Admiral BOONE. It takes time to make a determination. We have quite a percentage on the list that are in that category. I can find that in a few minutes.

Mr. HAGEN. Madam Chairman, may I ask a question?

The CHAIRMAN. Yes, indeed.

Mr. HAGEN. From the standpoint of the ratio of service connected to nonservice connected, the larger percentage of nonservice connected is in the G. M. and S. category. What is the reason for that? 88.4 percent in that category are nonservice connected. Is that the weak point?

Admiral BOONE. That is the point discussed the most by the public, whether a certain category of those should or should not be admitted to VA hospitals-G. M. and S. cases. We do not hear much about TB or NP cases.

Mr. EDMONDSON. Madam Chairman.

The CHAIRMAN. The gentleman from Oklahoma.

Mr. EDMONDSON. I wonder if it is possible to state whether any sizable percentage of the approximately 21,000 or 22,000 on the waiting list are voluntarily on the waiting list, and how many of them are involuntarily on the waiting list? Some men might come in and see about being admitted and not be ready to go in at that time, and get on a waiting list until they are ready to go in.

Admiral BOONE. That is true, but we have a system now, if they refuse to go in when a bed is available, they drop down to the bottom of the list and lose their precedence by their election not to go in at that time.

Mr. EDMONDSON. Your classification, then, would make all these involuntary from the standpoint they would like to go in immediately but have to wait. Is that the situation as to the 22,000? Admiral BOONE. I think in the main.

The CHAIRMAN. Is it not also true that our private hospitals are filled, like in Michigan?—both their TB and NP hospitals are filled. Admiral BOONE. That is very true. There are large waiting lists at this time to get into non-Federal institutions. I was in a State the other day where they have a 2,000-bed psychiatric hospital and only 2 doctors. That is hardly custodial care.

I can break down this non-service-connected percentage and give the legal authority applicable to these cases. Where we have 65 percent non-service-connected cases, we have this situation, in 9 categories:

(1) 11 percent of the 65 percent had service-connected disabilities; hospitalized for treatment of other disabilities which had apparently not directly affected their service-connected disabilities. The Solicitor gives as authority applicable to these cases, VA Regulation 6047 (C) (1); section 706, title 38, U. S. C. A.

(2) 25 percent of the 65 percent were permanently and totally disabled and were receiving VA pensions for such disabilities; hospitalized for treatment of permanent and total disabilities and/or other disabilities. The Solicitor gives this authority: VA Regulation 6047 (D) (1); section 706, title 38, U. S. C. A.

(3) 8 percent of the 65 percent had no service-connected disabilities and had filed no claim for compensation or pension; hospitalized for treatment of non-service-connected tuberculosis or psychosis. The Solicitor gives as authority: VA Regulation 6047 (D) (1); section 706, title 38, U. S. C. A.

(4) 3 percent of the 65 percent had no service-connected disabilities and had filed no claim for compensation or pension; hospitalized for treatment of other long-term disabilities requiring hospital care for more than 90 days. Authority: VA Regulation 6047 (D) (1) or (D) (2); if disabilities permanent, section 706, title 38, U. S. C. A.; if disabilities not permanent, proviso of section 706, title 38, U. S. C. A. That proviso means he signs a certificate he cannot pay.

(5) 2 percent of the 65 percent, disabilities not yet adjudicated but had filed claim for compensation for service-connected disabilities. The Solicitor gives as authority: VA Regulation 6047 (D) (1); if discharged for disability in line of duty, section 706, title 38, Ú. S. C. A.; if not, proviso of section 706, title 38, U. S. C. A.

(6) 4 percent of the 65 percent, disabilities not yet adjudicated but had filed claim for pension for permanent and total disabilities. The authority for that is the same authority as I have just stated.

(7) 1 percent of the 65 percent, nonveterans (U. S. Armed Forces personnel, humanitarian cases, and so forth). They may be taken to our institutions when no service institutions are available. That is only 1 percent of the 65 percent. The authority for that is VA Regulation 6047 (B) (1) and (C) (1); section 686, title 31, U. S. C. A. ; section 706b, title 38, U. S. C. A.

(8) 10 percent of the 65 percent had no service-connected disabilities and had filed no claim for compensation or pension; hospitalized for treatment of general medical and surgical disabilities requiring hospital care for less than 90 days. Authority: VA Regulation 6047 (D) (1); proviso of section 706, title 38, U. S. C. A.

(9) 1 percent of the 65 percent, status not determined. When the status is determined, it will fall in one of the foregoing categories. That means information has not been provided to the central office. The authority for that is VA Regulation 6046 (C) (2).

