"The bill covers railroad retirement beneficiaries as well as OASI beneficiaries. It provides that agreements between the Secretary and providers of services or their agents will be entered into also on behalf of the Railroad Retirement Board. Coverage for railroad beneficiaries would include services secured in railroad hospitals which, otherwise, may not be participating under the program, and services in Canadian hospitals, which for OASI beneficiaries are excluded from the program. In the case of individuals who may be entitled to monthly benefits under both programs the limitations on number of days, units of care, and the deductible provisions would be applied as if the individuals were covered under a single program. "The administration of present law requires close coordination between RRB and BOASI in recordkeeping and claims processes. There has been continuing and extensive experience between these agencies in the kinds of coordination that would be required under a health benefits program. Where individuals are entitled under both programs, agreement would be reached on which organization will issue the identification card. Railroad hospitals and Canadian hospitals would send their requests for verification of eligibility direct to the RRB. Hospitals in the United States, other than railroad hospitals which do not have an agreement with the Secretary, would accept either card and a common procedure would be established for requesting verification of eligibility. The RRB could be linked with the OASI wire communications system. Bills could be paid under uniform policies and procedures, and the trust funds of the two programs could be adjusted periodically through the financial interchange provisions of the act." The same provisions for administration by the Railroad Retirement Board of hospital insurance benefits for railroad employees were included in the bills, H.R. 3920 and S. 880, both introduced on February 21, 1963, and the bill, H.R. 11865, which was passed by the Senate on September 3, 1964. In his testimony before the House Committee on Ways and Means on H.R. 3920, the Secretary of Health, Education, and Welfare (Mr. Celebrezze) stated as follows: "As in the case of other benefits under the social security system, overall responsibility for administration of the hospital and related benefits would rest with the Secretary of Health, Education, and Welfare. Similar responsibility for railroad retirement annuitant rests with the Railroad Retirement Board. Agree ments by hospitals and other providers with the Secretary would be made on behalf of both the Secretary and the Board."' The Secretary made the same statement in his testimony before this committee on H.R. 11854. The same provision for the administration by the Railroad Retirement Board of hospital insurance benefits for railroad employees was incorporated in the bills, H.R. 1 and S. 1, introduced January 4 and January 6, 1965, respectively. Each of these bills mentioned above were known as administration bills so that every bill for hospital insurance benefits introduced since 1961 has had the approval of the President of the United States as to the administration by the Railroad Retirement Board of the program as it relates to railroad employees. The bill, H.R. 1, which contained the agreed-upon provisions for the administration by the Railroad Retirement Board of the hospital insurance program for railroad employees, was considered by the House Committee on Ways and Means and reported by that committee as H.R. 6675, without such provisions. The reported bill was passed by the House of Representatives on April 8, 1965. The amendments of Senator Douglas would restore the omitted provisions so as to confer jurisdiction upon the Railroad Retirement Board for the administration of the hospital insurance program as it relates to railroad employees. We strongly urge the adoption of these amendments. The restoration of the omitted provisions would be in conformity with the agreement of long standing between the Department of Health, Education, and Welfare and the Railroad Retirement Board (see statements of Secretaries Ribicoff and Celebrezze quoted earlier) and in conformity with the congressional policy of long standing to confer upon the Railroad Retirement Board jurisdiction 1 Hearings on the bill. H.R. 4222, before the Committee on Ways and Means, House of Representatives, 87th Cong., 1st sess., vol. 1. beginning July 24, 1961, pp. 160-161. 2 Hearings on H.R. 3920, before the Committee on Ways and Means, House of Representatives, 88th Cong., 1st and 2d sess., pt. 1, beginning Nov. 18, 1963, p. 47, under heading of "Administration." 3 Hearings on H.R. 11865, before the Committee on Finance, U.S. Senate, 88th Cong., 2d sess., beginning Aug. 6, 1964, p. 111, under heading of "Administration." for the administration by the Board of all types of benefit programs for railroad employees, their dependents, and survivors. We are informed that the Railroad Retirement Board is in favor of Senator Douglas' amendments to H.R. 6675 and we are also informed that the Department of Health, Education, and Welfare has no objection to the adoption of such amendments. In conclusion, Mr. Chairman, we believe that there is every reason for the adoption of such amendments and we hope that this committee will act favorably thereon. The CHAIRMAN. The next witness is Dr. Wyrth P. Baker. Dr. Baker is representing the American Institute of Homeopathy. STATEMENT OF WYRTH POST BAKER, M.D., M.H.D., F.A.C.P., REPRESENTING THE AMERICAN INSTITUTE OF HOMEOPATHY, THE SOUTHERN HOMEOPATHIC MEDICAL