Admiral BOONE. Mr. Congressman, I am quite sure you were not here the first day I testified, and I inserted in the record a very fine article from the national commander of the American Legion in the February number of the Legion magazine. He uses 14.4 percent, rather than my figure of 10 percent, but absorbed much of that 14.4 percent as entitled.

Mr. SPRINGER. I am familiar with that article. It is a very good article.

Admiral BOONE. And the breakdown in the 14.4 needs to be considered. Because there are a lot of elements in that which reduce it beyond the 14.4 percent.

Mr. EDMONDSON. I think Mr. Springer has stated a point of view that, in my experience, is certainly the point of view of the World War II veteran, by and large. But I think that at the same time I am very doubtful, even though it seems to me advisable to inquire into that situation and to see what can be done along that line, that that will meet the specific problem on which I get most of my mail on the subject of veterans' care, and that is the problem of your neuropsychiatric and of your tubercular patients, who have to wait a long time to get beds in the tubercular or neuropsychiatric wards of the hospitals.. Mr. SPRINGER. I think you are right. It seems to me this is the group that ought to be taken off. This group of neuropsychiatric and tubercular in the service-connected are the first people that should be taken care of. That is the heart of the program, as I see it. But there has been, by some groups, apparently, back before World War II, emphasis upon this group up here; that is, taking care of a man merely because he is a veteran. You take him through medical care solely because he is a veteran, whether he has service connection or not.

I think the admiral is right that we ought to have quality, but if it is necessary to sacrifice anything the quality should be distributed down here, and we should take this group off the top who do not have, as I see it, a real call on the VA medical program.

Admiral BOONE. Mr. Congressman, may I be brutally realistic, from my position where I sit, my official position? This always applies, as I have found, since I have been in the job, to "the other fellow."

When it is my interests, my family, my relative, and, I may say my constituents, it is a matter of "Won't you please make an exception?" I get a lot of telephone calls to make exceptions.

And then, I must say this, in all fairness. I have had this personal experience, and every manager from his experience tells me it is a high percentage. When the patient runs out of money, people interested in him want him taken to the VA hospital and even ask for an ambulance to take him there. In your own State, one Sunday, I was telephoned and asked to take a patient in who had cancer. I said, "Non-service-connected?" The answer was, "Yes." I said, "Has he a private physician?" "Yes."

"What does the private physician say?"

"Well, he wants him in the VA hospital. This man can't afford to pay him any more."

Mr. SPRINGER. I think you are right, Admiral. I think the fundamental question, coming back to this, is: Are we, the Government, obligated to take care of 20 millions of veterans just because they are veterans, upon a specialized medical program? I think that is the real, fundamental problem, isn't it?

Admiral BOONE. And that is the decision which you so well know has to be made in the Halls of Congress.

Mr. SPRINGER. We understand.

Admiral BOONE. We act on the laws of today, and we shall act on the laws of tomorrow.

Mr. SPRINGER. I think I am presenting a fundamental viewpoint that is held by the public at large, and I think I am speaking for a large group of veterans in that program.

I will yield to the gentleman from Tennessee.

Mr. EVINS. There is a latitude, in that the admitting officer has jurisdiction to admit or deny admittance of a veteran based on the circumstances of the case. There is also the so-called pauper's oath provision required under law, as the gentleman knows. If the veteran makes a statement over his own signature that he does not have the money, that he is unable to pay, you would not want to deny him, as a veteran who had fought for this country, some medical care.

Mr. SPRINGER. Well, I think you are raising the other viewpoint, Mr. Evins. Not being dogmatic about it, I think there are two viewpoints there. That is the question whether the veteran is entitled to it merely because he is a veteran and nothing else.

Mr. EDMONDSON. There is something wrong with the management or operation, when people who have the appendectomies and tonsillectomies are taken care of, and the people who have tuberculosis and neuropsychiatric ailments are not being taken care of.

The CHAIRMAN. The gentleman from Connecticut; and then the gentleman from Texas.

Mr. CRETELLA. There are two questions I would like to ask you. One is on this question of a veteran with a nonservice-connected disability and request for hospitalization. Are you merely satisfied with his own statement that he is unable to pay?

Admiral BOONE. That is the law. It says we shall accept his state

ment.

Mr. CRETELLA. Without further investigation?

Admiral BOONE. Yes. Of course, after he is in, if you had somebody who gave you valid proof that he premeditatedly intended to defraud his Government, you can take action. But you have to prove it. While I am not a lawyer, I am told that proving fraud is one of the most difficult legal procedures.

Every American citizen has a responsibility, if he knows somebody has signed that oath fraudulently, and he can prove it and have that man prosecuted. I think that is an onus which rests on every citizen of the United States, and not just on the hospital manager. Certainly the attending physician in communities knows more about the economic status of patients and neighbors than would the admitting officer or manager of hospitals where patient presents himself for admission and the referring physician has responsibilities to the Government to inform the hospital of patient's economic status.

Mr. CRETELLA. The same holds true with any request for public welfare. Any person entitled to it can get it. But by the same token, some investigation is made. If a man says he cannot pay for it, that, of itself, is not fraud. Ability to pay is one thing, and fraud is another.

Admiral BOONE. It is his opinion that he cannot afford to pay. Now, I have said this to medical people. Opinion, something within

yourself, is very hard to disprove. For instance, none of us physicians can disprove a person thinking he has a headache or a backache. There is no way to disprove it. That is his opinion. He has got it. And in this instance, the presumption is that the man's opinion is that he cannot afford to pay. Certainly I have no desire to protect in anyway anybody who would practice fraud on his country.

VETERANS' ADMINISTRATION, Washington 25, D. C., August 5, 1952. To: Managers, all Veterans' Administration hospitals, regional offices, and area medical directors.

