Page images

Whereas such discriminatory exclusion of physicians and their patients from access to hospitals of their choice is in criminal violation of the antitrust laws of the State of California and of the United States; and

Whereas in 1961, the California Democratic Council went on record to the effect that, “Doctors should not be denied access to use of hospitals for reasons other than medical competency and professional character”: Therefore, be it

Resolved, That the California attorney general be urged to investigate and prosecute California hospitals, and county and State medical societies for criminal violations of the antitrust laws relative to exclusion of licensed physicians from hospital staffs. Respectfully submitted.

BEN ROSNER, M.D.. Chairman, Subcommittee on Medical Issues, 13th Assembly District Coun

cil of Democratic Clubs; Chairman, Subcommittee on Medical Issues,

9th Congressional District Council of Democratic Clubs. There is no doubt that we have a great shortage of physicians. I have before me a little item from the Daily Review of Hayward dated March 12, 1962, "Human Factors"—this is on page 1—“More Cancer Cases Could Be Considered." Then listed here is a statement: “The shortage of medical manpower to perform the immense task of examining well people to detect cancer in its early stages is one of the human factors in this problem of cancer.” I could quote many other probJems. I think it is important. I have statistics on medical school application decline while population grows.

Mr. O'HARA. Might I interject for just a moment here?
Dr. ROSNER. Yes.

Mr. O'HARA. We also recognize that the time is short. If you think you could set forth more completely and more convincingly the points that you

have made by reference to these matters, and if you want to submit a background statement or background material, we shall grant you permission to do so and have it printed in the record following your statement.

Dr. ROSNER. Thank you. I would appreciate that opportunity and thus will not further state any more matters right now; if you gentlemen have any questions of me, I would be glad to answer them.

Mr. O'HARA. I want to thank you and all the others who have testified for taking the time to attend these hearings.

I might add that I am aware, and I am sure other members of the subcommittee are, too, of the problems that have been created in certain places from time to time by practices associated with the admitting of physicians to hospital staffs. Since one of the problems confronting any program to aid the aging is a general lack of trained

a personnel in medical and other fields, this is certainly one of the questions that would be examined by any commission, agency, or office that might be established by Congress following the recommendations of this committee.

I assure you that if this committee reports any bill, it will call attention to the problem of the shortage of personnel in the field. I think you may rest assured that the problem to which you have referred would be a part of that investigation.

Mr. Giaimo, do you have any questions?

Mr. O'HARA. We wish to thank you again, Dr. Rosner, for appearing. We are hopeful that the problems you have raised and those raised by other witnesses will receive some attention in the months ahead.

Dr. ROSNER. Thank you, Congressman O'Hara. I believe it will. Thank all of you gentlemen.

Mr. O'HARA. We have received a statement from the Honorable • Jeffery Cohelan, representing the 7th District of California. I will

ask the committee counsel, Mr. Robert McCord, to read Mr. Cohelan's statement, and the reporter will record it for inclusion in the record of the hearings. STATEMENT OF HON. JEFFERY COHELAN, A REPRESENTATIVE IN


Mr. McCORD (reading): Mr. Chairman, I appreciate this opportunity to file a statement with your subcommittee. As you know, I warmly endorse the important work which you are performing, and I deeply regret that my legislative schedule prevents me from being with you today. I particularly regret not being with you since you are holding this important hearing in my hometown of Berkeley ; in the great 7th Congressional District which I have the privilege to represent, and on the campus of my alma mater, the University of California.

I firmly believe, Mr. Chairman, that there is no more important task confronting us today than to rigorously explore, and, on the basis of this exploration, find meaningful solutions to the many and complex problems confronting our Nation's senior citizens.

These problems are not isolated to a single area. If they were, solutions might be easier to find. They are not limited, furthermore, to the 17 million persons in the United States age 65 and over, a group which represents more than 9 percent of our total population and more than 15 percent of our entire adult population. These problems are also of serious concern to the many young people who have aged parents to support; to the middleaged who find employment opportunities closing to them; and to these who are about to step over the threshold into the strange and uneasy world of retirement.

These problems range the entire spectrum of our daily existence. They enter into such significant facets of our daily life as education, medical care, housing, employment, pensions, and productive use of retirement years.

In the area of medical care, studies show that our senior citizens go to the hospital more frequently and stay longer than their younger neighbors; that their physical activity is limited by six times as much disability as the rest of our population; and that their annual medical bills are twice that of persons under 65, although their average annual incomes are only half as high.

In the area of employment, data developed by the U.S. Department of Labor provides ample evidence of discrimination because of age, and of the irrelevant nature of such discrimination. Such experiences are not only degrading for the able individual, but are a severe loss to our economy and to our society. In this respect, I am gratified that the Federal equal employment opportunities bill which I supported and joined in introducing, and which would make it unlawful for an otherwise qualified individual to be discriminated against in employment merely because of his age, has been approved by the House Committee on Education and Labor.

Mr. Chairman, similar cases can be made for each of the other areas I have mentioned in which our senior citizens suffer serious and continuing hardship, and I am sure that persuasive and moving examples will be brought out in these timely hearings which you are conducting today.

