Those are just two remarks.

I believe Mr. March has something he wanted to add.

Mr. MARCH. Mr. Chairman, as you look at this rather broad panorama and the difficulty of drawing firmly the priorities that the Congress and the executive branch ought to keep an eye on, a couple of thoughts occur to me concerning gaps in what we are presently doing. I think this is true for the Government as a whole.

When you get right down to it, we are rather at a very beginning stage in the business of measuring the return from various public activities.

Among the most difficult, of course, is research, but fundamentally, if we are ever to be very scientific in where we put the resources of the country, shall we say, among fields of research or as between research or, say, the practice of medicine, the choice of a dollar for research or a dollar for rendering medical care, we will have to strengthen the fundamental knowledge that goes toward evaluating the returns in the large.

From the point of view of economic return, looking over this field of health and the same is true of education, we have very little fundamental information and very little fundamental research going on in the Government and outside in the universities on these larger questions of where to put the resources.

Another area which is almost at a similar stage of underdevelopment in terms of fundamental across-the-board knowledge, in my observation from working in the Budget Bureau, is in this area of manpower.

Now, in the health area more than perhaps in any area of the programs that we touch upon, the bottleneck is the lack of trained or skilled manpower.

The manpower that you need for health tends to compete with, tends to come pretty much from the same sources as the manpower needed for scientific research and technological development across the board in the economy. This is particularly true in the research area. Yet, while we have some estimates about the supply of doctors and the shortage of doctors and researchers and NIH does try to make its projections, we have not in the Government as a whole really developed this process of balancing the supply and demand so that you can place these needs for skilled manpower in the broader setting of the total manpower picture and what the universities can produce. So, consequently, often we are counting on each other's manpower in expanding the programs. Perhaps in this latter area the program that the Labor Department was charged with, under the Manpower Development and Training Act, of developing a broad manpower picture, will prove eventually to be very helpful.

It seems to me anyway that if the Congress and if the executive branch are to zero in on these fundamental problems that you are asking about-how much do you put in medical research-we have to at least get answers in these two categories.

I should like also to just mention quickly another third category of possible need for research which we are very cognizant of in the Budget Bureau. That is the area of intergovernmental financial relationships. This is very pertinent in the health field, particularly in the care area; how much of the responsibility and how much financial capacity

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do the several layers of government have; where should the responsbility rest; how much should the Federal Government provide in grants versus relying on the States and localities to finance health activities which, let us say, it is agreed, should be in the public areas as opposed to the private area.

Mr. ROBERTS. In other words, if I understand what you are saying. it is that we need to know more about the skilled manpower so that we can work out more information as to where the research should be done, where it should go?

Mr. MARCH. Yes, sir.

Mr. ROBERTS. We are short on the people who could give us the answers?

Mr. MARCH. And consider, for example, if you have a total stock of manpower, and skilled manpower is really limited, whether you want to place the allocation toward the research side and does this undermine your capacity to render the care on the service-rendering side of the picture?

Mr. ROBERTS. Is it that we are just not turning out these people or is it that the ones who are being turned out are being scooped up by private industry in better paying positions than government is able to afford?

Mr. MARCH. I think my first point was essentially that, as a country. we have not really carefully, on a broad scale basis in the manpower area, appraised our needs in a long range way so that we evaluate our needs on the one hand and the potential supply on the other hand, so that you have a clear picture of what the gap is.

We tend to operate in little areas, in fragments of the manpower picture. We do not really ever pull it together. So we do not know fully where we are going in terms of information. This is the first lac.

The second thing is that, while we make valiant efforts to try to allocate the resources, say, as far as the Federal budget is concerned, this process is still far from perfect. So that you may add to your imbalances and so I think that that basically, then, we have to improve the advance information we need to plan ahead and guide where we want to go and then consider also the second stage of where you put the money from the standpoint of both the availability of people to do the job and the intrinsic return that you have. In the medical area it is very hard to tell in the large whether $100 million extra spent for medical research is going to do more good than, say, $100 million for health for children, you see, or health for the aged, or some other category.

Mr. STAATS. Mr. Chairman, I would like to add here, too, to what Mr. March has said to emphasize that as a part of the analysis of manpower we might well come to the conclusion that we ought to be spending more money, we ought to be doing more to encourage training of people over the long period in certain fields.

The significance of the long-term planning efforts which I mentioned in my formal statement is that the leadtime on this is a very, very great one, as you know, so that the manpower analysis is one which has the value that Mr. March referred to but also has important implications for what the Government may be able to do to train manpower in certain fields where there is a national need. Mr. ROBERTS. Thank you very much.

