arizona Mental Health Page Center:

Benefit package-National health insurance_

Questions posed by Chairman Rogers and Dr. Beigel's responses-Beall, Hon. J. Glenn, Jr., a U.S. Senator from the State of Maryland, section-by-section analysis of the "Long-Term Care Amendments of 1975".

Blue Cross Association:

Attachments to Mr. McNerney's prepared statement:
Appendix A-Cost containment activities-Blue Cross
System.

Appendix B-Access

Appendix C-A model for national health insurance-the
Federal employees health benefit program....

Composition of Blue Cross governing boards__

Letter dated April 5, 1976, from Mr. Sibery to Dr. Hyde, pro-
fessional staff member, Interstate and Foreign Commerce
Committee re questions posed by Chairman Rogers and Mr.
Sibery's responses.

Letter from Mr. McNerney to Chairman Rogers re evaluation
of health care systems in various other countries; personnel
necessary for possible national health insurance program,
public or private; and estimate of loss of jobs in the industry
if system goes either public or private..

The increment approach to national health insurance
Children's Defense Fund of the Washington Research Project:
Attachments to Ms. Schorr's prepared statement:

Attachment I-American children are not as healthy as
they could be.

Attachment II-A list of health support services..

Letter dated May 3, 1976, from Ms. Schorr to Chairman Rogers
re questions posed by Chairman Rogers and Ms. Schorr's
responses.

750

756

794

1354

1357

1360

349

260

1435

361

961

962

1005

Clovis, William L., M.D., Philadelphia, Pa., letter dated March 24, 1976, to Chairman Rogers__

1578

Colorado Foundation for Medical Care, Colorado PSRO, activity profile-1972-75

900

Conable, Hon. Barber B., a Representative in Congress from the
State of New York, brief description of H.R. 2268, Medicare Long-
Term Care Act of 1974_.

784

Congressional Budget Office:

Attachments to Ms. Rivlin's prepared statement:

Table 1-Average annual increases in overall and health care
prices for selected years, 1955-75 and for economic stabil-
ization period (ESP).

1186

Table 2-Federal outlays for health services, 1977 and 1981.. 1187
Table 3-Total national spending (private and public) for
personal health services, 1977 and 1981....

Use of excess profits tax to influence health care costs..
Council of Community Hospitals, John F. Horty, president, statement_
Equitable Life Assurance Society of the United States, appendixes to
Mr. Miller's prepared statement:

Appendix A-Description of various types of policies or plans
to provide catastrophic coverage..

Letter dated March 31, 1976, from Mr. Miller to Dr. Hyde,
Professional Staff Member, Interstate and Foreign Commerce
Committee re questions posed by Chairman Rogers and Mr.
Miller's responses...

1187

1313

1505

213

256

Table 1.-Number of people with private health insurance by
type of coverage and source of insurance, Dec. 31, 1974.
Table II.-Private health insurance coverage, benefits and
premiums, all ages, 1950-74_.

213

213

Table III.-Private health insurance, benefits and premiums,
adjusted for medical care price changes, all ages, 1950-74.....

214

Additional material submitted for the record-Continued

Ford, Loretta C., R.N., Ed.D., dean, School of Nursing, and director of nursing, University of Rochester Medical Center, attachments to prepared statement:

Bibiography..

Map-Number and location of pediatric and medical nurse
practitioners in collaborative practice settings in New York
State...

Questions posed by Chairman Rogers and Ms. Ford's responses. -
Gibson, Robert W., M.D., medical director, Sheppard & Enoch Pratt
Hospital, and president-elect, American Psychiatric Association,
attachments to Dr. Gibson's prepared statement:

Excerpts from a working draft of a source book on cost, utilization,
and quality care. Stephen S. Sharfstein, M.D., Chief, Eval-
uation Branch Office of Program Development and Analysis,
NIMH..

