any reservations about taking Federal money into the operation of their university?

Mr. HESTER. Well, I was not part of New York University when this commenced, but I certainly know there are no reservations on the part of the university now on entering into matching programs with the Federal Government.

Mr. LONG. You think this program is a proper activity for the Federal Government?

Mr. HESTER. If it is the policy of the Federal Government to try to increase the health facilities of the country, I see no other way to accomplish it than by doing it through these means.

Mr. LONG. Do you think this should be the problem of the Federal Government? Do you think this problem is serious enough that in the absence of adequate action taken by the State government the Federal Government should move into it?

Mr. HESTER. I have seen the predicted shortages in this field. I am well acquainted with some of the problems of trying to meet the cost of medical education.

I do not see how we are going to meet those predicted needs unless there is substantial aid from some other source of which we are aware, and I assume that is the Federal Government.

Mr. ROBERTS. Mr. Younger.

Mr. YOUNGER. Thank you, Mr. Chairman.

Many of the universities and colleges in New York do get help from the State although they are still considered private schools.

Do you receive any financial aid from the State of New York? Mr. HESTER. None directly. Our students receive what is called scholar incentive awards, which is a sum of money which they receive as residents of the State of New York if they are paying a certain amount of tuition, and it varies with their income level.

We do not receive any directly, as the university.

Mr. YOUNGER. You do from the fees charged students?

Mr. HESTER. Yes, indeed.

Mr. YOUNGER. The student gets money from his State to pay his fees?

Mr. HESTER. Yes; he gets some portion of it.

Mr. YOUNGER. You just have a different method of milking the State than most schools?

Mr. HESTER. Of course, we have a number of students from outside the State of New York to whom this does not apply, and we have a number of foreign students.

The minimum is $100 a year, which I think applies to a large number of students, and our tuition is $1,500. So it is not a substantial element.

Mr. YOUNGER. New York as a State does not have a State university, like

Mr. HESTER. Yes, it does, sir.

Mr. YOUNGER. Other States?

Mr. HESTER. Yes, it does.

Mr. YOUNGER. Where is it located?

Mr. HESTER. It is located within a number of places within the State.

It is not a single physical entity as it is in some States, but it has a total enrollment of some 100,000 students in various colleges through

out the State, teachers' colleges, medical college, and a number of other units.

Mr. YOUNGER. Is Cornell a part of it?

Mr. HESTER. Some of the colleges in Cornell are part of the State system.

The School of Agriculture

Mr. O'BRIEN. Labor relations

Mr. HESTER. Right [Continuing]. Is operated on contract from the State.

Mr. YOUNGER. Can you shed any light on how we are going to keep the doctors down on the farm?

Mr. HESTER. You mean keep them from going to the big cities?

Mr. YOUNGER. That is right.

Mr. HESTER. I cannot. I wish I could.

Mr. YOUNGER. That seems to be the real problem.

Mr. HESTER. Yes.

Mr. YOUNGER. If it were not for supplying doctors to the rural communities, I doubt if there is a need for this bill according to the testimony we have had, although there is a case for it.

But the real case and the real need are in the rural areas.

All of the testimony demonstrates that, but nobody has suggested a sound method how we are going to get the doctors into the rural

areas.

Mr. HESTER. I have thought a good deal about this, particularly in connection with the provisions of this act, and I do not have any simple solution to it.

Mr. YOUNGER. That is all, Mr. Chairman.

Mr. ROBERTS. Thank you, sir.

The next witness is Dr. Chester H. Pheiffer, on behalf of the American Optometric Association. Dr. Pheiffer, you may proceed.

STATEMENT OF CHESTER H. PHEIFFER, O.D., DEAN OF THE COLLEGE OF OPTOMETRY, UNIVERSITY OF HOUSTON, HOUSTON, TEX., ON BEHALF OF THE AMERICAN OPTOMETRIC ASSOCIATION, ACCOMPANIED BY W. P. MacCRACKEN, JR., WASHINGTON COUNSEL

Dr. PHEIFFER. Mr. Chairman and members of the committee, my name is Chester H. Pheiffer. I reside in Houston, Tex. My appearance is on behalf of the American Optometric Association. This organization represents more than two-thirds of the practicing optometrists of the United States.

