Mr. FENN. Are those 3,000,000 of people residents of Pennsylvania, or do you include part of Ohio?

Mr. SwICK. That would take in part of Ohio.

Mr. FENN. And also West Virginia?

Mr. SwICK. Also part of West Virginia. It would take in Wheeling.

Mr. FENN. So it is not all Pennsylvania. It is all in accord with what you have stated-that the State lines should not govern the ultimate decision.

Mr. SwICK. I have never argued for State lines, but that has been injected apparently in the last year, and there has been such a fight for State lines that I said this: If States lines are to prevail, then I am here to fight for my State.

Mr. FENN. Oh, yes; I understand.

Mr. SwICK. Because there was only one other State in the Union that gave more men to this great conflict.

Mr. FENN. But the hospital at Aspinwall would better accommodate, in your opinion, these 3,000,000 of people than if it were located in some other place?

Mr. SWICK. Absolutely. There is no question about that. They have the facilities; they have the ground. There is a big farm there in which the neuropsychiatric cases could work and enjoy themselves, and Aspinwall is absolutely fitted and suited for an addition. Mrs. ROGERS. Thank you very much, Doctor.

Mr. WELSH. Madam Chairman, will you hear Congressman Chase? Mrs. ROGERS. We should be very glad to hear him. He is a member of the committee.

STATEMENT OF HON. J. MITCHELL CHASE, A REPRESENTATIVE IN CONGRESS FROM THE STATE OF PENNSYLVANIA

Mr. CHASE. Madam Chairman and members of the committee: I believe it is conceded by your committee that there is an urgent need for hospitalization throughout the country, and that is particularly true of Pennsylvania. I can speak with certain knowledge, other than as a Member of Congress, in regard to hospitalization, because of my connection with the American Legion as its commander in the State of Pennsylvania some years ago.

I have introduced a bill providing for a hospital in northern central Pennsylvania, but my contention is not for any particular site or any particular hospital. It is to take care of those men who to-day are in need of help.

I would like to place in the record a statement by Frank Pinola, the State commander of the American Legion of Pennsylvania, giving statistics which I believe will be helpful to your committee. Mrs. ROGERS. If you will leave it with the reporter, it will be made a part of the record.

(The matter referred to is as follows:)

HOSPITAL SITUATION IN PENNSYLVANIA

To the MEMBERS OF CONGRESS FROM PENNSYLVANIA.

GENTLEMEN: The passage of the Rogers bill, together with the amendments tacked on in the Senate, has called to my attention the hospital situation in Pennsylvania. An examination of the hospitals and of the statistical data has impressed upon me the fact that our disabled have been sadly neglected.

An unready Nation, because of its need, sent unready soldiers into battle. These raw, green troops stood up in the crucible of the western front. They were pushed beyond endurance-sleepless, hungry, cold, inadequately provided for, by our rich but unready Nation-in order that victory might be attained six months ahead of scheduled plans.

The cost was terrible, not only in dollars and cents but in lives ruined. Thousands of those who came back paid in overstrain in mind and body. As the years have passed the number of these has grown steadily.

The local boards rejected 13,000 mental and nervous cases, and the camps sent back 34,000 more. Yet in spite of this preliminary weeding out, the statisticians of the Veterans' Bureau have discovered that the percentage of mental cases in the World War veterans' group is higher than in the civilian population. The rate of nervous and mental disorders in the ex-service population of 4,647,699 is 438.5 per 100,000. The rate shown by the Bureau of Census report for a group of males 35 to 39, was found to be 429.5 per 100,000. These figures conclusively prove that the war caused an increase in mental disability for which the Government is responsible. For the care of these it is in honor bound.

The construction of Government hospitals has not kept pace with the demand for beds for the mental cases. One reason for this is that three years elapse, on the average, between the date of construction authorization and the completion of a hospital. Another reason is that at the time we try to complete the hospitals for those in need, without looking ahead to the possible increase. This is very important, because well-known psychiatrists insist that the peak of mental cases will not be reached until 1940. The chief reason, however, has been the failure of Congress to determine a. national policy in building hospitals.

Heretofore they have been located without reference to State lines. Through the amendments tacked on to the Rogers bill, it seems that the trend of Congress is definitely toward recognition of State lines. We in Pennsylvania have too long ignored State lines, with the result that we are woefully lacking in facilities for our disabled, while other States have pressed their claims vigorously and obtained results for their residents.

A glance at the following data reveals the unfair treatment accorded to Pennsylvania:

(a) Tuberculosis..

4. Veterans in hospitals with reported home addresses in States indicated, Dec. 31, 1929:

334

(b) Neuropsychiatric.

1, 121

(c) General..

392

(d)

Total

1,847

2,992

2,310

5. Per cent of patients of each type from States indicated hospitalized with

in home State:

According to the figures of the Veterans' Bureau in Washington, there are 185 mental cases in Pennsylvania awaiting hospitalization and 43 general cases. These are not correct. A careful check-up by the regional officers of the Vet

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erans' Bureau in Philadelphia, Pittsburgh, and Harrisburg reveals that there are nearly 500 veterans who are in civil or State hospitals in Pennsylvania.

