MYOPIA RESEARCH WITNESS MRS. SYLVIA N. RACHLIN, EXECUTIVE VICE PRESIDENT, MYOPIA INTERNATIONAL RESEARCH FOUNDATION, INC. Mrs. RACHLIN. Thank you, Mr. Chairman, and members of the committee. There is very good news. First, thank you all for all you have done all of these years for our program, formally and informally. It has been a very eventful year because so many more doctors are interested now in concentrated work on myopia research. And thank you so much for allowing the patients to be represented through me. The papers before you outline our program, and in there lies your opportunity to save more than a million American children from blindness. Your many friends in the New York City Center Central Labor Council and through the country send you warmest regards and appreciation for all you have done, not only in health, but in so many other areas. Now, Mr. Chairman, and members of the committee, it is through your hands that the National Eye Institute might become one of the greatest eye centers for research in the world. Thank you. [Mrs. Rachlin's full statement follows:] STATEMENT OF MRS. SYLVIA N. RACHLIN, EXECUTIVE VICE PRESIDENT, MYOPIA INTERNATIONAL RESEARCH FOUNDATION, INC. Mr. Chairman and members of the House of Representatives Subcommittee on Appropriations for Labor, Health, Education, and Welfare: Eye care for Americans afflicted with myopia, commonly known as nearsightedness, is a billiondollar a year industry. The Food and Drug Administration has recently referred to "100 million Americans who wear eyeglasses." This would bring the cost for eye care well beyond the billion-dollar mark. This statistic is particularly disturbing to the myope who feels he is regarded more as consumer than as patient. Since its incorporation in 1963, the Myopia International Research Foundation has sought to further interest in comprehensive, interdisciplinary research into the causes, treatment, and prevention of nearsightedness. More immediately, it seeks to save the eyesight of children afflicted with progressive, pathological myopia for which there is no known cure. Because the foundation has adhered to a policy of strict academic impartiality and refrained from even the semblance of endorsement or commercialization, its exhibits have received much acclaim at meetings of the American Academy of Ophthalmology and Otolaryngology, International Congresses of Ophthalmology, and elsewhere-thousands of doctors visiting and asking to be involved. The Voice of America has twice broadcast the foundation program overseas. To improve channels of communication among doctors interested in myopia research throughout the world, the Myopia International Research Foundation publishes and distributes myopia research papers without charge to interested doctors throughout the world. The Myopia International Research Foundation is idealistic in its operation. No money whatsoever is spent on any administrative salaries or professional fund raisers. Within the United States, this foundation seeks the establishment of a national myopia center with the following three-fold structure: 1. Myopia research projects in the National Eye Institute, National Institutes of Health (a) Establishment of analytical and statistical procedures by the Biometrics Branch of the National Eye Institute. (b) Grants to the National Eye Institute enabling myopia research projects and establishment of analytical and statistical procedures. 2. A myopia service program under the National Eye Institute (a) Collaborative study permitting the creation and development of service programs for myopes throughout the United States, and a standardization of records and reporting forms. Through their personal doctors, myopes-young and old-would participate by submitting comprehensive cumulative records to the national myopia center for continued analysis by research experts. (b) Grants enabling myopia service programs. 3. The national registries of myopia pathology, a myopia eye study bank, should be developed under the U.S. Public Health Service. All universities, hospitals, other laboratories involved in eye research, and eyebanks throughout the United States would participate in coordinating clinical research. Participating laboratories would receive eyes of myopes and their families which have been donated for the purpose of research into the pathology of myopia from its incipience through its advanced stages. Findings would be correlated with other research. This plan for the national registries of myopia pathology, originated by the Myopia International Research Foundation, has received the enthusiastic endorsement of many individuals and organizations across the Nation. A national myopia center structured upon this three-phase program would stimulate nationwide interest and participation by myopes and their families and friends in research under public and private health auspices. It is a recognized fact that over one-third of the population is nearsighted. Countless adults have suffered loss of employment and become financial burdens to their families and the community because of pathological or degenerative changes in myopia. In addition, the Federal Treasury suffers a loss in revenue through exemptions for legal blindness, reduced earnings, and increased medical deductions for eye care. Members of this honorable committee: Fully cognizant of the reasons for current retrenchment, the professional consensus is that myopia problems require much applied research. By mail and telephone the Myopia International Research Foundation receives daily appeals from myopes or their relatives for that answer which is not yet known to medical science. In their behalf we beg your earnest consideration and help. COMMUNITY SERVICES COMMITTEE, NEW YORK CITY CENTRAL LABOR COUNCIL AFL-CIO, Mrs. SYLVIA N. RACHLIN, Executive Vice President, Myopia International Research Foundation, Inc., MRS. RACHLIN: It has been my extreme pleasure, and privilege, to have been associated with the work of your foundation over these past years and I want you to know that the officers of the New York City Central Labor Council, AFLCIO and myself feel privileged to be able to contribute to such a worthwhile effort. The many thousands of individuals, union members, members