The CHAIRMAN. Admiral, as I understand it, a man with serviceconnected disabilities is allowed hospitalization for other disabilities not service-connected, but he is carried as a non-service-connected case. Is that right? That is, although he may have service-connected disabilities, while he is hospitalized for other disabilities he is classified as nonservice connected?

Admiral BOONE. That is right.

The CHAIRMAN. I think most people forget that.
Mr. FRELINGHUYSEN. Madam Chairman.

The CHAIRMAN. The gentleman from New Jersey.

Mr. FRELINGHUYSEN. I am wondering if we are asking you to duplicate testimony you gave before the Appropriations Committee?

Admiral BOONE. That is correct, as to percentages of nonservice connected, except I did not have at that time the authority to quote for admission.

Mr. FRELINGHUYSEN. In the testimony you gave before the other committee you say 11 percent of the 65 percent had entitlement, and you go on to say approximately 50 percent, as I understand it, will be non-service-connected cases in our VA hospitals. Is that correct?

Admiral BOONE. In making my estimate, I figured about 8 or 10 percent are in that zone of debate, whether they should be taken in. Subtract the 8 or 10 percent from that 65 percent, and they would be the ones who would be nonservice connected but would have entitlement.

Mr. FRELINGHUYSEN. Roughly, 50 percent?

Admiral BOONE. Yes; but nearer 55 to 57 percent.

Mr. FRELINGHUYSEN. The only other question I was going to ask was how many vacant beds there are in the national picture, roughly? Admiral BOONE. Roughly, about 2,300 beds were taken out of operation, in the main, by the drastic 1953 budget cut. We were required to make a reduction in force of 2,250 employees from the August 31 hospital strength. We had to close beds, wards, and deprive that many veterans of hospitalization. We always have a certain number of beds out of commission due to altering or painting or some housekeeping jobs, but 2,300 beds we lost due to the budget cut.

Mr. FRELINGHUYSEN. You attribute that solely to the budget cut? Admiral BOONE. The 2,300 beds; yes.

Mr. FRELINGHUYSEN. I was wondering how many beds you estimate would be necessary to provide hospitalization to all service-connected and non-service-connected veterans, if there were no practical considerations to set a ceiling?

Admiral BCONE. I think I should state for 1952 we had an authorized average bed capacity of 119,421. That is actual. We had an average operating bed capacity of 109,841, roughly 10,000 less. We had an average daily patient load of 98,034, with an occupancy rate of 89 percent. I want to state that the American Hospital Association estimates an 85-percent occupancy rate is high, because you need about 15 percent as a cushion for emergencies.

Mr. FRELINGHUYSEN. My question was the amount needed to take care of all service-connected or non-service-connected.

Admiral BOONE. We estimated for 1953 that we would require 121,857 authorized beds and 109,750 operating beds. That was our estimate for the 1953 budget.

Madam Chairman said Mr. McNamara had been asked not to go into the 1954 estimates, and we are now required to reappraise the 1954 budget, and I think I should be absolved from discussing the 1954 budget.

The CHAIRMAN. I will absolve you under the circumstances.
Mr. TEAGUE. Madam Chairman.

The CHAIRMAN. The gentleman from Texas.

Mr. TEAGUE. Mr. Sam Stavisky, in an article published in the February 14, 1953, issue of Collier's magazine, says:

About 25,000 of the VA's 128,282 hospital beds are now empty, although 22,000 sick and diseased veterans are knocking vainly at the hospital doors. Thirteen new VA hospitals with 8,000 beds are due to be completed this year, but the agency has neither the money nor the personnel to operate them.

Would you comment on that statement?

Admiral BooNE. I dislike very much to have to comment on newspaper or magazine stories as to their factuality.

Mr. TEAGUE. Then this story is not true?

Admiral BOONE. I dislike to say a person does not state the facts. Mr. TEAGUE. It seems to me if this goes out to the people of the country and it is not true, it should be set straight.

Admiral BOONE. If there are statements made in there that are not the fact, I hope the public will be given the facts. We are having some very damaging reverberations because of that and similar articles. I have a letter on my desk from one manager who says it has wrecked the morale of his office. This is not the only story. Sadly, it seems to be the popular sport to attack the Veterans' Admin

istration, and those of us in the VA but those who are attacked must be of enough substance to weather it.

Mr. TEAGUE. I have read your testimony before the Appropriations Committee, and have read this article, and I do not know the situations as to beds. I do not think the Appropriations Committee knows. I would like to know. I think we should have exact facts.

Admiral BOONE. May I ask Commander Bigelow if he can answer your question? Commander Bigelow retired from the Navy after 45 years' service. He retired one evening and was in my office at 8:30 the next morning. He is director of our program analysis staff, and has been before many, many committees of Congress. He is here. He has bursitis, but I think he can answer your question.