The responsibility for seeking solutions to these grave problems is not, and must not be, of course, merely a matter of concern for the Federal Government. It is, rather, a challenging responsibility for all levels of government, for private agencies, and for the individual citizen.

The Federal Government, however, does have an important role to play, and to date I do not believe it has done enough. It is for this reason that I support the bill on which your committee is holding hearings—a bill which would establish a permanent and independent U.S. Commission on Aging. It is for this reason that I have inroduced my own bill to establish a select committee in the House of Representatives to conduct a full and comprehensive study of matters pertaining to the problems of older people.

The Senate has for some time had a very competent and effective committee functioning in this important field. Unfortunately, there is presently no single committee in the House of Representatives dealing on an across-the-board basis with the highly interrelated problems of our senior citizens. It is my firm conviction that we in the House can ill afford to further neglect concentrated and sustained inquiry in this area of grave human need.

Mr. Chairman, the problems of our aging population are formidable in scope; they are complex in their ramifications; and, as a cursory inspection of current data will show, they require our urgent attention.

I heartily commend this distinguished subcommittee of the House Committee on Education and Labor for undertaking these important hearings. I sincerely hope that your findings will pave the way for the kind of appropriate action and sound legislation which I am confident will lead to creative solutions to an ever-growing national problem.

Mr. O'HARA. I wish to state that we appreciate having Mr. Cohelan's statement included in the record of these hearings in Berkeley. Mr. Cohelan's interest in these problems is well known in Washington.

We had hoped to have time to ask for statements from interested citizens in the audience who might care to make them. Unfortunately, we have run over the time allotted for these hearings, and it will not be possible to do so.

However, any person in the audience who wanted to testify but did not have the opportunity may submit a brief written statement either today or within the next few weeks, if he will speak to me or to one of the members of the staff immediately following the adjournment of this hearing. We shall be happy to make arrangements so that will be possible.

We thank you very much, all of you, for taking the time to help us in our consideration of these problems. I shall declare the hearing at Berkeley, conducted by the General Subcommittee on Aged and Aging of the House Committee on Education and Labor, adjourned. (Whereupon, at 1:05 p.m., the subcommittee adjourned.) (The following was received for the record :)


Hollywood, Calif., April 20, 1962. Re H.R. 10014. GENERAL SUBCOMMITTEE ON EDUCATION, Washington, D.C. (Attention Cleveland M. Bailey, Chairman).

MR. CHAIRMAN, MEMBERS OF THE SUBCOMMITTEE: The White House Conference on Aging which convened in 1961 brought to light sobering facts concerning our senior citizens. Fifty States and three American territories contributed their findings gathered over a 2-year period.

In brief, they told a story of our Nation substantially different from our popular picture; while America is still a young nation, as sociologists and demographers have been reminding us, we are no longer a nation of young people. Modern medicine and sanitation, control of infectious diseases, a more comfortable way of living have combined to prolong life so that today, in 1962, we are privileged to have among us more than 16 million citizens over 65 years of age. By 1970, in a conservative estimate we may well have 22 to 23 million in the 65-and-over age group, certainly a substantial proportion of our total population. Thoughtful citizens will be grateful that the needs and desires and problems of so many should be the concern of such a bill as H.R. 10014.

Because southern California is one of many regions particularly attractive to our senior citizens, in planning California City we felt compelled to do some careful and painstaking research into the area of their special needs. Our own efforts demonstrated clearly the need not only of new, more realistic and imaginative programs in housing, recreation, health, and social services but in that vital area of the whole man and the total field of his independently chosen

community relationships. Senior citizens, our research indicated to us, did not want to be retired from society and isolated in what might well be termed “a senior citizen ghetto"; side by side with a desire for an environment in which particular physical and social amenities are conveniently at hand, we detect a strong desire by senior citizens to remain active in the community's life and to engage in social and recreational activities together with people of all ages within the community. Parenthetically it may be noted that for many people the older years are precisely the ones in which for the first time they have the available hours for participating actively in a community life and to give to the community the benefit of the accumulated experience that years have afforded them.

We endorse the objectives of this bill, first because they do take the compartmentalizing devil out of our senior citizen planning and programing and afford older people their full measure as is the reasonable desire and just due of any adult.

But we also take particular note in H.R. 10014 of provisions for solid research projects, on State and local levels, with regional findings channeled into a central Federal agency. This would fill a large existing void.

No single private developer can afford to do all research necessary to create optimum proportions in his planning for senior citizens. Just as one illustration of what could be accomplished by a type of information clearinghouse on a Federal level, the simple cataloging of all working senior citizen projects in the United States could be of immense help to private developers and thus to senior citizens. Furthermore, there must be some central agency coordinating research, and channeling and disseminating the gathered knowledge to those responsible for local programs.

Localities differ and perhaps, also, the needs existing in the localities. Only an overall and central agency operating through local agencies and projects can put this information together, in perspective, in a manner which can be most effectively utilized.

