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COMMITTEE ON LABOR AND PUBLIC WELFARE

RALPH YARBOROUGH, Texas, Chairman
JENNINGS RANDOLPH, West Virginia JACOB K. JAVITS, New York
HARRISON A. WILLIAMS, JR., New Jersey WINSTON L. PROUTY, Vermont
CLAIBORNE PELL, Rhode Island

PETER H, DOMINICK, Colorado
EDWARD M. KENNEDY, Massachusetts GEORGE MURPHY, California
GAYLORD NELSON, Wisconsin

RICHARD S, SCHWEIKER, Pennsylvania WALTER F. MONDALE, Minnesota

WILLIAM B. SAXBE, Ohio
THOMAS F. EAGLETON, Missouri

RALPH T. SMITH, Illinois
ALAN CRANSTON, California
HAROLD E. HUGHES, Iowa

ROBERT O. HARRIS, Staff Director

John S. FORSYTHE, General Counsel
Roy H. MILLENSON, Minority Staff Director

EUGENE MITTELMAN, Minority Counsel

SUBCOMMITTEE ON HEALTH

RALPH YARBOROUGH, Texas, Chairman
HARRISON A. WILLIAMS, JR., New Jersey PETER H. DOMINICK, Colorado
EDWARD M. KENNEDY, Massachusetts JACOB K. JAVITS, New York
GAYLORD NELSON, Wisconsin

GEORGE MURPHY, California
THOMAS F, EAGLETON, Missouri

WINSTON L. PROUTY, Vermont ALAN CRANSTON, California

WILLIAM B. SAXBE, Ohio
HAROLD E. HUGHES, Iowa

John S. FORSYTHE, Counsel
LEROY GOLDMAN, Professional Staf Member

JAY B. CUTLER, Minority Counsel

CONTENTS

Page

3

12

23

WEDNESDAY, SEPTEMBER 2, 1970

Symington, Hon. Stuart, a U.S. Senator from the State of Missouri.--

Symington, Hon. James W., a Representative in Congress from the State

of Missouri

Jackson, Ben F., chairman, Medical Center Committee, St. Louis Univer-

sity Board of Trustees.

Reinert, Rev. Paul C., S.J., president, St. Louis University --

Drummond, Edward J., S.J., vice president, St. Louis University Medical

Center..

Felix, Robert H., M.D., M.P.H., dean, St. Louis University School of

Medicine

Danforth, William H., M.D., vice chancellor for medical affairs, Washing-

ton University; accompanied by Dr. Roy Vagelos, chairman, department

of biochemistry; Dr. Gerald Perkoff, professor of medicine, and director,

division of health care research; and Dr. David A. Bensinger, assistant

dean, Washington University School of Dentistry -

Bensinger, David A., D.D.S., assistant dean, Washington University School

of Dentistry -

Edwards, Joseph C., M.D., president, St. Louis Medical Society

Fiordelisi, Rocco, M.D., intern, St. Louis University Hospitals -

Whittico, James M., M.D., past president, National Medical Association..

Mosley, Julian, third-year medical student, Washington University -

Scruggs, Karen, second-year medical student, Washington University

Bond, William, second-year medical student, St. Louis University

Nichols, Henry, M.D., resident, Washington University Medical Center -

Franzel, G. A., 0.D., vice president, Missouri Optometric Association;

accompanied by Gordon G. Heath, O.D., director, Division of Optom-

etry, Indiana University -

Henley, A. J., director, Yeatman Medical Health Center-

Pagano, Sam, D.D.S., president, Greater St. Louis Dental Society, and Dr.

Russell Buchert, D.D.S., president, Missouri Dental Association.

North, Sister Mary Stephen, S.S.M., School of Nursing and Allied Health

Professions, St. Louis University; William Stoneman, M.D., program

coordinator bistate regional medical program; Charles E. Berry, A.B.,

M.Sc.H.A., J.D., associate dean, School of Nursing and Allied Health

Professions, St. Louis University; Oliver H. Duggins, Ph. D., chairman,

Life Sciences Division, Forest Park Community College.