Mr. TEAGUE. Since this comes up this afternoon, I think the question should be answered.

The CHAIRMAN. Yes; but before we begin on that, Mr. Prouty has been waiting for some time to ask a question. Go ahead, Mr. Prouty. Mr. PROUTY. Is it not true that the average stay for a GMS patient in a VA hospital is 30 days, as contrasted to the average stay in a private hospital of 8 days?

Admiral BoONE. That is correct. However, we cannot compare the care of veterans with the care of other civilians. The situation as to veterans is very different. We make an effort to rehabilitate people, to restore them in society. We keep them until they can go back and live in their homes. A civilian in a private institution is sent home as soon as he can get his foot out of bed. So that comparing veterans in VA hospitals with civilians in private institutions is not fair as there are many variables.

Mr. PROUTY. I raised that question because I wondered if the length of stay of veterans in VA hospitals could be reduced.

Admiral BOONE. May I say this: A doctor in private life, before he sends a patient to a hospital, usually does the preliminary work necessary on the patient so that when he goes in he is ready for surgery, let us say. In a VA hospital, all that is done after the patient gets in. Also, the records in a VA hospital are very different. They must be for all times for Government purposes, to protect the Government and to protect the veteran. That is not true in a private hospital necessarily.

Mr. LONG. May I ask a question?

The CHAIRMAN. Dr. Long, the gentleman from Louisiana.

Mr. LONG. Admiral, does not the age of the veteran, as compared with the age of the civilian, have a great deal to do with the number of days they spend in hospitals!

Admiral BOONE. A great deal. When you compare civilians in private hospitals with veterans in VA hospitals, you are comparing children who go in private hospitals for a day or two.

Mr. LONG. The greater age of the veteran, compared to children and younger people in civilian hospitals, would make a great deal of difference?

Admiral BOONE. I thank you for raising that question. That is right. The average age of Spanish War veterans is 76; the average age of World War I veterans is 59; and down the scale. We know when we get to be 76 and 59 we have diseases from which we do not recover rapidly. And you are trying to average old-age groups with children going in for a tonsillectomy or an ingrowing toenail, who are

in and out before you can get a history of them. So I think it is not a comparison that should enter into the situation.

That is a very important thing for the public to understand, and they do not understand it. Most of our difficulties in life are due to lack of information and misinformation. We try to give information, and that is one of our biggest services-to provide information. Some people do not want information.

As to Mr. Teague's previous question, I am glad Mr. Teague has asked for this information here. I think there was a time I will say this frankly-when a lot of figures were given out. We are now doing our best to screen all figures.

Mr. TEAGUE. In your statement, will you give the estimate you submitted to the Bureau of the Budget, the amount allowed by the Bureau of the Budget, and the amount allowed by the Appropriations Committee?

The CHAIRMAN. We seem to have innumerable committees investigating the Veterans' Administration, with a view to destroying the work being done for the veterans. It is one of the most vicious things I have come across in a good many years.

Admiral BOONE. That fact, Madam Chairman, in my almost 64 years, is incomprehensible to me as a physician. In my job I cannot understand how anyone in my profession would be other than constructive in approaching this job, and I am sorry there are some that are not constructive. This great medical program not only benefits the veterans, but it benefits this Nation, and it benefits humanity. Mr. CRETELLA. Madam Chairman.

The CHAIRMAN. The gentleman from Connecticut.

Mr. CRETELLA. You gave a figure of 21,000 non-service-connected cases awaiting entry into a hospital; is that correct?

Admiral BOONE. 21,444 plus.

Mr. CRETELLA. And I believe you said when one of those on a waiting list was reached, if he was not ready to go in the hospital at that time you would take him from the top of the waiting list and put him at the bottom of the list?

Admiral BOONE. Yes. He may have sickness in the family, or some other circumstance may prevent his going in when a bed is available. He is then put at the bottom of the list.

Mr. CRETELLA. Then if there is that rotation from top to bottom, the 21,000 always stay static. Is anyone ever removed?

Admiral BOONE. Yes; however, there is flexibility.

Mr. CRETELLA. But they are never removed, they are just rotated? Admiral BOONE. No. Admissions are made continually from waiting lists. The waiting list has a flexibility, but it is not too flexible. Commander Bigelow has some figures, Mr. Teague.

Mr. BIGELOW. As of December 31, 1952, we had total authorized beds of 120,173. Of that number, 108,208 represented operating beds. There were 11,965 beds unavailable. Here is a summary of the reasons for their unavailability: 3,092 beds were new beds not yet activated.

Mr. TEAGUE. Why not?

Mr. BIGELOW. New construction; new hospitals. These are not operating beds.

Ceiling or funds inadequate, personnel not recruitable accounted for 3,340.