1. VA Form 10-P-10, Application for Hospital Treatment and Domiciliary Care, has been revised, and the revision of April 1952 will be available for distribution in the near future. Instructions for all entries on VA Form 10-P-10 are contained in Technical Bulletin 10A-289 and changes thereto, and while applicable to the revision of November 1951, they are equally applicable to the revision of April 1952.

2. On the revision of April 1952, item 30 has been rearranged to include in the space used for this item a warning as to penalty provisions. The penalty provisions, as distinct from a warning, were printed on the reverse of the November 1951 revision.

3. It is essential that all personnel who come in contact with this form thoroughly understand the questions asked, and be familiar with its use and purpose.

4. In those instances in which an oath is required, the person who administers it will see that the questions and answers are read by or to the applicant and will check the appropriate block in item 31 to indicate the action taken.

5. Except where the applicant is mentally incapable of understanding or is in an emergent condition, the warning will be specifically called to his attention.

(For the Administrator.)

The CHAIRMAN. Will the gentleman yield for just 1 minute? Would you not like to have the law read? Would you like to have that one paragraph read?

Mr. CRETELLA. I can get it, if you will just cite it to me.

The CHAIRMAN. I think perhaps the members of the committee would like to hear it. Will you read it out loud, Mr. Cretella? We would like to have it in the record.

.Mr. CRETELLA (reading sec. 6, title I, Public Act No. 2, 73d Cong.). In addition to the pensions provided in this title, the Administrator of Veterans' Affairs is hereby authorized, under such limitations as may be prescribed by the President, and within the limits of the existing Veterans' Administration facilities, to furnish to veterans of any war, including the Boxer Rebellion and the Philippine Insurrection, domiciliary care where they are suffering with permanent disability, tuberculosis, or neuropsychiatric ailments, and medical and hospital treatment for diseases or injuries;

* *

*

Provided, That any veteran of any war who is not dishonorably discharged, suffering from disability, disease, or defect, who is in need of hospitalization or domiciliary care, and is unable to defray the necessary expenses therefor (including transportation to and from the Veterans' Administration facilities), shall be furnished necessary hospitalization or domiciliary care (including transportation) in any Veterans' Administration facility, within the limitations existing in such facilities, irrespective of whether the disability, disease, or defect was due to service. Statements under oath of the applicant on such form as may be prescribed by the Administrator of Veterans' Affairs shall be accepted as sufficient evidence of inability to defray necessary expenses.

Now, Admiral, there is one other question I should like to ask you. The members of this committee are not personally interested, but I

30158-53--7

VETERANS ADMINISTRATION

Form approved.

Budget Bureau No. 76-R001.3.

APPLICATION FOR HOSPITAL TREATMENT OR DOMICILIARY CARE

1. I HEREBY APPLY TO THE VETERANS 2. LAST NAME-FIRST NAME-MIDDLE NAME (Type or print) ADMINISTRATION FOR (Check)

3. CLAIM NO.

5. IF YOU SERVED UNDER A NAME OTHER THAN THE ONE LISTED ABOVE, ENTER THAT NAME AND SERVICE DATES IN THIS SPACE

6A. PERMANENT ADDRESS

7A. NAME OF PERSON TO BE NOTIFIED IN EMERGENCY

8. PLACE OF BIRTH

THE FOLLOWING DATA ARE FOR ADMINISTRATIVE PURPOSES and Are Not Used for Determination of Eligibility:

26. I DESIGNATE THE FOLLOWING PERSON OR PERSONS IN THE ORDER LISTED TO RECEIVE POSSESSION OF ALL MY PERSONAL PROPERTY LEFT ON PREMISES UNDER THE CONTROL OF THE VA AFTER LEAVING SUCH PLACE OR AT THE TIME OF MY DEATH

30. I AGREE to accept transfer to another hospital, or my home, if in the opinion of the medical staff such transfer is deemed expedient. I understand the questions. The answers to all questions are true and complete to the best of my knowledge and belief. I acknowledge notice of the effect of the law mentioned on the reverse side hereof.

(This application must be signed in all cases)

(Signature of applicant or representative)

WARNING.-If you knowingly make a false statement of any material fact in or in connection with this application, you are subject to possible forfeiture of veterans' benents, and prosecution in a United States Court.

31. Subscribed and sworn to before me this

day of.

19.

by.

, claimant, to whom the statements herein were fully made known and explained. I certify that the questions and answers thereto have, in my presence, been (SEAL) READ TO READ BY the claimant.

NOTE. The law provides that upon the death of any veteran receiving care or treatment by the Veterans Administration in any institution leaving no widow (widower), next of kin or heir entitled to inherit, all personal property, including money or balances in bank, and all claims and choses in action, owned by such veteran, and not disposed of by will or otherwise, will become the property of the United States as trustee for the Post Fund.

MEDICAL CERTIFICATE

(NOTE TO EXAMINING PHYSICIAN.-History, symptoms and physical findings must be recorded in sufficient detail to clearly support the diagnosis. If additional space is needed, attach plain sheets of paper)

INSTRUCTION.-If this application is to be referred from VA station to which originally submitted, stamp name and address of referring VA etation in the margin below

U. S. GOVERNMENT PRINTING OFFICE 16-65875-2

am, in the Allentown-West Haven Hospital. I have had many inquiries directed to me as to when that hospital will be opened. I directed a letter to the Veterans' Administration a week or more ago, and I have received no response yet. I received a call yesterday from one of the newspapers in my town, and my observation was brought closer by a statement in the Congressional Record, which I cannot lay my finger on just at the moment, as to why that hospital has not been finished and opened up. Can you tell me?

Admiral BOONE. Yes:

Construction delays, West Haven, Conn. TB building to be opened April 1953. General medical and surgical building to be opened July 1953.