Berry, Charles E., A.B., M.Sc., H.A., J.D., associate dean, School of

Nursing and Allied Health Professions, St. Louis University

Duggins, Oliver H., Ph. D., chairman, Life Sciences Division, Forest Park

Community College

Pepper Max, M.D., Department of Community Medicine, St. Louis

University-

FRIDAY, SEPTEMBER 4, 1970

Randall, Hon. William, a Representative in Congress from the State of

Missouri.

Stark Nathan J., immediate past chairman of the Board of Trustees,

Kansas City General Hospital; Group Vice President, Operations,

Hallmark Cards Inc...

Wadsworth, Homer C., president, Kansas City Association of Trustees

and Foundations.-

Page 239

261

313

335

336

337

338 346

359

Smull Ned W., M.D., director and chairman of pediatrics, Children's

Mercy Hospital, on behalf of Herman R. Sutherland, president, central

governing board of Children's Mercy Hospital, Kansas City Mo.--Cross, Edward B., M.D., vice provost for the health sciences, University

of Missouri-Kansas City; former Assistant Surgeon General of the

United States..
Noback, Richardson K., M.D., acting dean, School of Medicine, Univer-

sity of Missouri-Kansas City -
Strickland, William A., Jr., Ph. D., dean, School of Pharmacy, University

of Missouri-Kansas City Wagner, Myron, Ph. D., chairman, Department of Chemistry University

of Missouri-Kansas City--Burgess, Michael M., Ph. D., chairman, Department of Psychology,

University of Missouri-Kansas City -Curry, Hon. Charles E., presiding judge, Jackson County Mo.; accom

panied by Albert P. Mauro, director, planning and development, Kansas

City General Hospital..
Twin, Edward J., M.D., executive director, Kansas City General Hospital.
Bremen, Rudolph S., Ph. D., president, Kansas City College of Osteo-
pathy; and Morris Thompson, D.O., president, Kirksville College of
Osteopathy and Surgery; accompanied by Richard 0. Spavins, D.O.,

dean, medical affairs, Kansas City College of Osteopathy and Surgery -Miller, Gerald L., M.D., president-elect, Missouri State Medical Associa

tion; Wallace P. McKee, M.D., president, Jackson County (Mo.)
Medical Society; Maxwell G. Berry, chairman of the Board of Gov-
ernors, American College of Physicians, and past president, American
Society of Internal Medicine; and Francis M. Maple, M.D., president,
Missouri Society of Internal Medicine, and chief of staff, St. John's
Hospital, Springfield, Mo...
McKee, Wallace P., M.D., president, Jackson County (Mo.) Medical

Society --
Rodgers, Samuel U., M.D., director, Wayne Miner Neighborhood Health

Center; Mrs. Pauline Smith, president of the Advisory Board, Wayne
Miner Neighborhood Health Center; and James I. Threatt, director,

Model Cities Program, Kansas City, Mo.
Robinson, Hamilton B. G., D.D.S., dean, University of Missouri-Kansas

City School of Dentistry -
Yeckel, George H., president, Kansas City Area Hospital Association

and executive director, Menorah Medical Center.
Koltai, Leslie, Ph. D., chancellor, District Metropolitan Junior College,

Kansas City, Mo..
Smull, Ned W., M.D., president, Health Resources Institute, Kansas

City, Mo...
Harkins, Joseph F., executive vice president, Health Resources Institute,

Kansas City, Mo..
Wilkinson, Charles B., M.D., executive director, Greater Kansas City

Mental Health Foundation.

378

381

385

478

489

503

511

563

571

81 86

208 211 149

STATEMENTS
Bensinger, David A., D.D.S., assistant dean, Washington University
School of Dentistry..

Prepared statement.
Berry, Charles E., A.B., M.Sc.H.A., J.D., associate dean, Sshool of Nurs-
ing and Allied Health Professions, St. Louis University, St. Louis, Mo..