Summary of "Coverage and Utilization of Care for Mental
Conditions Under Health Insurance-Various Studies, 1973-74."
Evelyn S. Myers, American Psychiatric Association.......
Data Demonstrating Economic Feasibility of Covering Mental
Illness, American Psychiatric Association---
Goodman, Alvin I., M.D., director, Renal Center, Westchester County
(New York) Medical Center:

Page

474

475

476

589

660

663

Letter dated February 26, 1976, to Chairman Rogers re advis-
ability of passing a national health insurance bill this year__
Letter dated February 26, 1976, to Congressman Maguire, re
savings in health expenditures if recommendations of panel
were implemented..

538

540

Health, Education, and Welfare Department:

23 most frequently occurring primary discharge diagnoses-fiscal
year 1973.

Amount and percentage distribution of personal health care
expenditures, by source of funds, selected fiscal years, 1929-75-
An alternative to use of the insurance concept in health care
financing-

Comments re physician fees resulting from the use of paramedical
personnel..

Contractor average unit claims processing costs-

Correspondence between Chairman Rogers and HEW re John
D. Hutchinson's concern about certain data in Dr. Robert
Van Hoek's testimony of February 18, 1976-

Direct reimbursement unit claims processing costs.
Disclosure of PSRO data and information...

Estimated cost increases attributable to the new catastrophic
protection and cost savings attributable to reforms in cost
sharing and limits in reimbursements..

Estimated health expenditures under selected national health
insurance bills, a report to the Congress, Secretary Weinberger,
July 1974...

Estimates on the number of additional physicians needed under
a national health insurance scheme. - -

How the tax system might be changed to help control inflation
of health care prices--.

Letter dated April 26, 1976, from Louis M. Hellman, M.D.,
Administrator, Health Services Administration, to Chairman
Rogers re answers and comments in response to questions posed
by Chairman Rogers to Dr. Van Hoek.

299

54

306

453

289

867

289

855

15

1226

451

1313

Medicare part A benefit payments by kind of facility.
Methodology: NHI-related physician manpower estimates..
Responses to Congressman Scheuer's verbal questions___

"Research in Health Care Financing-October 1975," publication

of the Social Security Administration..

Results of studies of incentives for institutional providers..
Summaries of the National Center for Health Services Research
projects.

What ORS does and does not produce with respect to the cost
estimates of various national health insurance proposals. ---

858

296

451

457

379

464

432

450

Additional material submitted for the record-Continued

Heinz, Hon. H. John, III, a Representative in Congress from the
State of Pennsylvania, statement...

Ingram, Weitzman, Mertens & Co., Inc., questions posed by Con-
gressman Maguire with Joseph V. Terenzio's and James C. Ingram's

responses..

Joint Council of Socio-Economics of Allergy, Robert J. Becker, M.D., president, letter dated February 20, 1976, to Chairman Rogers with position statement attached..

Lauer, Robert E., D.D.S., Columbus, Ohio:

Attachments to prepared statement, dental care data..........
Letter dated April 14, 1976, to Chairman Rogers re questions
posed by Chairman Rogers and Dr. Lauer's responses..

Lave, Judith R., Ph. D., associate professor of economics and urban
affairs, Department of Economics, Carnegie-Mellon University,
tables from Dr. Lave's prepared statement:

Table I-Changes in average cost-1964–73..........
Table II-Relative availability of specific service.-

Lee, Philip R., M.D., professor of social medicine and director, health
policy program, School of Medicine, University of California, San
Francisco, attachments to prepared statement:

Page

764

1077

1546

690

760

1093

1094

Table 1-Supply of active physicians (M.D.), by specialty:
actual 1970; projected 1980 and 1990..

492

Table 2-Estimates of U.S. population 1975 and 1990.
Table 3-Annual rate of office visits by patient age, for primary
care physicians; United States, May 1973-April 1974...
Table 4-Estimated "desired" utilization of office-based ambu-
latory care under three assumptions with regard to national
health insurance, 1975 and 1990..

493

493

493

Table 5-Physician increments required by increases in desired
utilization induced by national health insurance..
Table 6-Estimated distribution of office-based physicians
(M.D.), in primary care specialties, 1973 and 1990.-
Table 7-Mean number of office visits per week and weeks worked
per year for four specialists....