Now, to get back to some of the programs that this committee is harged with authorizing, could you give us any figures as to how uch will be added annually by the mental retardation bills? That assuming that they are passed in this session of the Congress. Mr. MARCH. Mr. Chairman, while we have those projections, I do ot think we brought them with us.

Could we supply them for the record?

Mr. ROBERTS. It is all right. Supply them for the record.

We had a rather difficult time in the hearings in getting these figures larified and I think if we had them from the budget, it would be of lot of help.

Mr. STAATS. We have those figures.

(The information referred to follows:)

COMMUNITY MENTAL HEALTH CENTERS ACT OF 1963

Mr. ROBERTS. Mr. Harris, the chairman of the full committee, raised a question at the beginning of the hearings as to whether it would not be advisable to place dollar ceilings and time limits on the authorizations for the appropriations for NIH just as the Congress has placed these limitations on other programs administered by the Public Health Service.

Do you have any comments on the effects which such limitations have and can you suggest any realistic ceilings in this respect?

Mr. STAATS. This thought has been suggested by various people. We feel that the time and dollar limitations which have been placed on the construction programs of the Public Health Service have been very useful. It has served the purpose of causing a review and reappraisal of those programs periodically.

We have been less certain about the value of such a limitation in connection with the basic research programs of NIH; that is the grants made by NIH.

We do think that there would be merit in a periodic appraisal through hearings and through the development of reports from the agency to be sure that in this important area that periodically, say every 3 years or whatever the time period might be feasible, that there would be a careful reappraisal of the legislation which underlies the program as well as the direction of the program itself.

This kind of reappraisal, we think, could be very useful.

Mr. SUTTON. I think that is the general position that the Bureau has taken in many reports on legislative proposals. We suggest, often, dollar limitations on construction programs but we think that, in the operating area or in the research area, the intangibles with respect to the universities, for example, are so great that there needs to be greater flexibility than the legislative process can always permit. Evaluation and review, particularly of new programs that have recently been authorized, though, is exceedingly valuable and I think we would particularly endorse the review on the 3- to 5-year basis of the newer programs. The committee should assure that the programs are carrying out the objectives that were originally intended. Mr. ROBERTS. I have been wondering, particularly in programs that are authorized by this subcommittee, if at the beginning of each new Congress it would not be well to let the departments know perhaps a month or so ahead that we would like to have a kind of a review, not detailed but at least get a good look at what has transpired in a 2-year period prior to the beginning of a new session.

I think that could very well be done without too much trouble and without too much expense.

I think it would give us a lot of information, too, that we need in looking at administration bills and at various proposals that come before our subcommittee.

Finally, I have a question which relates to another subject in which the parent committee is interested, and that is the ratings of radio and TV programs.

Since your Bureau is heavily involved in statistics, do you use any sampling techniques for securing your data?

Mr. STAATS. We do not directly collect data, as you know, Mr. Chairman. It would be an unusual case where the Bureau of the Budget would directly go to the public for data itself. This would

be obtained through the appropriate program agency. Sampling is a well established procedure. It is used in our census. It is used in many other governmental programs.

The Bureau of the Budget has had for many years an individual who has been expert in the field of sampling working with the agencies in terms of how best to devise procedures, the appropriate kind of sample, and so on. Properly used, sampling can be equally as accurate and can be much more economical than a complete survey. Mr. ROBERTS. Who is this individual?

Mr. STAATS. He would be in our Office of Statistical Standards, which deals with one of the four functions I mentioned earlier.

Now, in the field of public opinion polls, this has been a highly controversial area, as you know. This is one which I do not know that we have ever taken a position on, as such, but I believe that our view would be that again, if properly developed, a sampling procedure in this area is perfectly appropriate.

Mr. ROBERTS. Who is the individual whom you have in mind?

Mr. STAATS. Mr. Raymond T. Bowman is the head of our Office of Statistical Standards. Mr. Raymond Nassimbene is the individual. I would be glad to have him discuss this matter informally with any of your staff.

Mr. ROBERTS. I will have the staff get in touch with him.

Thank you again, gentlemen, for a very wonderful presentation. I just regret that we did not have more members of the subcommittee present to appreciate it, but I think it has been very beneficial certainly to us and will add considerably to the record of the hearings we have had.

Mr. STAATS. Thank you, Mr. Chairman.

Mr. ROBERTS. Thank you, all you gentlemen, for participating. The subcommittee will be in recess subject to the call of the Chair. (Whereupon, at 12 noon, the subcommittee recessed, subject to the call of the Chair.)