ASSOCIATION; THE AMERICAN FOUNDATION FOR HOMEOPATHY; THE HAHNEMANN THERAPEUTICS SOCIETY; THE WASHINGTON HOMEOPATIC MEDICAL SOCIETY; THE PENNSYLVANIA HOMEOPATHIC MEDICAL SOCIETY; THE HOMEOPATHIC RETAIL PHARMACISTS; THE HOMEOPATHIC MANUFACTURING PHARMACISTS; PHYSICIANS (M.D.) OF THE UNITED STATES, SPECIALISTS IN HOMEOPATHIC THERAPEUTICS; THE OHIO STATE HOMEOPATHIC MEDICAL SOCIETY; AND THE HOMEOPATHIC LAYMEN'S LEAGUE OF U.S. THERAPEUTICS Dr. BAKER. Mr. Chairman, members of the Finance Committee of the Senate, I deeply appreciate the privilege of appearing before you today, and I have a brief statment which I should like to make. been practicing in Washington since 1933. I am graduate of Hahnemann Medical College, 1930, Philadelphia. I am licensed to practice in Maryland, the District of Columbia, Delaware, Pennsylvania, and Kansas. I represent the following organizations at their request: Primarily the American Institute of Homeopathy, which is the main or parent organization of the homeopathic profession: the Southern Homeopathic Medical Association, the American Foundation for Homeopathy, the Hahnemann Therapeutic Society, the Washington Homeopathic Medical Society, the Pennsylvania Homeopathic Medical Society, the Homeopathic Retail Pharmacists, the Homeopathic Manufacturing Pharmacists, and Physicians of the United States, the Ohio State Homeopathic Medical Society, and the Homeopathic Laymen's League of U.S. Therapeutics, who specialize in homeopathic therapeutics. My subject is the omission of the "United States Homeopathic Pharmacopeia" from H.R. 6675, section 1861, paragraph (t) under "Drugs and Biologicals," page 83, line 16, following the words "the United States Pharmacopeia." The attention of the members of this Committee is respectfully directed to the above mentioned omission and consideration of the facts which are presented below for their information. A pharmacopeia is a book containing a list of drugs, chemicals, and medical preparations with descriptions of them, tests for their identity, purity, and strength and formulas for making the preparations, issued by an official organization. In the United States, as well as England, Germany, France, Switzerland, India, and other countries, there are two such books; the Pharmacopeia and the Homeopathic Pharmacopeia. The most recent edition of the "United States Homeopathic Pharmacopeia" was published in 1964 by the American Institute of Homeopathy, founded in 1844, the oldest official national medical organization in the United States, which represents the Homeopathic physicians. This is the new pharmacopeia. It is necessary to have two pharmacopeias because the technique of preparation, standardization, and dosage of drugs used by homeopathic technique may be entirely different from drugs used physiologically and some of the drugs which are most valuable when used homeopathically do not appear in the "U.S. Pharmacopeia" at all, nor in the National Formulary" (see p. 785). It is essential to the continued health of an appreciable segment of the population that homeopathic drugs be kept available for their use for the following reasons: 1. These drugs are effective in a wide variety of physical, mental and emotional illnesses or disorders, acute and chronic. 2. They are often more effective in certain chronic disorders than the more commonly employed physiologic drugs. 3. They are of particular value in treating elderly patients and children. 4. These drugs are nontoxic: Reactions to them are rare, poisonous effects do not occur, fatal reactions are unheard of. 5. Their use is economical; unit cost is from 0.1 to 5 percent of physiologic drugs and the amount used is in even smaller proportion. 6. Homeopathic drugs have been used since 1796 throughout the world and their use in the United States has been approved by the Federal Food, Drug, and Cosmetic Act, Public Law 717, 75th Congress and its subsequent revisions. 7. Thousands of patients and their physicians depend on homeopathic treatment for the maintenance of their health and well-being. The size and extent of the use of homeopathic drugs is indicated by the following statistics which were compiled from the confidential reports of six of the leading manufacturers of these preparations. Each of these organizations wrote to me and gave me statistics which I have compiled. Number of wholesale customers supplied, 1,597. Number of pills or tablets sold-in excess of 1,750 million. Number of gallons of liquids sold-in excess of 30.000. Estimate of approximate number different patients treated by physicians, 6. million. . Estimate of number of persons who use homeopathic drugs with or without the advice of a physician, 12 million. 4 II.R. 6675, section 1861 (t) under "Drugs and biologicals" states: The term "drugs" and the term "biologicals," except for purposes of subsection (m) (5) of this section, include only such drugs and biologicals, respectively, as are included in the United States Pharmacopoeia or the National Formulary, or in New Drugs or Accepted Dental Remedies (except for any drugs and biologicals unfavorably evaluated therein), or as are approved by the pharmacy and drug therapeutics committee, of the medical staff of the hospital furnishing such drugs and biologicals. The words "United States Homeopathic Pharmacopoeia" apparently were inadvertently omitted from this paragraph in the mistaken belief that the United States Pharmacopoeia or National Formulary would cover the pharmacology standards of all drugs in legitimate use. To ascertain the fact that this was inadvertently, I spoke to Mr. Wilbur Cohen, Assistant Secretary-now Under Secretary-of the Department of Health, Education, and Welfare, with whom I had a most cordial conversation, and thereafter wrote a letter to him asking the following questions: Have your medical advisers expressed opposition to the inclusion of the Homeopathic Pharmacopoeia? Are you opposed to the inclusion of the Homeopathic Pharmacopoeia? Are the members of the Committee of your Department which prepared the bill opposed to including the Homeopathic Pharmacapoeia in H.R. 6675? If there is opposition, please give me the reasons. If there is no opposition, will you and/or the committee recommend inclusion of the Homeopathic Pharmacopoeia in H.R. 6675 to the Senate Finance Committee? In response to this letter I received the following: In reply to your letter of April 28, I am enclosing a copy of my letter to Congressman Broyhill concerning the inclusion of homeopathic drugs and medicines in H.R. 6675: "DEAR JOEL: This is in reply to your letter of April 19 concerning the inclusion of homeopathic medicines in H.R. 6675. This matter did not come up in executive sessions of the House committee. We would neither favor nor oppose the inclusion of the Homeopathic Formulary among the formularies accepted for purposes of the Senate bill." With your permission, I shall add this statement and his letter to your records. It is essential that the United States Homeopathic Pharmacopoeia be specified following the United States Pharmacopoeia for the following reasons: (1) The Homeopathic Pharmacopoeia sets standards for homeopathic drugs which will be used by pharmacy committees of the hospitals, insurance companies, and other organizations and agencies concerned with reimbursement for medical costs, insurance, and regulation as they apply to this medical specialty. (2) Its omission would indicate disapproval to some organizations, particularly those insurance companies which already attempt to avoid payment for drugs used by their clients and committees which limit the choice of drugs by standardization and in the name of economy. (3) Omission of the Homeapathic Pharmacopoeia would be inconsistent with the above-mentioned food, drug, and cosmetics law and in addition to the Healing Arts Practice Act of the District of Columbia, Public Law 831, February 27, 1929, which specifies that one member of the Board of Examiners in Medicine and Osteopathy shall be a member of the homeopathic medical profession. (4) Its omission could prevent thousands of patients of homeopathic physicians from obtaining the drugs and treatment of their choice even though they are forced to pay for drugs which they do not want and in many cases fear. (5) This would be a deliberate act of discrimination against an important segment of the patient community and unjustified limitation of their freedom of choice, and interference with commerce. The members of the Finance Committee of the U.S. Senate are respect fully requested to carefully study the proposed bill, its effects on patients as described, and if, in their opinion, the proposed change in the bill is indicated for their benefit, to take immediate action to have the words "United States Homeopathic Pharmacopoeia" inserted following the United States Pharmacopoeia. My official positions are: president, Board of Examiners in Medicine and Osteopathy for the District of Columbia; president, Southern Homeopathic Medical Association; president, Washington Homeopathic Medical Society; president, Hahnemann Therapeutic Society; member, board of trustees, American Institute of Homeopathy; vice chairman, Department of Internal Medicine, Sibley Memorial Hospital, Washington D.C.; and member, Homeopathic Medical Society of the State of Pennsylvania. Thank you. I am authorized to speak for these organizations. I shall be glad to answer any questions you may have concerning this. The CHAIRMAN. Senator Long, any questions? Senator ANDERSON. Would you submit for the record Doctor, some examples of homeopathic drugs that are not mentioned in the compendiums mentioned in the bill, United States Pharmacopeia, National Formulary, New Drugs? If you can submit some things that are not included-I don't mean different strengths or dilutions of drugs but drugs that are not included in the other. Dr. BAKER. I don't have a copy of the United States Pharmacopeia with me, but I have the Homeopathic Pharmacopeia. This other book, incidentally, is what we call the Homeopathic Materia Medica which corresponds to the various materia medica representing the various drugs. Senator ANDERSON. I am trying to find out why the House might have left it out. Dr. Cohen says he neither proposes nor opposes putting it in. Dr. BAKER. Correct. Senator ANDERSON. But if he thought it should have been in there, he should have said so. What is it that is left out? Could you supply us with an example of that so we may have some ideas about this? Dr. BAKER. The homeopathic drugs are prepared differently. Senator ANDERSON. But the drug, once approved, carries homeopathic doses. Dr. BAKER. No, not as it appears in the United States Pharmacopeia. The dosage is different. Senator ANDERSON. I said I know the doses are different. But if a drug is approved, it is approved no matter what dosage is given, isn't that correct? Dr. BAKER. That is correct. Senator ANDERSON. So if it is in the regular manual of United States Pharmacopeia, you do not have to worry about the doses. Dr. BAKER. I shall give you a few of the drugs, for instance: baptisia, tinctora, asclepias, apis, mellifica, anacardium, orientale, alumen, lycopodium. (The following was later received for the record :) |