STATEMENT OF HON. FRED S. PURNELL, A REPRESENTATIVE IN CONGRESS FROM THE STATE OF INDIANA Mr. PURNELL. I simply want to add a word of approval to this program. I will say frankly I am not as familiar with the facts as I should like to be. Gentlemen are here who will supply the committee with that information. I come primarily at the suggestion of Floyd Young, whom I know very well and whose statements I have great confidence in. Of course, there are some general facts with which we are all cognizant. A 150-bed hospital is on its face a small hospital for a great State like Indiana. It looks as though we are asking in Indiana for something in addition to that which we had not yet received, but it does strike me from the standpoint of economy that it might be well to let this 350-bed addition be regarded as a part of the principal improvement and let it all go through together. I am particularly impressed with this further thought that now when building materials are so cheap it is a wonderful opportunity for the Government to take advantage of that situation in behalf of these World War soldiers. I know the committee will give consideration to the facts as they will be presented by these gentlemen who come here for the purpose, and I want to indorse the general proposition. STATEMENT OF HON. DAVID HOGG, A REPRESENTATIVE IN CONGRESS FROM THE STATE OF INDIANA Mr. HOGG. The first proposition about the proposed hospital enlargement is this: Is it needed? There is no one who disputes the necessity of the additional hospital facilities. No one will deny the assertions of these World War veterans. The hospital is needed. There is only one of two ways to meet that need. One is to lessen the service which the hospital renders the veterans. I am sure that no one will be found in Congress who would vote for such a proposition as that. The other alternation is clear. If we are going to give necessary betterments to the welfare of the veterans, now is the time to do it. I do not believe any of us will live to see the time when building will be as cheaply done as it is now. I say to the committee, with all the seriousness and emphasis I possess, that it is imperative that we have these increased facilities. At my office in Fort Wayne, when I am there, never less than 40 to 50 veterans come every day, and I know from first hand there is need for this hospital. I am here to urge the imperative necessity of a substantial increase in facilities. STATEMENT OF HON. CARL R. CHINDBLOM, A REPRESENTATIVE IN CONGRESS FROM THE STATE OF ILLINOIS Mrs. ROGERS. Mr. Chindblom is here to say a few words in regard to his bill, H. R. 10378, which is as follows: [H. R. 10378, Seventy-first Congress, second session] A BILL To authorize the erection of a further addition to Veteran's Bureau Hospital Numbered 105 at North Chicago, Illinois, and to authorize an appropriation therefor Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled, That the Director of the United States Veterans' Bureau, subject to the approval of the President, is authorized and directed to contract, at a cost not to exceed $1,720,000, for the erection of a modern, sanitary, fireproof, three hundred and fifty bed-patient capacity further addition to the existing Veterans' Bureau Hospital Numbered 105, at North Chicago, Illinois, for the diagnosis, care, and treatment of neuropsychiatric disabilities, such construction to provide additional hospital, domiciliary, and out-patient dispensary facilities for persons entitled to hospitalization under the World War veterans' act, 1924, as amended; such facilities to include the necessary buildings and auxiliary structures, mechanical equipment, approach work, roads and trackage facilities leading thereto, sidewalks, vehicles, livestock, furniture, equipment, and accessories; and also to provide accommodations for officers, nurses, and attending personnel; and also to provide proper and suitable recreational centers; and the Director of the United States Veterans' Bureau is authorized to accept gifts or donations for any of the purposes named herein. SEO. 2. The construction herein authorized shall be done in such manner as the President may determine; and he is authorized to require the architectural, engineering, constructing, or other forces of any of the departments of the Government to perform or assist in such work, and to employ individuals and agencies not now connected with the Government, if in his opinion desirable, at such compensation as he may consider reasonable. SEC. 3. For carrying into effect the preceding sections, relating to additional hospital, domiciliary, and out-patient dispensary facilities, there is hereby authorized to be appropriated, out of any money in the Treasury not otherwise appropriated, the sum of $1,720,000 to be immediately available and to remain available until expended; and not to exceed 3 per centum of this sum shall be available for the employment, in the District of Columbia and in the field, of necessary technical and clerical assistants, at the customary rates of compensation, exclusively to aid in the preparation of the plans and specifications for the projects authorized herein and for the supervision of the execution thereof, and for traveling expenses, field office equipment, and supplies in connection therewith. Mr. CHINDBLOM. Last February 28 I introduced H. R. 10378 for a 350-bed addition to Veterans' Bureau Hospital 105 at North Chicago. I have since been advised that it is desired to increase the capacity of that addition to 500 beds, and, of course, my bill can be amended so as to make the increased authorization. Senator Glenn has in fact