According to the report of the Director of the Veterans' Bureau for the year ending June 30, 1929, New York had 2,837 veterans, of whom 2,482 were hospitalized at home; Illinois had 2,110 veterans, of whom 1,734 were hospitalized at home; Massachusetts had 1,125 veterans, of whom 996 were hospitalized at home; and Pennsylvania had 1,821 veterans, of whom 832 were hospitalized at home, about 250 of these being in the United States naval hospital at Philadelphia. So that Pennsylvania had in hospitals outside of the State 989 of its disabled veterans. Of these, about 543 were at Perry Point, Md.

The Veterans' Bureau hospitals in New York State provide 2,619 beds. The Rogers bill gives them 1,600 more beds.

In Illinois the Veterans' Bureau hospitals provide 1,882 beds-1,082 are now under construction and 150 are planned, making a total of 3,114.

The Veterans' Bureau hospitals in Pennsylvania have 642 beds, but many of these are occupied by nonresidents of Pennsylvania. Four hundred and eightyone beds are being constructed at Coatesville and 50 additional beds are provided for at Aspinwall. But upon completion of Coatesville Hospital, No. 49, at Philadelphia with its 418 beds is to be closed. (Director's report, p. 108.) So that when Coatesville is completed Pennsylvania will have 702 Veterans' Bureau beds, many of which will be occupied by nonresidents of Pennsylvania. Cer-, tainly Pennsylvania is badly neglected.

THE GENERAL MEDICAL AND SURGICAL SITUATION

Prior to the Rogers bill the Veterans' Bureau had in existence over 21 general medical and surgical hospitals. In Philadelphia the naval hospital is used, with 319 beds; in Chicago the naval hospital is used, with 550 beds; and in Brooklyn the naval hospital is use, with 550 beds. In this respect we are not so bad off. However, the hospital at Philadelphia should be replaced. The Secretary of the Navy so declared in his report. It is a fire trap, and constantly parts of the various buildings are falling, floors are dropping, and lives of patients are endangered, and the use of the structure interfered with. A recent personal examination disclosed many repairs of recent origin and some were actually in progress. The buildings are of flimsy construction, the exterior consisting of plaster on wood lath. They have been in existence for nearly 11 years. We ask you, Congressman, to back the Darrow bill for a new naval hospital at Philadelphia providing at least 500 beds for general medical and surgical cases of the Veterans' Bureau. We are informed that there is a political move on foot to build naval hospitals at Washington and Chicago and to sidetrack Philadelphia. This you should not permit. If, however, the Darrow bill is not passed. then we feel that a 500-bed hospital should be constructed in Philadelphia by the Veterans' Bureau for general medical and surgical cases. We are also of the opinion that the main building at Hospital No. 49 in Philadelphia should be used as a diagnostic center, with 100 beds. With the wonderful consultants available in Philadelphia, there should be no need of sending veterans either to New York, Washington, or Cincinnati.

THE TUBERCULAR SITUATION

The tubercular hospital at Aspinwall accommodates 221. Of these many are residents of Ohio, West Virginia, and western New York. We have 43 veterans at Mount Alto and 92 in New York Tubercular Hospital. There are 39 of our boys at Oteen, N. C., and many others are scattered throughout the country in Arizona, New Mexico, Colorado, Texas, and Arkansas. There are awaiting hospitalization at the Philadelphia regional office alone, 25 patients. A new T. B. hospital of 250 beds could be filled at once. And in the event that the Rankin bill is passed, a 500-bed T. B. hospital would not be sufficient. We, therefore, recommend that a 500-bed T. B. hospital be erected at once in the north central portion of the State as urged by the Scranton convention.

MENTAL SITUATION

According to the report of the Veterans' Bureau under date of December 31, 1929, there are in hospitals 1,121 mental cases from Pennsylvania. We have approximately 500 in civil and State hospitals, so that the present load is about 1,621. This clearly demonstrates the necessity of immediately enlarging Coatesville. This hospital admits of expansion to 2,000 and even 3,000 beds. The

plans, however, have already been drawn and the specifications prepared for a hospital of 1,250 beds. These plans I have seen myself at the Philadelphia regional office for the Veterans' Bureau. We believe that the representatives of Pennsylvania in Congress should push the immediate construction of Coatesville according to the present plans to 1,250 beds. We could then house those veterans who are in other hospitals, State and civil, and bring back some of the 543 who are at Perry Point, Md.. The removal of some from Perry Point would leave beds for the use of Virginia, Maryland, North Carolina, and South Carolina, all of whom are clamoring for hospitals.

It is the policy of the bureau to hospitalize veterans as near to their homes as possible. (Report of the Director, p. 7.) Fifty-seven per cent of all patients are under treatment within the State of their reported home address. New York has 93.52 per cent of its patients at home; Illinois has 88.99 per cent of its patients at home; yet Pennsylvania has only 36.48 per cent of its patients at home.

THE RANKIN BILL

The Rankin bill (H. R. 7825) proposes to extend the presumption of service connection in N. P. cases, T. B. cases, and certain other diseases from January 1, 1925, to January 1, 1930, said presumption to be conclusive in cases of T. B. and rebuttable in all other cases. The passage of this bill will entitle many more veterans in Pennsylvania to hospitalization. The American Legion in Pennsylvania is committed to a bill of this character by two resolutions adopted at the convention in Scranton last August, and, therefore, we respectfully ask our Pennsylvania Congressmen to support the Rankin bill.

Do not be concerned with the cost of the Rankin bill, because the recent reports of the Treasury Department show that the World War debt has been reduced by $10,173,691,974, with a corresponding reduction in annual interest charges of $436,088,486, all since 1923. This reduction in interest is a sum larger than the total annual amount paid by the Government in compensation, hospitalization, and insurance to disabled World War veterans, their dependents, and the widows and orphans of our dead. The report shows further that the interest on our public debt has been reduced annually during the past eight years an average of $54,500,000 a year, or for example, a sum greater than the estimated annual cost of the benefits to the disabled of the World War which the Veterans Bureau has estimated would be provided by the Rankin bill.

To summarize our position—

We asks our Congressmen to support the Darrow bill for the construction of a new naval hospital in Philadelphia; in the event that this hospital is not built, we ask that they procure the erection of a 500-bed general medical and surgical hospital to be located at Philadelphia; we ask that when hospital No. 49 is vacated a diagnostic center with 100 beds be established in the present main building; we ask the establishment of a 500-bed T. B. hospital in north-central Pennsylvania; and we ask the immediate expansion of Coatesville N. P. to 1,250 beds.

These we ask in the name of the disabled of Pennsylvania, who are entitled to hospitalization within their own State, the same treatment accorded the disabled of New York, Massachusetts, and Illinois. We believe that the people of Pennsylvania will support every Congressman who backs this program, because it is fair, it is reasonable, and, above all, because it is just.

FRANK L. PINOLA,

State Commander, the American Legion of Pennsylvania. Mr. CHASE. I would like to cite a fact of recent occurrence, when it was absolutely impossible to secure hospitalization for a man who was badly in need of it, and through the efforts of General Hines the man was finally hospitalized in Indiana.

Mrs. ROGERS. Was he a service-connected case?

Mr. CHASE. Yes; he was. Those conditions prevail. We find it impossible to get hospitalization for men in Pennsylvania. Mrs. ROGERS. Even service-connected cases?

Mr. CHASE. Yes, that is true; and it is generally known and conceded that men who are hospitalized near home have a better chance

to recover. Certainly we of Pennsylvania have never tried to advocate that State lines should be considered, and it is a lamentable condition, if it does exist, that there is a fight made by Members of Congress for hospitals in particular States.

I think that the facts of this case, in so far as Pennsylvania is concerned, will prove conclusively to this committee that we need hospitals in Pennsylvania, and that it is going to be beneficial to the disabled man. I heartily agree with all that has been said here by the other members of the delegation, and I sincerely hope that your committee is going to give recognition, not so much to Pennsylvania but to the disabled man. And in your selection of sites I feel that you are going to place hospitals in Pennsylvania; that you will give us more beds, not because it is Pennsylvania but because we have a large population of service men; and, as this statement will show, Pennsylvania and that section has not been given the consideration that is due, not to Pennsylvania but to the service men of that State. This bill that bears my name provides for a general hospital. I believe that it is the contention of the American Legion of Pennsylvania that the hospital ought to be for tubercular patients. I am going to take that up, and if that is what they want I will have a bill introduced to that effect. But I sincerely hope that this committee is going to give to the service men-not to Pennsylvania— what justly belongs to them. There is not a thing that has been asked by the Pennsylvania delegation or by the Legion of Pennsylvania that can not be backed up by facts. It is fair, and in so far as the money consideration is concerned, I would like to say now that so long as we in Congress make efforts to reduce taxes, we can not with consistency deny to the disabled man hospitalization or anything else that is consistent with fairness. The money consideration does not appeal to me to the slightest extent, and I do not believe we ought to be guided by that.

Mrs. ROGERS. No; but, of course, if we reduce taxes, indirectly the veterans are helped. We do want the whole picture, though, Mr. Chase, and we want to take care of the men. That is why we are having these hearings now.

Mr. CHASE. Possibly they are helped, Mrs. Rogers, by tax reduction, but it is little as compared with what they would be helped by hospitalization.

Mrs. ROGERS. And you want to take care of them? Just as this committee does. We have the deepest desire to hospitalize the veterans.

Mr. CHASE. Absolutely.

Mrs. ROGERS. Thank you very much, Congressman.

Mr. WELSH. I will ask Doctor Temple to say a few words.

Mrs. ROGERS. Doctor Temple, the committee will be very pleased to hear you.

STATEMENT OF HON. HENRY W. TEMPLE, A REPRESENTATIVE
IN CONGRESS FROM THE STATE OF PENNSYLVANIA

Mr. TEMPLE. Mrs. Rogers and members of the committee, there are only a very few minutes remaining until the House of Representatives meets, and therefore I will have to be brief.