I received an A.B. degree with honors in psychology from the University of Louisville in 1943, an M.A. degree from the Ohio State University in 1944, and the Ph. D. degree in 1949. At the Ohio State University I taught courses in general and experimental psychology and summer postgraduate research laboratory for optometrists and also worked on the gustatory and olfactory problems of certain distillates for Seagrams, and of powdered milk for the armed services. in conjunction with the dairy department, as well as conducted a project on the visual discrimination of areas for the Air Materiel Command.

In 1949 I joined the staff of the Southern College of Optometry teaching general and child psychology, psychological optics, and visual training. For service to the students and to optometry, I was given the L.A. Farmer award in 1950. In 1954 I received the O.D. degree, having completed the required courses.

I joined the staff of the University of Houston College of Optometry in 1954. Among the courses I taught were: psychology of vision, analysis of optometric data, visual training, history of optometry, socio-legal aspects, illumination, and clinical practice. In 1958, I was appointed director of clinics; 1959, full professor; 1961, dean of the college of optometry.

During the 1960-61 academic year, I was elected chairman of the faculty assembly, the highest elected post a faculty member can achieve. My research interests have been in the field of children's visual care, visual phenomena, and caecanometry or the effect of toxic involvements on vision.

Approximately a year ago when similar bills were considered by this committee of the 87th Congress, Dr. Alfred Rosenbloom, dean of the Illinois College of Optometry, testified and suggested certain amendments. It is my understanding that the testimony taken at that time will be made available to the members of this committee and therefore I will refrain from repeating the facts set forth in Dr. Rosenbloom's statement. However, I endorse them wholeheartedly and commend them for your careful consideration. It is particularly gratifying to note that some of the amendments which Dr. Rosenbloom suggested were adopted by the committee and are in H.R. 12. Part C of H.R. 12, entitled "Student Loans" differs in its entirety from part C of H.R. 4999, 87th Congress, as introduced, although it conforms to that bill as reported. The original H.R. 4999 provided for scholarship grants; the bill as reported and now before the committee provides for student loans. All we asked a year ago was that our students be granted the same financial assistance as that to be made available to students of medicine, osteopathy, and dentistry. Our position today is the same but we believe it is even stronger because we are not asking for grants for optometry students, but merely loans which will be repaid with interest. We believe the bill should be amended so as to make the student loan provisions available to optometry students as well as to students of medicine and dentistry. This can be accomplished by a few simple amendments on pages 18, 19, and 20 of H.R. 12.

The suggested amendments are attached to my statement.

We recognize that a group must be important to the public welfare in order to obtain financial assistance, thus it would seem necessary to point out the importance of optometry to the public welfare. We believe that we can give you some ideas of optometry's importance with just a few summary sentences.

Very few people past the age of 45 are able to perform efficiently in our modern culture without the help of a vision specialist. Many of our children and young people are hampered in their academic work as well as in their everyday life without the assistance of a vision specialist. Since the future of our Nation is dependent on our children, as they are hampered, so is our Nation.

In addition to caring for the visual welfare of the public, optometry has also participated in producing a great amount of important scientific knowledge. The increased demand on vision by our culture not only in everyday life on the surface of the earth, but under the seas, in the air, and in space, points up the importance of vision and thus of the vision specialist, namely the optometrist, in today's educational, cultural, and economic worlds.

While our primary objective is to provide for the visual welfare of the civilian population, we hope you will bear in mind the fact that last year between 15 and 20 percent of the members of our graduating classes were commissioned as optometrists in the armed services.

In addressing our annual meeting in 1961, Maj. Gen. O. K. Neiss, Surgeon General, U.S. Air Force, after describing a number of air research projects in which optometrists were engaged, including study of radiation damage to the eye, eye protectioin of aircrew personnel, feasibility of contact lenses for flying personnel, and so forth, said:

While the research of Air Force optometrists is necessarily devoted to problems related to military requirements, the results of our research may have farreaching benefits to man's efforts to conquer space.