introduced a bill in the Senate, S. 5074, for $2,000,000, authorized to provide for a 500-bed addition at North Chicago. may introduce a new bill, so that the two bills will be identical. I There are other bills pending with reference to Illinois. I can not assume to speak for other representatives of Illinois, but incidentally I might call attention to the fact that there are bills providing for additions to the Edward Hines Hospital at Maywood, H. R. 14574, introduced by Mr. Igoe, and S. 5073, by Senator Glenn. There are two bills or joint resolutions introduced by Mr. Hall and Senator Glenn for certain equipment for the hospital at Dwight. Mrs. ROGERS. Bills introduced by Mr. Hall and Mr. Igoe are as follows: [H. R. 14574, Seventy-first Congress, third session] A BILL To authorize an appropriation of not to exceed $2,000,000 to round out the construction program at the Edward Hines, Junior, Hospital, Hines, Illinois, and for other purposes Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled, That there is hereby authorized to be appropriated not to exceed $2,000,000 to round out the construction program at the Edward Hines, Junior, Hospital, Hines, Illinois, such construction to include the following buildings, and so forth: One nurses' quarters, $135,000; one attendants' quarters, $120,000; two six-family apartment buildings, $84,000; four two-family duplex, $108,000; one recreation building for personnel, $130,000; enlarge present patient recreation building, $23,000; extension of roads and street lighting, $45,000; close ends of buildings numbered 21 and 22 similar to building numbered 20, $17,500; new canteen and post office, $40,000; one new tuberculosis infirmary building, three hundred beds, $600,000; enlarge bakery and garbage incinerator, $18,000; replace all wood-covered walks with brick, $135,300; one new occupational therapy shops building, $40,000; general landscaping scheme, $400,000. SEC. 2. The Congress of the United States hereby declares it to be the policy of our Government to provide sufficient beds in modern, sanitary, fireproof Government hospitals, to care for all sick and disabled veterans entitled to hospitalization under the World War veterans' act, 1924, as amended, and to this end requests the Administrator of Veterans' Affairs to submit annually to the Speaker of the House of Representatives and to the President of the Senate an estimate of the hospital construction necessary to fulfill this policy. [H. J. Res. 422, Seventy-first Congress, third session] JOINT RESOLUTION To authorize personal quarters, an elevator, and kitchen equipment at Veterans' Bureau Hospital Numbered 53, Dwight, Illinois Resolved by the Senate and House of Representatives of the United States of America in Congress assembled, That whereas Veterans' Bureau Hospital Numbered 53, located at Dwight, Illinois, is in need of certain buildings and equipment, to wit: An apartment building for properly housing the personnel and staff of the hospital; an elevator for the purpose of conveying patients from one floor of said hospital to another; a new electric range, new dish-washing machine, and other equipment, including a tile floor, to effect more efficient operation of the kitchen, the purchase and installation of such equipment is hereby authorized. Mr. CHINDBLOM. I shall ask leave to extend my remarks upon the necessity particularly for the enlarged facilities at North Chicago. Last winter when I introduced this bill I had data which I thought were then up to date and which then convinced me that it was not only desirable but an absolute necessity that this addition should be built at North Chicago. The recommendation, of course, comes from the representatives of the American Legion. Nobody knows better than they do the needs for Federal hospitalization of veterans of the World War, and we are all, I am very sure, anxious to cooperate with them in securing for these deserving men the treatment which they must have and which we must provide. Representatives of the ex-service men are here from Illinois, and I shall content myself with permitting them and the other representatives of the Legion to present the necessity of the legislation which we are pressing. I am sure they will present facts and figures that will prove the full necessity for the increased facilities for hospitalization that we are asking for the Illinois area. Mr. LUDLOW. It is a pleasure now, I am sure, for you to hear from Mr. Compton, secretary to Senator Robinson of Indiana. STATEMENT OF G. O. COMPTON Mr. COMPTON. The time of this committee is entirely too valuable for me to take it up. I am a poor substitute for the junior Senator from Indiana, who unfortunately is not permitted to be present in person on account of a death in his family, and he is at present in Indiana. No one realizes more thoroughly than the Senator the inadequate provisions that have already been made for the veterans of Indiana, and he is very desirous of sponsoring and doing everything in his power to see that additional provisions are made for this hospital which is now in process of construction in Indiana. Mr. RANKIN. If Senator Robinson desires to insert a statement in the record he will be permitted to do so. Mr. COMPTON. He will be glad to have that privilege. Mr. RANKIN. I am sorry that he can not attend the hearing. Mr. LUDLOW. No one has the interest of the veterans more at heart or is better qualified to present the needs of the Indiana veterans than Dr. George W. Bowman, who will be our next witness. STATEMENT OF DR. GEORGE W. BOWMAN, INDIANAPOLIS, IND., REPRESENTING INDIANA DEPARTMENT, AMERICAN LEGION Doctor