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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 RICHARD H. FULTON, Tennessee

GUY VANDER JAGT, Michigan OMAR BURLESON, Texas

WILLIAM A. STEIGER, Wisconsin JAMES C. CORMAN, California

PHILIP M. CRANE, Ilinois WILLIAM J. GREEN, Pennsylvania

BILL FRENZEL, Minnesota SAM M. GIBBONS, Florida

JAMES G. MARTIN, North Carolina JOE D. WAGGONNER, JR., Louisiana

L. A. (SKIP) BAFALIS, Florida
JOSEPH E. KARTH, Minnesota

WILLIAM M. KETCHUM, California
OTIS G. PIKE, New York
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
ANDREW JACOBS, JR., Indiana
ABNER J. MIKVA, Illinois
MARTHA KEYS, Kansas
JOSEPH L. FISHER, Virginia

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

JOHN J. DUNCAN, Tennessee OTIS G. PIKE, New York

PHILIP M. CRANE, Illinois CHARLES A. VANIK, Ohio

JAMES G. MARTIN, North Carolina
RICHARD H. FULTON, Tennessee

DONALD D. CLANCY, Ohio
OMAR BURLESON, Texas
JOE D. WAGGONNER, JR., Louisiana
WILLIAM R. COTTER, Connecticut
MARTHA KEYS, Kansas

(II)

CONTENTS

Opening remarks of Hon. Dan Rostenkowski, chairman, Subcommittee on

Health..

Press release of Monday, May 19, 1975, announcing oversight hearings on

selected issues in medicare program policy ---

ADMINISTRATION WITNESSES

Department of Health, Education, and Welfare:

Hon. Caspar W. Weinberger, Secretary, Hon. Stephen Kurzman,

Assistant Secretary for Legislation, Hon. Theodore Cooper, M.D.,

Assistant Secretary for Health, and Thomas Tierney, Director,

Bureau of Health Insurance, Social Security Administration...

PUBLIC WITNESSES

American Hospital Association, John Alexander McMahon.

American Medical Association, Ernest T. Livingstone, M.D., Edgar T.

Beddingfield, Jr., M.D., and Harry Peterson.

American Osteopathic Association, John C. Taylor, D.O., and Frank J.

McDevitt, D.O.

American Osteopathic Hospital Association, Michael F. Doody-

American Protestant Hospital Association, Charles D. Phillips.

Association of American Medical Colleges, Sidney Lewine.

Association of American Physicians and Surgeons, Frank K. Woolley -

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

Bromberg, Michael D., Federation of American Hospitals -

Catholic Hospital Association, Sister Mary Kieran Harney--

Church, Hon. Frank, a U.S. Senator from the State of Idaho, statement...

Council of Community Hospitals, Everett A. Johnson, Sister Myra James,

and John Hoff

Doody, Michael F., American Osteopathic Hospital Association..

Erickson, Curtis C., Great Plains Lutheran Hospitals, Inc.-

Federation of American Hospitals, Michael D. Bromberg-

Garn, Hon. E. J. (Jake), a U.S. Senator from the State of Utah, letter.

Great Plains Lutheran Hospitals, Inc., Curtis C. Erickson.

Hannaford, Hon. Mark W., a Representative in Congress from the State

of California..

Harney, Sister Mary Kieran, Catholic Hospital Association

Hoff, John, Council of Community Hospitals---

Hospital organization panel:

John Alexander McMahon, American Hospital Association; Michael

D. Bromberg, Federation of American Hospitals; Michael F. Doody,

American Osteopathic Hospital Association; Sister Mary Kieran

Harney, Catholic Hospital Association; Charles D. Phillips, Ameri-

can Protestant Hospital Association; and Sidney Lewine, Associa-

tion of American Medical Colleges.

James, Sister Myra, Council of Community Hospitals.

Johnson, Everett A., Council of Community Hospitals -

Keys, Hon. Martha, a Representative in Congress from the State of

Kansas.

Lewine, Sidney, Association of American Medical Colleges.

Livingstone, Ernest T., M.D., American Medical Association.

McDevitt, Frank J., D.O., American Osteopathic Association.

McMahon, John Alexander, American Hospital Association.

Peterson, Harry, American Medical Association...

Phillips, Charles D., American Protestant Hospital Association..

1

Physician organization panel:

Page

Ernest T. Livingstone, M.D., Edgar T. Beddingfield, Jr., M.D., and

Harry Peterson, American Medical Association; and John C. Taylor,

D.O., and Frienk J. McDevitt, D.O., American Osteopathic Associa-

tion.

136

Pickle, Hon. J. J., a Representative in Congress from the State of

Texas.

207

Sebelius, Hon. Keith G., a Representative in Congress from the State

of Kansas

188

Taylor, John C., D.O., American Osteopathic Association

136
Woolley, Frank K., Association of American Physicians & Surgeons.-

181

MATERIAL SUBMITTED FOR THE RECORD

Aitchison, Kenneth W., North Dakota University Medical Center Re-

habilitation Hospital, letter forwarded by Senator Quentin N. Burdick.- 446

Akron City Hospital, Harry B. Warner, letter forwarded by Congressman

John Seiberling

316

Allen, George B., New York Hospital Association, letter and statement_439, 441

Altman, Jarvin, Sparks Regional Medical Center, letter

478

American Academy of Family Physicians, Herb L. Huffington, M.D.,

letter..

316

American Association of Neurological Surgeons, Richard L. De Saussure,

M.D., statement.

317

American Dental Association, L. M. Kennedy, D.D.S., letter.

318

American Fork (Utah) Hospital, Wayne R. McTague, letter..

319

American Health Care Association, Wiley M. Crittenden, Jr., statement.. 320

American Medicorp, Inc., Medical Advisory Council, William M. Thomp-

son, M.D., statement.

322

American Nurses' Association, statement.

324

American Protestant Hospital Association, Donald I. Gent, letter

325

American Society of Internal Medicine, statement-

325

Anita, Sister, St. Joseph's Hospital, letter forwarded by Senator Quentin N.

Burdick.

446

Anthony, Sister Louise, St. Raphael Hospital, communication forwarded
by Congressman Christopher J. Dodd...

463
Antolak, Stanley J., Jr., M.D., St. Paul, Minn., letter to Congressman
Rostenkowski, enclosing letter to Congressman Karth..

328
Arkansas Medical Society, Paul C. Schaefer, letter..

329
Arnoldine, Sister M., Towner County (N. Dak.) Memorial Hospital, letter
forwarded by Senator Quentin N. Burdick.

449
Austin, Tex., hospital administrators, letter forwarded by Congressman
J. J. Pickle.--

208

Bachman, Joan, Community Memorial Hospital, letter forwarded by

Senator Quentin N. Burdick

447

Baird, Michael D., M.D., University of Oregon Health Sciences Center,

mailgram.-

453

Baptist Hospital, Nashville, Tenn., C. David Stringfield, letter..

330

Baylor University Medical Center, David H. Hitt, letter forwarded by

Congressman Olin E. Teague...

331

Beck, Eugene C., Panguitch Hospital, Sanpete Valley Hospital, and Sevier

Valley Hospital, letter..

453

Benoit, Richard E., Central New York Hospital Association, Inc., letter.- 344-
Bingham, Fletcher H., