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COMMITTEE ON INTERSTATE AND FOREIGN COMMERCE

HARLEY O. STAGGERS, West Virginia, Chairman

TORBERT H. MACDONALD, Massachusetts

JOHN JARMAN, Oklahoma
JOHN E. MOSS, California
JOHN D. DINGELL, Michigan
PAUL G. ROGERS, Florida

LIONEL VAN DEERLIN, California
J. J. PICKLE, Texas

FRED B. ROONEY, Pennsylvania
JOHN M. MURPHY, New York

DAVID E. SATTERFIELD III, Virginia
BROCK ADAMS, Washington

W. S. (BILL) STUCKEY, JR., Georgia
PETER N. KYROS, Maine
BOB ECKHARDT, Texas
RICHARDSON PREYER, North Carolina
BERTRAM L. PODELL, New York
HENRY HELSTOSKI, New Jersey
JAMES W. SYMINGTON, Missouri
CHARLES J. CARNEY, Ohio
RALPH H. METCALFE, Illinois
GOODLOE E. BYRON, Maryland
WILLIAM R. ROY, Kansas

JOHN BRECKINRIDGE, Kentucky
THOMAS A. LUKEN, Ohio

SAMUEL L. DEVINE, Ohio
ANCHER NELSEN, Minnesota
JAMES T. BROYHILL, North Carolina
JAMES HARVEY, Michigan 1
TIM LEE CARTER, Kentucky
CLARENCE J. BROWN, Ohio
DAN KUYKENDALL, Tennessee
JOE SKUBITZ, Kansas
JAMES F. HASTINGS, New York
JAMES M. COLLINS, Texas
LOUIS FREY, JR., Florida

JOHN WARE, Pennsylvania

JOHN Y. MCCOLLISTER, Nebraska
DICK SHOUP, Montana

BARRY M. GOLDWATER, JR., California
NORMAN F. LENT, New York

H. JOHN HEINZ III, Pennsylvania
WILLIAM H. HUDNUT III, Indiana
SAMUEL H. YOUNG, Illinois

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SUBCOMMITTEE ON PUBLIC HEALTH AND ENVIRONMENT

PAUL G. ROGERS, Florida, Chairman

DAVID E. SATTERFIELD III, Virginia
PETER N. KYROS, Maine
RICHARDSON PREYER, North Carolina
JAMES W. SYMINGTON, Missouri
WILLIAM R. ROY, Kansas

1 Mr. Harvey resigned January 31, 1974.

ANCHER NELSEN, Minnesota
TIM LEE CARTER, Kentucky
JAMES F. HASTINGS, New York
H. JOHN HEINZ III, Pennsylvania
WILLIAM H. HUDNUT III, Indiana

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February 1, 1974 (St. Louis, Mo.).

Andrus, Len Hughes, M.D., professor and chairman, Department of
Family Practice, School of Medicine, University of California at
Davis, Davis, Calif._

134, 167

Becker, Dr. Martin M., past president, Missouri Podiatry Association 475, 492
Borman, Edward H., executive director, Missouri Osteopathic As-
sociation__.

523, 538

Brian, Dr. Earl W., secretary, Health and Welfare Agency, State of
California, Sacramento.

233, 304

Cassell, Eric, M.D., clinical professor of public health, Cornell Uni-
versity, Ithaca, N. Y.

11, 77

Commoner, Barry, Ph.D., director, Center for the Biology of Natural
Systems, Washington University, St. Louis, Mo.--

11, 66

Davis, Karen, Ph.D., research associate, the Brookings Institution... 203
Denenberg, Herbert S., commissioner, Insurance Department, Com-
monwealth of Pennsylvania, Harrisburg-

Donnell, Dr. James M., mayor, Wichita, Kans..

233

Hagen, Dr. Joseph, president, Greater St. Louis Dental Society -
Hartzell, Roy L., United Auto Workers..

425, 428

Haughton, James G., M.D., executive director, Health and Hospitals
Governing Commission of Cook County, Ill., Chicago, Ill.
Henderson, Morris, director, St. Louis Comprehensive Health Care
Center__

389, 401

134, 159

475, 477

Statement of-Continued

Henley, A. J., project director, Yeatman Neighborhood Health Page Center

Hepner, Dr. Jim, director of Washington University Health Care
Administration____

389, 399

389, 393

Hogeman, George A., president, Paul Revere Life Insurance Co.,
Worcester, Mass...

Jones, Wellington, executive vice president, Blue Cross-Blue Shield of
Kansas---

233, 314

523, 533

Jorgensen, G. Jerome, vice president, Kansas Hospital Association. 523, 536 Kersting, Vincent H., secretary, Local No. 6310, Communications Workers of America....

475

Klarman, Herbert E., Ph. D., professor of economics, New York
University, New York, N. Y...

203, 220

Klippel, Dr. Allen, assistant professor of surgery, Washington University..

389

Komanetsky, Dr. William M., Council of Medical Staffs..

425, 432

McDonald, Mrs. Charlotte, executive director, Missouri Nurses
Association_

425, 431

551

McGee, Ralph, executive secretary-treasurer, Kansas State Federa-
tion of Labor (AFL-CIO)...
Maples, Tom, international representative, United Auto Workers. 551, 555
May, Mrs. Morton D., board member, Jewish Hospital of St. Louis 408, 410
Metcalf, William, executive director, Northeast Kansas Community
Action Program, and consumer representative on Health Planning
Council, State of Kansas..

564, 566

Miller, C. Arden, M.D., professor, Maternal and Child Health,
University of North Carolina, School of Public Health, Chapel Hill,
N.C...

134

456, 470

Miller, Jefferson L., St. Louis, Mo..
Myers, Robert J., professor of actuarial science, Temple University,
Philadelphia, Pa....

233, 308

Oliver, John, director, Employee Relations Department, E. I. du Pont
de Nemours & Co., Wilmington, Del.

Parker, Robert, executive director, Alliance for Regional Community
Health (ARCH).

334

408, 419

Patterson, Jacqueline J., assistant director of health and social welfare,
Midwest Regional Office, National Urban League__
Perkoff, Dr. Gerald T., Division of Health Care Research, Washington
University Medical School-

456

456, 460

Perrin, Edward B., Ph. D., director, National Center for Health Sta-
tistics, Health Services and Mental Health Administration, Public
Health Service, Department of Health, Education, and Welfare.
Phelps, Charles E., Ph.D., Rand Corp., Santa Monica, Calif...
Piper, Harry M., managing director, St. Luke's Hospital.
Podrebarac, Matthew D., commissioner, Board of County Com-
missioners, Wyandotte County, Kans

334

334, 357 456, 471

Rocklage, Sister Mary Roch, president, St. John's Mercy Medical
Center

564

456, 466

Ross, Richard M., chairman of the board, Medserco, Inc...
Roudebush, Mrs. George, St. Louis County.

408, 411

408, 414

Rule, Joseph, community affairs consultant, E. I. du Pont de Nemours & Co., Wilmington, Del.

334, 367

Saunders, Paul N., project director, Joint Community Health Services, Inc...

475, 489

Silver, George A., M.D., professor of public health, Yale University
School of Medicine, New Haven, Conn....

134, 140

Sommer, Bruce T., New Democratic Coalition of Metropolitan St.

Louis

408, 416

Stalnaker, Armand C., president, General American Life Insurance
Co...

498

Stoneman, Dr. William, associate dean, St. Louis University Medical
School..

Taylor, Dr. Thomas, president, Kansas Medical Society...

456, 463

523, 541

Statement of-Continued

Tikwart, Al W., Jr., Shawnee Mission, Kans...
Tucker, Jerry, United Auto Workers....

Page

551, 559

389, 397

User, Dr. J. Richardson, governmental activities committee, United
Cerebral Palsy Associations, Inc., and member Missouri Governor's
Advisory Council on Mental Retardation and Developmental
Disabilities -

498, 501

Visotsky, Harold M., M.D., professor and chairman, department of
psychiatry, director, Institute of Psychiatry, Northwestern Uni-
versity Medical School, Chicago, Ill.

White, Kerr L., M.D., professor of medical care and hospitals, Johns
Hopkins University, Baltimore, Md..

Additional material submitted for the record by

American Federation of Physicians and Dentists, letter dated Feb-
ruary 4, 1974, from Stanley S. Peterson, M.D., president, to Con-
gressman Symington___

American Nurses' Association, attachment to Ms. Gabrielson's
prepared statement, considerations for a plan of national health
insurance ANA

Anderson, Ronald, Ph. D., professor, Center for Health Administra-
tion Studies, University of Chicago, attachments to prepared

statement:

Table 1.-Percent distribution of families in the United States by
level of family outlay for medical care: 1970___
Table 2.-Percent of distribution of families in the United States
by family outlay for medical care as a percentage of family
income: 1970_.

Table 3.-Aggregate family outlay for medical care as a percent of
family income, by income group: 1953, 1958, 1963, and 1970..
Table 4.-Family income of families with large outlays for
medical care: 1970.......

11, 50

11

517

532

350

350

351

352

Table 5.-Poverty level of families with large outlays for medical
care: 1970__.

352

Table 6.-Race of families with large outlays for medical care:
1970_

353

Table 7.-Employment status of families with large outlays for
medical care: 1970.

353

Table 8.-Age of oldest person in families with large outlays for
medical care: 1970__.

354

Table 9.-Residence of families with large outlays for medical
care: 1970__.

354

Definition of terms.

355

Brian, Dr. Earl W., secretary, Health and Welfare Agency, State of
California, letter dated January 21, 1974, from Dr. Brian to Chair-
man Rogers re comments to the written questions submitted by the
chairman..

Cassell, Eric, M.D., clinical professor of public health, Cornell Uni-
versity, Ithaca, N. Y., article entitled "Disease as a Way of Life"--
Council of Medical Staffs (St. Louis):

"Doctor Surplus' Leads Edwards to Predict Cut in U.S. Fund-
ing," article from the International Medical News Service. ___
Letter dated November 13, 1973, from Dr. B. W. Finkel, president,
the Jewish Right.

330

80

443

448

"Much is Taken ***," by Emily Winter from the Reporter,
Downes Grove, Ill., November 26, 1974.

446

"Review and Outlook-No Time for Patients?," article from the
Wall Street Journal, December 6, 1973.-

447

"Snoopers Can See Your Medical Record," editorial from the St.
Louis Globe-Democrat, January 24, 1974..

445

Summary of PSRO (fact sheet) –

444

"The Mood in Congress," address by Congressman David Satter-
field at the AAPS 30th annual meeting-October 9-13, 1973__

435

Additional material submitted for the record by-Continued

Davis, Karen, Ph. D., research associate, the Brookings Institution, Page tables contained in Ms. Davis' prepared statement:

Table 1.-Medicare reimbursement per enrollee for selected
services, by region and race, 1968----.

Table 2.-Hospital costs and three-party payments, 1950-72,
selected years..

Table 3.-Cost per day per patient in short-term community
hospitals: average annual rate of increase and percentage dis-
tribution of increase, selected periods, 1951-70__
Table 4.-Physician fees and third-party payments, 1950-72,
selected years--

Denenberg, Herbert S., commissioner, Insurance Department, Com-
monwealth of Pennsylvania:

"Our Health Delivery System: Dr. Strangelove Meets Alice-in-
Wonderland on the Way to National Health Insurance".
"The Philadelphia Blue Cross 1971 Contract Negotiations-Part
A: Philadelphia Blue Cross Requests a Rate Increase: Denen-
berg Responds"

E. I. du Pont de Nemours & Co., letter dated January 4, 1974, from
John Oliver, director, to Chairman Rogers re what percentage of
GNP the American people would be willing to pay for health care.
Eckhardt, Hon. Bob, a Representative in Congress from the State of
Texas, attachments to prepared statement:
Figure 1.-Infant mortality...

Figure 2.-Male life expectancy at birth_
Figure 3.-Female life expectancy at birth_

Figure 4.-The gaps in private health insurance coverage..
Health, Education, and Welfare Department, attachments to Mr.
Perrin's prepared statement:

Table 1.-Percent of persons with private health insurance
coverage by type, age, and year: United States, 1959 and 1970.
Table 2.-Percent of persons under 65 years with private hospital
insurance by income, age, and year: United States, 1959 and
1970_

Table 3.-Percent of persons under 65 years of age with private
hospital insurance coverage by color income, and age: United
States, 1963 and 1970..

208

210

211

211

243

260

385

9

10

10

11

342

342

343

Table 4.-Percent of persons 17-64 years of age in the labor force
with private hospital insurance coverage, according to occupa-
tion: United States, 1970..

343

Table 5.-Percent of persons under 65 years of age with private
health insurance coverage by type, age, region, and year:
United States, 1959 and 1970---
Table 6A.-Distribution of all hospital discharges by proportion
of bill paid by private hospital insurance for persons under 65
years of age according to selected demographic characteristics:
United States, 1972__

344

Table 6B.-Distribution of hospital discharges for which at least part of the bill was paid by private hospital insurance by proportion paid by private insurance, for persons under 65 years of age according to selected characteristics: United States, 1972 Table 7.-Number and percent distribution of persons under 65 years with no health insurance by reason for having no coverage, according to family income and age: United States, 1968Paul Revere Life Insurance Co., George A. Hogeman, president, letter dated January 8, 1974, from Mr. Hogeman to Chairman Rogers re answers to written questions submitted by the chairman___ Kansas Catholic Conference, Vincent DeCoursey, executive director, letter dated January 31, 1974, to Congressman Roy----Logan College of Chiropractic, William N. Coggins, statement... Missouri Optometric Association, position paper on health manpower funding, American Optometric Association-October 1973.. Missouri Podiatry Association, proposals for national health insurance status of podiatrists' services-a summary

344

345

345

325

578

514

485

497

National Association of Retail Druggists, William E. Woods, Washington representative and associate general counsel, statement____

579

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