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"Ways and Wicans. Siccommittee on SELECTED MEDICARE ISSUES

Health

HEARING

BEFORE THE

SUBCOMMITTEE ON HEALTH

OF THE

COMMITTEE ON WAYS AND MEANS

HOUSE OF REPRESENTATIVES

NINETY-FOURTH CONGRESS

FIRST SESSION

ON

SELECTED MEDICARE ISSUES

SEPTEMBER 19 AND 26, 1975

Printed for the use of the Committee on Ways and Means

U.S. GOVERNMENT PRINTING OFFICE

WASHINGTON : 1975

60 447

KF27
.W344
1975c

COMMITTEE ON WAYS AND MEANS

AL ULLMAN, Oregon, Chairman WILBUR D. MILLS, Arkansas

HERMAN T. SCHNEEBELI, Pennsylvania JAMES A. BURKE, Massachusetts

BARBER B. CONABLE, JR., New York DAN ROSTENKOWSKI, Illinois

JOHN J. DUNCAN, Tennessee PHIL M. LANDRUM, Georgia

DONALD D. CLANCY, Ohio CHARLES A. VANIK, Ohio

BILL ARCHER, Texas OMAR BURLESON, Texas

GUY VANDER JAGT, Michigan JAMES C. CORMAN, California

WILLIAM A. STEIGER, Wisconsin WILLIAM J. GREEN, Pennsylvania

PHILIP M. CRANE, Illinois SAM M. GIBBONS, Florida

BILL FRENZEL, Minnesota JOE D. WAGGONSER, JR., Louisiana

JAMES G. MARTIN, North Carolina JOSEPH E. KARTH, Minnesota

L. A. (SKIP) BAFALIS, Florida OTIS G. PIKE, New York

WILLIAM M. KETCHUM, California RICHARD F. VANDER VEEN, Michigan J. J. PICKLE. Texas HENRY HELSTOSKI, New Jersey CHARLES B. RANGEL, New York WILLIAM R. COTTER, Connecticut FORTNEY H. (PETE) STARK, California JAMES R. JONES, Oklahoma ANDY JACOBS, JR., Indiana ABNER J. MIKVA, Illinois MARTHA KEYS, Kansas JOSEPH L. FISHER, Virginia HAROLD FORD, Tennessee

John M. MARTIN, Jr., Chief Counsel
J. P. BAKER, Assistant Chief Counsel
JOHN K. MEAGHER, Minority Counsel

SUBCOMMITTEE ON HEALTH

DAN ROSTENKOWSKI, Illinois, Chairman

JAMES C. CORMAN, California
OTIS G. PIKE, New York
CHARLES A. VANIK, Ohio
OMAR BURLESON, Texas
JOE D. WAGGONNER, JR., Louisiana
WILLIAM R. COTTER, Connecticut
MARTHA KEYS, Kansas

JOHN J. DUNCAN, Tennessee
PHILIP M. CRANE, Ihinois
JAMES G. MARTIN, North Carolina
DONALD D. CLANCY, Ohio

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58.3

416

518

164

369
513
174

137

209

PUBLIC WITNESSES

Adams, Joseph P., International Chiropractors Association.-

Ahern, Margaret, Council of Home Health Agencies and Community

Health Services.-

Ambulance and Medical Services Association of America, Wilford H.

Leonard
American Academy of Physician Assistants, Thomas Godkins, John Elliott

Dixon, J.D., and Dr. Donald W. Fisher...
American Association of Professional Standards Review Organizations,

John W. Bussman, M.D.--
American Association of Retired Persons, National Retired Teachers Asso-

ciation, Ernest Giddings and Laurence Layne..
American Cancer Society, Illinois Division, James E. Cassidy, M.D., and

John J. McLaughlin, M.D..
American Chiropractic Association, William H. Dallas_-
American Congress of Rehabilitation Medicine, Richard E. Verville-
American Dental Association and the American Society of Oral Surgeons,

Dr. I. Lawrence Kerr, Hal Christensen, and Edwin Cohen...-
American Dietetic Association, Annie Galbraith, Isabelle Hollahan, and

Jeanne Kruhm..
American Health Care Association, Dr. Thomas G. Bell, Bruce Taylor, and