of their families, and retired workers who visit the eye clinics of our labor health centers, one can readily appreciate the additional thousands who stand to benefit when favorable consideration will be granted to your Myopia International Research Foundation by our Congress. We are aware that through your foundation you are presently engaged in the promotion of communication among all those involved in myopia research, from the patient seeking relief to the doctor carrying on clinical studies. Through the free publication and dissemination of clinical reports and observations to doctors in all parts of the world, researchers have been informed of corroborative materials for work in process and have indicated areas for further investigation in myopia research. On behalf of the 600 individual local unions and 1,250,000 individual trade union members we represent, I trust you will receive the needed support of our congressional leaders in the fight against the ravages of myopia. With all best wishes, I remain Sincerely yours, GERALD R. WATERS, Sr., Director. MYOPIA INTERNATIONAL RESEARCH FOUNDATION, INC., PERTINENT FACTS The Myopia International Research Foundation, Inc., launched the first comprehensive, interdisciplinary research program in the United States into the causes, treatment, and prevention of nearsightedness. Our immediate goal is to save the eyesight of more than 1 million American children-besides millions around the world-who are doomed to blindness because of progressive, pathological myopia for which there is no known cure. This we are doing with the cooperation of doctors in the United States and elsewhere throughout the world. The Myopia International Research Foundation sponsored the First International Conference on Myopia in 1964. Since 1965 we have petitioned the Congress of the United States for the establishment of a national myopia center under the aegis of the U.S. Public Health Service. Each year we have appeared before subcommittees of the House of Representatives and Senate. The Myopia International Research Foundation has been invited to exhibit at conventions of the American Academy of Ophthalmology and Otolaryngology. An increasing number of ophthalmologists has become interested in our program. By invitation, the Myopia International Research Foundation has had exhibits at the International Congress of Ophthalmology in Germany, 1966, and in Mexico, 1970. These presentations were enthusiastically attended by eminent doctors from all continents, who applauded our program and asked to be involved. The Voice of America has twice broadcast details of our program to all nations. Through gifts of printing, myopia research papers are published and distributed without charge to interested doctors in all nations. The Myopia International Research Foundation is idealistic in its operation. No money whatsoever is spent on any administrative salaries or professional fundraisers. Our intensive efforts continue daily to help widen the channels of communication among doctors interested in myopia research in all nations. Mr. FLOOD. Thank you very much. Dr. Frank A. Finnerty, professor of medicine, District of Columbia General Hospital. FORMULA FUNDS FOR HYPERTENSIVE TREATMENT SERVICES WITNESS DR. FRANK A. FINNERTY, JR., PROFESSOR OF MEDICINE, GEORGETOWN UNIVERSITY SCHOOL OF MEDICINE, AND MEMBER, BOARD OF DIRECTORS, CITIZENS FOR THE TREATMENT OF HIGH BLOOD PRESSURE Dr. FINNERTY. Yes, sir, Mr. Chairman. I am back here again in my yearly visit with a plea for blood pressure and to testify for the $15 million authorized Public Law 94-63 for the treatment services. I want to make a couple of pleas here, but, first of all, some facts that there has been really some great advance in our evangelism, as it were, in making the public aware of the badness of blood pressure. Back in 1973, as an example, 50 percent of the 23,000,000 people out there really did not know they had blood pressure, and in this past year, a recent survey has shown that now just 29 percent of the public does not know it. So there has been an advance in terms of awareness. But I think what really is the problem is that we still have 9 million, at least 9 million, people out there who know that they have no money to actually be treated and the treatment of blood pressure, as you know, is not just some wild story, because blood pressure is indeed the com monest cause of stroke and heart failure and a contributing feature to the end stage disease and the commonest cause of death in blacks. So we need funds so these people can be treated, and, furthermore, the treatment is frequently simple, as simple as a pill a day. In the past couple of years-let me give you some facts of what has been done and what can be accomplished. There has been a 21-percent decrease in the deaths from hypertension, taken by itself. There has been a 14-percent decrease in the deaths from hypertensive heart disease and renal diseases, and what I think is on the verge of sensationalism, there has been almost a 10-percent decrease in strokes in the past 2 years. Now, if you put this in the setting that Ted Cooper has testified to this very committee, that every year 200,000 deaths are due to blood pressure or its complications and even in that setting we still see such a good decrease in the facts that I mentioned above. Now, as far as cost spending, in which you are interested, certainly we talked about the deaths but more important there are the facts that there are 260 million hospital days that go into the complications of blood pressure, mainly to the strokes and to the coronaries and the social security people tell us that the commonest disability claim is due to blood pressure and its complications. You say, "Well, you have given all the money to the NIH and why do we need more money." You know that you give the money to NIH and they cannot, by rule, apparently spend it on any treatment services, so what we are saying is that there is no reduplication there. They do the research and indeed research should be done, but they can't pay for the treatment, and the big message here is that there are still at least 9 million people out there who know they have the blood pressure, and who can't afford the therapy, and it truly