In summary, then : while we, as developers, are proud of our own conscientious efforts to plan properly for senior citizens in California City, we feel that our planning and programing for our older age groups would be greatly reinforced by the passage of this bill and in the firm and full implementations of its commission, agencies, titles, and objectives. Very truly yours,

N. K. MENDELSOHN, President.

STATEMENT OF CALIFORNIA PODIATRY ASSOCIATION The California Podiatry Association wishes to go on record as favoring establishment of a Federal Commission on Aged and Aging.

As members of a profession which deals in treatment of foot ailments among the elderly, we have the occasion to regularly be reminded of the need for adequate care for the aging. All too often disabled older patients are seen whose disability could have been minimized or eliminated entirely through proper treatment at the proper time. The confusion that is evidenced by these people when questioned as to why treatment was not instituted earlier is a good example of the lack of a central coordinating agency for the aged which could offer guidance, assess their needs, disseminate information to them, and finally develop some action in a field which needs a boost in the proper direction.

Present programs by the State of California provide a measure of foot care for the aged welfare patient. The old age security program of the State has enabled many thousands of foot sufferers to resume an active role in society instead of being relegated to the bed patient or rocking-chair status. Unfortunately, even a large percentage of welfare patients are deprived of needed foot care through lack of knowledge, mental confusion, transportation problems, and other geriatric peculiarities. Local community agencies have examined the problems of aging and have made minor efforts to meet them. The subject as a whole is being touched on lightly with concern being the principal form of decision.

Despite the efforts that are being made the foot health needs of the aged welfare persons are not being met, and more especially meeting the needs of older people in low-income groups who do not meet State welfare requirements remains an unanswerable problem. This applies particularly to those individuals living in smaller population areas where the opportunity to be treated at medi

87006—62-pt. 1-12

cal schools, podiatry association clinics, and private hospital clinics does not exist. There is no present means or agency to handle this group and the incidence of foot morbidity is high with these individuals.

The California Podiatry Association feels that impetus must be provided so that this challenge can be met. The ultimate goal is the establishment of local community foot clinics (possibly through public health departments) or county foot clinics. Another method of meeting this problem in the rural and sparsely settled areas is through the use of mobile units that might be established in cooperation with other groups, such as dentists, optometrists, nurses, and other therapists. Some new and bold approach must be found if we are to bring adequate foot care to these low-income groups that cannot be serviced through large central community organizations.

Again the stimulus of an active commission in Washington may be the motivating factor needed to get such programs in operation. Certainly, Federal organizing and financial support, at least in the organizational stages, will be imperative if we are to get programs underway that combine the talents of many professions and resources.

Such a commission would also encourage the implementation of decisions and recommendations made by the various State conferences and by the White House Conference on Aging. The California Governor's Conference on Aging in October 1960, cited the need for diagnostic facilities and regional rehabilitation centers. New self-care and other services in hospitals were stressed. Within these structures as well as in independent practice the resources of the dental, optometric, and podiatric professions should be afforded the elderly, according to the conference recommendations.

While the podiatrist is only licensed to treat, both medically and surgically, all conditions of the foot, his examination will often reveal other pathological conditions which are then referred to a physician and surgeon.

In southern California several bundred nursing homes, retirement homes, sanatoriums, and hospitals have podiatrists in attendance. The demand is growing as the value of comfortable, ambulatory patients is realized by administrators, and medical and nursing personnel.

A partial survey. made recently of the members of the California Podiatry Association, which numbers less than 400 members, found that 100 members of the association were serving 1,000 patients monthly at these institutions and devoting approximately 3,000 hours per month. The survey revealed the following:

(1) Podiatrists and podiatry students have spent 2 hours each Monday morning for the past 22 years giving foot care for the indigent elderly at the Laguna Honda Home operated for the aged by the city and county of San Francisco.

(2) At the California Podiatry College and Hospital 20 podiatrists and 60 students treat 500 patients over 65 each month at foot clinics operated for lowincome groups.

(3) The southern division of the California Podiatry Association operates a foot clinic for low-income groups in Los Angeles with 30 podiatrists participating. Over 400 elderly patients are treated each month.

(4) Other institutions in which podiatrists treat low-income elderly persons are: Eastern Star Home, Los Angeles ; State hospitals at Patton, Napa, Norwalk, and Porterville; Masonic Hospital and Home, Decoto; Motion Picture Hospital and Home, Calabassas ; California Home for the Aged, Reseda ; Los Angeles County Chronic Hospital; City of Hope, Duarte; county and public hospitals in many California cities and counties.

Yet, neglected oldsters are all too common. A large segment of these are of low-income background, but short of welfare recipiency, oldsters on a fixed pension based on preinflation levels, and widows with curtailed social security benefits. If the problems involving these individuals can be met, another group will be able to get necessary preventive treatments to enable them to be active individuals. An increasing number of podiatrists are taking interest in geriatric foot care. A more recent survey than that mentioned above indicates that at this time over 50 percent of the members of the California Podiatry Association were engaged in regular attendance at one of the institutions mentioned or at other retirement or nursing homes, sanatoriums, or hospitals.

The Geriatric Foot Health Committee of the California Podiatry Association has as its major objective the development of an attitude of keeping our senior citizens active and productive by the maintenance of proper foot health. Toward this goal we offer speakers and films, developed by this committee, and which

« PreviousContinue »