Bruce D, Thevenot --

American Hospital Association, Leo J. Gehrig, M.D., Allen J. Manzano,

and Irwin Wolkstein-

American Jewish Congress, Martin Hochbaum.-
American Medical Association, Edgar T. Beddingfield, Jr., M.D., C. Willard

Camalier, Jr., M.D., and Harry N. Peterson.-

American Nurses' Association, Cloace McGill, Alice Davis Seale, and

Constance Holleran.-

American Osteopathic Association, Earl A. Gabriel, D.O., John C. Taylor,

D.O., and John Perrin.---

American Personnel and Guidance Association, Dr. Herbert Rusalem..

American Psychiatric Association, Dorthy A. Starr, M.D.-.

American Psychological Association, Association for the Advancement of

Psychology, and Council for the Advancement of the Psychological Pro-

fessions and Sciences, Dr. Joan Willens.-

American Society of Oral Surgeons and the American Dental Association,

Dr. I. Lawrence Kerr, Hal Christensen, and Edwin Cohen----

American Speech and Hearing Association, Larry B. Cornish, Esq---

Association for the Advancement of Psychology, American Psychological

Association, and Council for the Advancement of the Psychological

Professions and Sciences, Dr. Joan Willens--

155

21

290

115

Association of American Medical Colleges, Council of Teaching Hospitals, Page
Charles Womer.

430
Bagger, Hope, New York Gray Panthers..

183
Beddingfield, Edgar T., Jr., M.D., American Medical Association --

115
Bell, Dr. Thomas G., American Health Care Association.--

155
Bernstein, Sol, M.D., Los Angeles County Medical Center, Faculty
Medical Group---

443
Blue Cross Association, Bernard R. Tresnowski.

92
Blue Shield Plans, National Association of, William E. Ryan and James
D. Knebel ---

141

Brickner, Dr. Phillip W., St. Vincent's Hospital and Medical Center of

New York.

313

Bromberg, Michael D., Federation of American Hospitals.

Buchanan, L. C., M.D., Decatur, Ga----

522

Buckley, Irene G., National Cancer Foundation.--

265

Bussman, John W., M.D., American Association of Professional Standards

Review Organizations ..

518

Camalier, C. Willard, Jr., M.D., American Medical Association---

115

Carney, Hon. Charles J., a Representative in Congress from the State of
Ohio

487
Carter, Hon. Tim Lee, a Representative in Congress from the State of
Kentucky

590
Cassidy, James E., M.D., American Cancer Society, Illinois Division.

569
Cholette, Robert, National Easter Seal Society for Crippled Children and
Adults

280

Christensen, Hal, American Dental Association and the American Society

of Oral Surgeons..-

137

Connecticut Council on Human Services, Gloria Schaffer-

33.)

Cohen, Edwin, American Dental Association and the American Society of

Oral Surgeons_-

137

Collins, Hon. Cardiss, a Representative in Congress from the State of
Illinois

512

Cornish, Larry B., Esq., American Speech and Hearing Association -

174

Council of Home Health Agencies and Community Health Services,

Margaret Ahern.--

240

Council of Hospitals and Health Related Institutions, Rose M. Hauer--- 576
Council for the Advancement of the Psychological Professions and

Sciences, American Psychological Association, and Association for the
Advancement of Psychology, Dr. Joan Willens.--

33

Dallas, William H., American Chiropractic Association ---

513

Dixon, John Elliott, M.D., American Academy of Physician Assistants.. 450

Fairfield County, Conn., Easter Seal Rehabilitation Center, Edmund S.

McLaughlin

339

Federation of American Hospitals, David G. Williamson, Jr., and Michael

D. Bromberg---

Fisher, Dr. Donald W., American Academy of Physician Assistants.

416

Gabriel, Earl A., D.O., American Osteopathic Association -

13+

Galbraith, Annie, American Dietetic Association -

271

Garrison, John, Hospital Association of New York State-

179

Gehrig, Leo J., M.D., American Hospital Association.

21

Georgia, Medical Association of, Harrison L. Rogers, Jr., M.D....