Prepared statement -
Bond, William, second-year medical student, St. Louis University
Bremen, Rudolph S., Ph. D., president, Kansas City College of Osteop-
athy; and Morris Thompson, D.O., president, Kirksville College of
Osteopathy and Surgery; accompanied by Richard 0. Spavins, D.O.,
dean, medical affairs, Kansas City College of Osteopathy and Surgery -

Prepared statement-
Burgess, Michael M., Ph. D., chairman, Department of Psychology,

University of Missouri-Kansas City -
Cross, Edward B., M.D., vice provost for the health sciences, University

of Missouri-Kansas City; former Assistant Surgeon General of the
United States.-

Prepared statement

359 362

337

261 300

1

Page 338 342

56

25

216 221

94 108

27 32 131

159

563 564 164 169

12

16

2

Curry, Hon. Charles E., presiding judge, Jackson County, Mo.; accom

panied by Albert P. Mauro, director, planning and development,
Kansas City General Hospital..

Prepared statement.
Danforth, William H., vice chancellor for medical affairs, Washington

University; accompanied by Dr. Roy Vagelos, chairman, Department
of Biochemistry; Dr. Gerald Perkoff, professor of medicine, and director,
Division of Health Care Research; and Dr. David A. Bensinger, assist-
ant dean, Washington University School of Dentistry
Drummond, Edward J., S.J., vice president, St. Louis University Medical

Center..
Duggins, Oliver H., Ph. D., chairman, Life Sciences Division, Forest
Park Community College.

Prepared statement.
Edwards, Joseph C., M.D., president, St. Louis Medical Society -

Prepared statement.
Felis, Robert H., M.D., M.P.H., dean, St. Louis University School of
Medicine.

Prepared statement.
Fiordelisi

, Rocco, M.D., intern, St. Louis University Hospitals. Franzel, G. A., O.D., vice president, Missouri Optometric Association;

accompanied by Gordon G. Heath, O.D., director, Division of Optome-
try, Indiana University
Harkins, Joseph F., executive vice president, Health Resources Institute,
Kansas City, Mo..

Prepared statement
Henley, A. J. director, Yeatman Medical Health Center.

Prepared statement..
Jackson, Ben F., chairman, Medical Center Committee, St. Louis Univer-
sity Board of Trustees.

Prepared statement..
Koltai, Leslie, Ph.D., chancellor, District Metropolitan Junior College,
Kansas City, Mo.

Prepared statement-
McKee, Wallace P., M.D., president, Jackson County (Mo.) Medical

Society..
Miller

, Gerald L., M.D., president-elect, Missouri State Medical Asso-
ciation; Wallace P. McKee, M.D., president, Jackson County (Mo.)
Medical Society: Maxwell G. Berry, chairman of the Board of Gover-
nors, American College of Physicians, and past president, American
Society of Internal Medicine; and Francis M. Maple, M.D., president,
Missouri Society of Internal Medicine, and Chief of Staff, St. John's
Hospital, Springfield, Mo..

Prepared statement, with attachment..
Mosley, Julian, third-year medical student, Washington University-
Nichols

, Henry, M.D., resident, Washington University Medical Center Noback, Richardson K., M.D., acting dean, School of Medicine, University of Missouri-Kansas City

Prepared statement.
Noth, Sister Mary Stephen, S.S.M., School of Nursing and Allied Health
Professions, St. Louis University; William Stoneman, M.D., program
coordinator, bistate regional medical program; Charles E. Berry, A.B.,
M.Sc.H.A., J.D., associate dean, School of Nursing and Allied Health
Professions, St. Louis University; Oliver I. Duggins, Ph.D., chairman,
Life Sciences Division, Forest Park Community College.

Noth, Sister Mary Stephen, prepared statement.--
Pagano, Sam, D.D.s., president, Greater St. Louis Dental Society, and

Dr. Russell Buchert, D.D.S., president, Missouri Dental Association..
Pepper, Max, M.D., Department of Community Medicine, St. Louis

University
Prepared statement
Perkoff, Dr. Gerald, professor of medicine and director. Division of Health

Care Research, Washington University School of Medicine, prepared
statement..
Randall

, Hon. William, a Representative in Congress from the State of Missouri.

503 506

381

378 379 145 153

313 322

182 203

179

225 758

71

231

Page Reinert, Paul C., S.J., president, St. Louis University..

23 Robinson, Hamilton B. G., D.D.S., dean, University of Missouri-Kansas City School of Dentistry

478 Prepared statement.

483 Rodgers, Samuel U., M.D., director, Wayne Miner Neighborhood Health

Center; Mrs. Pauline Smith, president of the Adivsory Board, Wayne
Miner Neighborhood Health Center; and James I. Threatt, director,
Model Cities Program, Kansas City, Mo.-

385 Prepared statements

387, 467 Scruggs, Karen, second-year medical student, Washington University 148 Smith, Mrs. Pauline, Chairman of Advisory Board of Wayne Miner Neighborhood Health Center, prepared statement

476 Smull, Ned W., M.D., director and chairman of pediatrics, Children's

Mercy Hospital, on behalf of Herman R. Sutherland, president, central
governing board of Children's Mercy Hospital, Kansas City, Mo.

239 Prepared statement.-

240 Smull, Ned W., M.D., president, Health Resources Institute, Kansas City, Mo.

511 Prepared statement.

513 Stark, Nathan J., immediate past chairman of the Board of Trustees,

Kansas City General Hospital; Group Vice President, Operations,
Hallmark Cards, Inc.

233 Stoneman, William III, M.D., program coordinator bistate regional medical program, prepared statement.

191 Strickland, William A., Jr., Ph. D., dean, School of Pharmacy, University of Missouri-Kansas City

335 Symington, Hon. James W., a Representative in Congress from the State of Missouri.

7 Prepared statement

10 Symington, Hon. Stuart, a U.S. Senator from the State of Missouri...

3 Thompson, Morris, President, Kirksville College of Osteopathy and Surgery, Kansas City, Mo, prepared statement...

372 Threatt, James I., director, Model Cities program, Kansas City, Mo., prepared statement...

387 Twin, Edward J., M.D., executive director, Kansas City General Hospital. 346 Prepared statement, with accompanying illustrations.--

347 Wadsworth, Homer C., president, Kansas City Association of Trustees and Foundations

236 Wagner, Myron, Ph. D., chairman, Department of Chemistry, University of Missouri-Kansas City..

336 Whittico, James M., M.D., past president, National Medical Association

Prepared statement-
Wilkinson, Charles B., M.D., executive director, Greater Kansas City
Mental Health Foundation.

571 Yeckel, George H., president, Kansas City Area Hospital Association and executive director, Menorah Medical Center.

489 Prepared statement.

494 ADDITIONAL INFORMATION Articles, publications, et cetera:

A Good Alternative to National Health Insurance," from Resident

and Staff Physician, August 1970.
“A New Approach to Medical Education," by E. Grey Dimond, M.D.,
July 1961

277 "American College Physicians Participate in the Volunteer Physicians Program for Vietnam," by Hal Î. Wilson, F.A.C.P., fro

the Bulletin, August 1970.

130 "Hospital Association Authorizes Addition of Director of Planning":

119 "It's Time to Negotiate A Medicare Fee Schedule," by Daniel F. Crowley, M.D., General and thoracic surgeon, Des Moines, Iowa, from Medical Economics, May 25, 1970.

126 “Medicine and Money,” reported by Paul Friedman and filmed by Gene Broda, from NBC News Presents ‘First Tuesday,' May 5, 1970

52 "Opening Medical Education,” by E. Grey Dimond, M.D., con

sultant to the chancellor for Health Affairs and distinguished professor of medicine, University of Missouri-Kansas City, Kansas City, Mo...

272

135 140

125

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