The optometrist performs an important function in finding and properly referring patients with pathology. It is worth while to note that there are fewer optometrists in the South than in other regions of the United States, and that the incidence of blindness in the South is higher than for other regions. Optometrists are relatively well distributed geographically. Without them, many small communities would not have visual care. Were it not for optometrists, many people in the low- and middle-income groups would be forced to go without visual care.

Our most recent surveys have indicated that there should be 1 practicing optometrist for every 7,000 members of the population. And may I interject that this is a minimum.

The average the country over falls far short of meeting this requirement, and the situation is growing steadily worse. The figures based on 1958 data which were submitted to the 1960 White House Conference showed, Mr. Chairman, that in your State of Arkansas there was 1 licensed optometrist for every 11,079 of the population. Mr. ROBERTS. You may change that, if you like.

Dr. PHEIFFER. Thank you, sir.

In Congressman Roberts' State of Alabama there was 1 for every 15,222 of the population; in Florida, the average was 1 for 10,704; in Louisiana, 1 for 11,938; in Maryland, 1 for 14,923; in Mississippi, 1 for 15,833; in my own State of Texas there was 1 for 10,751. Time will not permit my giving the figures for all 50 States, but I will be glad to furnish them for any member of this committee who is particularly interested in his own State. During the decade from 1950 to 1960, the population of Colorado increased 32.4 percent, but the number of optometrists increased only 1.2 percent. This was the situation several years ago.

It has grown steadily worse and our estimates are that unless there is a substantial expansion both in the facilities and the student population of our schools and colleges of optometry, by 1975 the ratio in New York State will be 1 optometrist for every 17,300 persons.

The figures submitted in 1960 showed that at the time they were compiled, there was 1 optometrist for approximately every 8,000 persons in New York State.

A report prepared by the office of development projects of the University of Houston states:

A detailed statistical study indicates that the future need for optometrists in a 16-State region encompassing the entire South, a region with a 1960 population of 57,160,000, is approximately 220 new optometry graduates yearly.

In this area are located only two optometry schools. These 2 schools entered 131 new students in 1962. I can assure you that some will not graduate for lack of application; others because the need to work will cut into their study time so deeply that they will not be able to make their grades and yet they are unable to attend school without working.

The 1960 Blue Book of Optometrists lists 4,317 licensed optometrists in the southern region. The 1962 Blue Book lists 4,322. It can readily be seen that the number of optometrists required to provide adequate visual care in the South is not being met. It has been estimated that the minimum need for optometrists in Texas alone during the years ahead will be 28 annually just to maintain the present ratio of 1 optometrists to every 12,000 Texans.

Not only is there an acute shortage of optometrists in this country, but there is an even greater shortage in the underdeveloped countries, particularly in South America.

In December, Dr. H. Ward Ewalt, Jr., of Pittsburgh, Pa., president of the American Optometric Association, and Dr. Ralph Wick of Rapid City, S. Dak., retiring president of the American Academy of Optometry, headed a delegation to attend the Colombian Optometric Congress held in Bogotá, Colombia.

Our president-elect, Dr. Judd Chapman of Tallahassee, Fla., will head a delegation which is going to attend the International Ophthalmic Congress in Geneva, Switzerland, this April. All the nations are looking to us for leadership in this area as well as many others. This will give you some idea of the seriousness of the situation which is developing and against which corrective measures need to be taken.

In order to meet the need for optometrists in the Nation as well as in the South, it is first necessary to increase the enrollment in the optometry schools. At present it is not possible to produce the number of optometrists necessary to satisfy the public needs in terms of deaths and retirement of optometrists as well as the population increase, due to lack of physical facilities.

Secondly, students have difficulty not only in finding finances to begin the program but to complete it. Many optometry students are forced to prolong the length of their program by the necessity to work, thus shortening their years of service to the public. Florida now has five 4-year scholarships issued each year; South Carolina has an assistance program award of $300 per student per year. A number of other States have made attempts or are planning to secure financial assistance for students from their respective States.

Another mode developed to help potential optometry students in the South was the creation of the Better Vision Scholarship Fund by