518

Giddings, Ernest, American Association of Retired Persons and National

Retired Teachers Association ----

164

Godkins, Thomas, American Academy of Physician Assistants-

416

Hamburg. Dr. Richard A., Unihealth Services Corp---

361

Hauer, Rose M., Council of Hospitals and Health Related Institutions.. 576

Hochbaum, Martin, American Jewish Congress..

200

Hollahan, Isabelle, American Dietetic Association.

209

Holleran, Constance, American Nurses' Association..

36

Holtzman, Hon. Elizabeth, a Representative in Congress from the State

of New York ---

488

Homemakers-Upjohn, Edward J. Wilsmann.

314

Hunt, James, M.D., National Kidney Foundation...

371

Hurst, 0. Ray, Texas Hospital Association --

579

Illinois Department of Public Health, Allen N. Koplin, M.D..

398

Page
389

513

585

443

361

191

21
513
550
36

339
570

383

Illinois End-Stage Renal Disease Network Coordinating Council, Ewald

T. Sorensen, M.D.---
International Chiropractors Association, Joseph P. Mazzarelli, Joseph P.

Adams, and Harry N. Rosenfield-

Kerr, Dr. I. Lawrence, American Dental Association and the American

Society of Oral Surgeons----

Knebel, James D., National Association of Blue Shield Plans...

Koch, Hon. Edward I., a Representative in Congress from the State of

New York...

Koplin, Allen N., M.D., Illinois Department of Public Health

Kruhm, Jeanne, American Dietetic Association---

Layne, Laurence, American Association of Retired Persons and National

Retired Teachers Association ----

Leonard, Wilford H., Ambulance and Medical Services Association of

anerica and Oregon State Ambulance Association -

Los Angeles County Medical Center, Faculty Medical Group, Sol Bern-

stein, M.D.

Lupin. Dr. E. Ralph, Unihealth Services Corp-

MacDonald, Dave, National Council of Health Care Services.-

Manzano, Allen J., American Hospital Association ---
Jazzarelli, Joseph P., International Chiropractors Association..
JcClelland, John F., National Association of Retired Federal Employees.-
McGill, Cloace, American Nurses' Association --
McLaughlin, Edmund S., Fairfield County, Conn., Easter Seal Rehabili-

tation Center-
McLaughlin, John J., M.D., American Cancer Society, Illinois Division --

Messer, Phyliss, National Association of Patients on Hemodialysis and

Transplantation

Moore, Florence M., National Council for Homemaker-Home Aide

Services

National Association of Home Health Agencies, Donald D, Trautman.--

National Association of Patients on Hemodialysis and Transplantation,

Phyliss Messer.---

National Association of Retired Federal Employees, John F. McClelland

and Judy Park.

Vational Cancer Foundation, Irene G. Buckley and Mary Overton.

National Council of Health Care Services, Dave MacDonald.

National Council for Homemaker-Home Health Aide Services, Florence M.

Moore

National Easter Seal Society for Crippled Children and Adults, Robert

Cholette

National Kidney Foundation, James Hunt, M.D.-

National Retired Teachers Association, American Association of Retired

Persons, Ernest Giddings and Laurence Layne_-

New York Gray Panthers, Hope Bagger---

New York State, Hospital Association of, John Garrison.-

O'Brien, Hon. George M., a Representative in Congress from the State of

Illinois

Oregon State Ambulance Association, Wilford H. Leonard.

Overton, Mary, National Cancer Foundation -

Park, Judy. National Association of Retired Federal Employees..

Pepper, Hon. Claude, a Representative in Congress from the State of

Florida

Perrin, John, American Osteopathic Association -

Peterson, Harry N., American Medical Association

Professional Care, Inc., Martin Weissman

Reese, Eva. Visiting Nurse Service of New York.

Renal Physicians Association, John H. Sadler, M.D.

Rogers. Harrison L.. Jr., M.D., Medical Association of Georgia

Rosenfield, Harry N., International Chiropractors Association -

Rusalem, Dr. Herbert, American Personnel and Guidance Association.

Ryan, William E.. National Association of Blue Shield Plans------

Sadler, John H., M.D., Renal Physicians Association --

St. Vincent's Hospital and Medical Center of New York, Dr. Phillip W.

Brickner

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