is as simple frequently as taking a pill a day. The $50 million is not going to solve the entire problem, but it surely will put a big step forward not only in treatment but showing the doctors that it doesn't have to be done by doctors but can be done by paramedics and nurses and there is great cost-saving there. [Dr. Finnerty's full statement follows:] Mr. Chairman and members of the committee: I am appearing here today to testify on behalf of the $15 million authorized by Public Law 94-63 for hypertension treatment services for fiscal 1977. We are deeply grateful to the Congress for appropriating $3,750,000 for the current fiscal year for these treatment formula grants. Dr. Theodore Cooper, Assistant Secretary for Health, has assured all organizations involved in this hypertension treatment effort that regulations for the allocation of these funds among the various States will be issued in plenty of time for distribution in the current fiscal year. As you know, Chairman, Dr. Cooper gave these same assurances to this committee when he appeared before you earlier this year. Since I testified before this committee last year on this matter, there have been a number of exciting developments in the field of hypertension control. Although hypertension still strikes 23 million Americans, it is gratifying that Dr. Robert Levy, Director of the National Heart and Lung Institute, recently reported that only 29 percent of these 23 million Americans are now unaware that they suffer with it, compared with approximately 50 percent in 1971. However, he qualified this observation by pointing out that there are still 9 million Americans who are now aware that they have this disease but are receiving either no treatment whatsoever or not enough. Tribute for the increased awareness on the part of the American people of the dangers of hypertension and its consequences must go to the educational efforts of the national high blood pressure education program since 1972, and to massive community educational efforts by more than 150 lay and professional organizations, including the American Heart Association, the American Medical Association, the National Medical Association, the American Hospital Association, and many other organizations too numerous to cite here. In that connection, we are proud of the role of the Citizens for the Treatment of High Blood Pressure, the voluntary citizens' organization which I represent here today. Operating without any governmental funds and on a very small budget, we believe that we have had a significant impact in initiating state and local detection and followup programs in this field. We believe that all of these efforts combined have resulted in a saving of lives which has few parallels, if any, in the difficult battle against chronic diseases. These are the objective facts as released by the National Center for Health Statistics: (1) Between 1973 and 1975, the death rate from hypertension alone declined a remarkable 21 percent. (2) Between 1973 and 1975, the death rate from hypertensive heart and renal diseases declined 14 percent. (3) Between 1973 and 1975, the stroke death rate declined 9.6 percent. These declines are all the more impressive in light of the fact that Dr. Theodore Cooper, Assistant Secretary for Health, recently stated that, undetected and untreated, high blood pressure is responsible for at least 200,000 deaths each year. It can, and frequently does, lead to stroke, heart attack, heart failure, and kidney failure. Heart attack, stroke, and other cardiovascular diseases account for over 53 percent of all American deaths annually. The declines which have been achieved, apart from humanitarian considerations, are dramatically cost-effective in holding down our Nation's medical care bill. For example, circulatory problems, the common result of prolonged hypertension, are responsible for 26 million days of hospitalization each year. Furthermore, data from the Social Security Administration indicate that hypertension and its consequences account for the largest single number of disability claims. However, the vital challenge before us is to deliver the effective treatments we now have against hypertension to the 9 million people who, as Dr. Levy has pointed out, are aware that they have the disease but cannot afford the treatment costs. As this committee knows, and as it stated in the report accompanying H.R. 10647 (supplemental appropriations, 1976), the National Heart and Lung Institute has no authority for the delivery of treatment services, so there is no duplication in our proposal with the entirely separate research and training activities of NHLI. Several studies have demonstrated conclusively that high blood pressure occurs most frequently among people at the lower socioeconomic levels. These, for the most part, are people who have no private physician and cannot afford one, or people who have a physician but cannot afford the relatively inexpensive costs of diagnostic laboratory procedures and antihypertensive medications. In essence, we will attempt, with the moneys voted us last year and the $15 million authorized in Public Law 94-63, to provide formula grant moneys to the States so that they can bring treatment services to the millions of our people who cannot afford them now. We realize, Mr. Chairman, that the amount of money we are requesting cannot do the total job, but it is a start. In a recent statement, the High Blood Pressure Coordinating Group underlined the fact that adequate control of hypertension can add as much as 18 years to life expectancy. But these precious additional years cannot be won unless our people are afforded the means to obtain the necessary treatment. SUMMARY OF RECOMMENDATIONS-FRANK A. FINNERTY, JR., M.D., REPRESENTING CITIZENS FOR THE TREATMENT OF HIGH BLOOD PRESSURE (1) For fiscal 1977, $15 million be awarded to the States on a formula basis for treatment services for high blood pressure. (2) That this investment in formula grants to the States will result in a further decline in the death rate from high blood pressure, hypertensive heart, and renal disease and stroke. Mr. FLOOD. Thank you very much, Doctor. Mr. August Gehrke, president of the National Rehabilitation Association. 70-075 - 76 pt. 7-2 |