BOWMAN. A generous Congress has allotted a 150-bed general hospital in Indiana. It will be the only general hospital within this central area, being 150 to 200 miles distant from all other hospital points. The central portion of the State of Indiana carries the heaviest potential hospital load of this entire territory. In housing the regional office of the State within this new hospital, savings in transportation costs over a vast network of hard-surface roads and extensive steam, electric, and bus systems, added ease of accessibilty, and time saving and actual shortening of hospitalization period for observation and diagnosis of cases will be effected sufficient to more than pay for that unit. Among these savings will be: Regional office rental, $15,600; railroad, Pullman, meals for patients, $19,139.40; same for attendants (estimated), $19,139.40; patients ($2.65 per diem) allowance, $10,017; attendants ($5 per diem) salaries; savings in salaries staff reduplication; estimated saving in payment of compensation, reimbursement of lost wages, and hospital per diem, $60,000 annually. At present, new hospitals are being built with service plants adequate for double or triple the size of the original unit. Consequently, additional enlargements are erected at a cost, not of approximately $3,300 but of about $1,800 per bed. With the given economies effective an additional 350 beds to our Indiana hospital could be erected at the lower construction figure, and by the same token the savings in force would absorb its added cost. Water and sewage systems are now being laid. It is more economical to incerase the bed capacity of an institution before actual construction begins than after a portion has been built. The operation of smaller hospitals as compared with larger plants has been proved to be more expensive per capita and economically unsound. Among the reasons are: 1. A dietary department equipped to serve 40,000 meals per month can serve 50,000 or more without additional personnel. 2. A power plant is the heart of an institution, wherein electricity is a by-product, and the greater the consumption the less the cost. The same steam generated for heating purposes in the buildings can just as well be forced through turbines for lighting, and a plant such as this could more cheaply and as easily serve a 600 as it could a 300 bed hospital. 3. The laundry can be operated to serve 600 much more cheaply than it can 300, because the equipment is practically the same for the former as the latter. It is simply a case of production, wherein if production is increased the cost decreases, and when patient capacity in the hospital drops, the cost mounts. 4. Purchasing power on local or nearer markets is much greater in the larger hospital because lower prices are obtained and more satisfactory contracts may be made by buying in larger quantities. Additions to surrounding hospitals in our zone, which are largely neuropsychiatric, are rapidly filled and in no way affect the general situation in this unsupplied area. With the highly increased liberalization of veteran legislation under H. R. 13174, Seventy-first Congress, second session, and due to an increased familiarity of privilege under provision of section 202-10, namely, the authorization of hospital treatments of any or all disabilities, there is and will be a steadily greater number availing themselves of it. The State of Indiana has been especially hard hit during the past year of drought and business depression with its resultant unemployment. The ex-service man has more than borne his share of these factors, being of more active earning age, and with growing young families. There are approximately 146,332 World War and 7,500 Spanish-American War veterans in Indiana. If as few as 20 per cent of these accept benefits under this act, upward of 26,000 will be hospitalized, some for short periods, others for long periods of treatment. Inasmuch as the majority of World War veterans are now becoming middle age, the time when malignant conditions and lingering illness are more apt to develop will require prolonged institutional care, thus retarding the patient turnover. It is only fair to presume that a number of beds in this institution will be allotted to other regional offices in adjoining States, as this has been the practice heretofore in the administration of Veterans' Bureau hospitals. The annual hospitalization figures over the 32 years previous to 1930 were between 1,200 and 1,500, and for 1930, 1,694. The need, frequency, and duration increases directly with the age of the patients. There are 156 on the current waiting list, and possibly 27 more awaiting examination to determine if they are to be hospitalized under the old legislation. There is at present a 100 per cent total disability rating in 176 (or 1.3 per cent of 13,033) claims filed in the Indiana regional office under the new legislation, many of whom will soon become hospital cases. It may readily be seen why a 150-bed unit is far from sufficient. We have 819 Indiana men hospitalized elsewhere. Their transfer to a station nearer their homes would be productive of great saving of compensation, transportation, shorter hospitalization periods, and inestimable benefits both physical and financial to them, their families, and their respective communities. The present 150-bed hospital is totally inadequate, but an additional 350 beds would go far to accomplishing these ends for the near future on a much lower operating basis, and with the savings at an almost negligible added cost to the Government. Consequently we sincerely urge that you favorably consider the granting of these |