493

494

494

494

Table 8-Estimated office-based ambulatory care visits potential,
given anticipated physician supply in 1990...
Table 9-Number and ratio per population of active non-Federal
physicians by geographic area and medical specialty (pre-
dominately primary care), California, July 1969
Figure 1-Urban-rural differences in physician supply.
References cited in prepared statement.-

Lucey, Hon. Patrick J., Governor, State of Wisconsin, questions
posed by Chairman Rogers and Governor Lucey's responses-
Mason, Dudley M., Lancaster, Pa., letter dated May 13, 1976, to
Chairman Rogers with attached questions posed by Chairman
Rogers and Mr. Mason's responses--

Miller, C. Arden, M.D., professor of maternal and child health,
School of Public Health, University of North Carolina, attachment
to Dr. Miller's prepared statement, addendum-Detail on benefits..
National Academy of Sciences, projections of prospective costs and
areas in which we should and should not be paying "current"
expenditures through NHI...

494

495

495

35

265

975

1407

National Association for Mental Health, Inc., Hilda Robbins, chairwoman, public affairs committee, statement..

1510

National Association of Temporary Services, Inc., William F. Neal, executive vice president, statement..

1514

National Caucus on the Black Aged, Inc., recommendations from the 1971 White House Conference on Aging...

780

National Council of Senior Citizens:

Health security program.

360

Letter dated February 27, 1976, from Mr. Cruikshank to Chairman Rogers re "Health Care Cost: A Distorted Issue," from the AFL-CIO American Federationist-June 1975.. National Health Law Program, article from the Los Angeles Times entitled, "Ailing poor trapped in bind on Medi-Cal-inadequate payments, red tape cited by doctors unwilling to accept patients"-

365

180

Additional material submitted for the record-Continued

National Lutheran Home, Washington, D.C., attachment to Rev- Page erend Reichard's prepared statement, "Old Age Plus Long-Term Illness Equals Poverty," article by Reverend Reichard... New Jersey Department of Public Advocate, Michael Perlin, Esq., director, Department of Mental Health Advocacy, statement.. New York State Moreland Act Commission of Nursing Homes and Residential Facilities, comparing methods of evaluating patients for proper level of chronic care- -Rochester, N. Y., study.. Pepper, Hon. Claude, a Representative in Congress from the State of Florida, attachments to prepared statement: Specific cutbacks in State medicaid programs: 1975--Summary of findings, recommendations, and areas for further study.

809

1475

817

Prudential Insurance Co. of America:

Letter dated April 30, 1976, from Mr. Kittredge, senior vice presi-
dent, to Chairman Rogers re evaluation of health care systems in
various other countries; personnel necessary for possible na-
tional health insurance program, public or private; and estimate
of loss of jobs in the industry if system goes either public or
private..

Letter dated May 21, 1976, from William C. White, Jr., vice
president, to Chairman Rogers re comments on Congress'
enactment of an overall national health insurance program and
implementation in incremental steps---

Rand Corp.:

Attachments to Mr. Newhouse's prepared statement:
Table 1-Extent of coverage for hospital services.-
Table 2-Extent of coverage for surgeon's services..
Table 3-Fraction of medical care expenditures paid directly
by user..

772

774

1439

356

1125

1126

1127

Table 4-Estimated increases in demand for various medical

services__.

1128

Table 5-Families with doctor office coverage by income,
1970_.

1129

Table A-1-Hospital utilization by age and income before
and after the introduction of medicare/medicaid.
Table A-2-Percentage of persons seeing a physician and
physician visits per person per year, by age and income,
before and after the introduction of medicare/medicaid...
Charts and tables contained in Mr. Mitchell's prepared statement:
Figure 1-Prepayment cost per family.__

Table 3-Payments and net benefits under a plan financed
by 67 percent premiums, 33 percent income tax and
variable cost sharing..

1206

Table 4-Distribution of employer-paid health insurance
premiums and indirect tax subsidies, 1975. -

1209

Reinhardt, Uwe E., Ph. D., associate professor of economics and public affairs, Woodrow Wilson School of Public & International Affairs, and Department of Economics, Princeton University: Letter dated March 24, 1976, to Chairman Rogers re reimbursement and regulation of inpatient facilities and reimbursement of physicians...

1076

Tables contained in Dr. Reinhardt's statement:

Table 1-National expenditures on physicians' services by
source of funds, fiscal year 1975.

1033

Table 2-Regional differences in health care statistics,
United States 1969-70-

1037

Table 3-Physician-population ratios, patient loads, and
medical fees by size of county, United States, 1970--
Table 4-Selected averages of variables for general and
family practice physicians by location and region..
Table 5-Secular movements of health care statistics,
Province of Quebec, Canada, 1971-74..

1038

1309

1050

Additional material submitted for the record-Continued

Rockefeller Foundation:

Health in the United States: 1776-1976..

The responsibility of the individual__

Page

79

90

1535

Roemer, Milton I., M.D., professor, Health Services Administration, School of Public Health, University of California, Los Angeles, letter dated May 17, 1976, to Chairman Rogers, with paper attached. 1579 Southern Perinatal Association, George Cassady, M.D., president, letter dated February 3, 1976, to Chairman Rogers with position paper attached... United Auto Workers, Melvin A. Glasser, director, Social_Security Department, letter dated March 29, 1976, to Chairman Rogers re questions posed by Chairman Rogers and Mr. Glasser's responses.. United Hospital Fund of New York, questions posed by Congressman Maguire with Joseph V. Terenzio's and James C. Ingram's responses. United Societies of Physiotherapists, Inc., Alan Leventhal, Ph. T., chairman, Committee on National Legislative Matters, letter dated March 10, 1976, to Chairman Rogers with statement attached. Washington Business Group on Health, Willis B. Goldbeck, staff director, letter dated February 12, 1976, to Chairman Rogers with dental insurance: survey of WBGH members attached..

ORGANIZATIONS REPRESENTED AT HEARINGS

Aetna Life & Casualty, Daniel W. Pettengill, vice president, Group Division.
American Hospital Association:

Gehrig, Leo J. M.D., senior vice president.
Perkins, Woodbury, M.D.

American Medical Association:

Kelly Robert T., M.D., member, Council on Medical Service.
Peterson Harry N., director, Department of Legislation.

Blue Cross Association:

McNerney, Walter J., president.

Sibery, D. Eugene, executive vice president.

Trensowski, Bernard R., senior vice president.

Brookings Institution, Karen Davis, Ph. D., senior fellow.

254

1077

1572

1536

Children's Defense Fund of the Washington Research Project, Lisbeth Bamberger Schorr, consultant.

Colorado Foundation for Medical Care, Kenneth A. Platt, M.D., medical director. Committee for National Health Insurance, Isidore S. Falk, chairman. Congressional Budget Office, Alice M. Rivlin Ph. D., Director.

Cumberland Regional Health Plan, Dominic DeCencio, Ph. D., executive director. Equitable Life Assurance Society of the United States, Morton D. Miller, vice president.

Health, Education, and Welfare Department:

Altman, Stuart H., Ph. D., Deputy Assistant Secretary for Health Planning.
Cooper, Theodore, M.D., Secretary for Health.

Gaus, Clifton R., Ph. D., Director, Division of Health Insurance Studies,
Office of Research and Statistics, Social Security Administration.

Goran, Michael J., M.D., Director, Bureau of Quality Assurance, Health
Services Administration.

Haislip, Gene R., Deputy Assistant Secretary for Legislation (Health).
Kurzman Stephen, Assistant Secretary for Legislation.

Mathews, Hon. David, Ph. D., Secretary.

Rosenthal, Gerald Ph. D., Director, National Center for Health Services
Research, Health Resources Administration.

Tierney, Thomas M., Director, Bureau of Health Insurance, Social Security
Administration.

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

Weikel, M. Keith, Ph. D. Commissioner, Medical Services Administration,
Social and Rehabilitation Services.

Health Security Action Council, Isidire S. Falk, member.
Ingram, Weitzman, Mertens & Co., Inc., James C. Ingram.
Interstudy, Paul M. Ellwood, Jr., M.D., president.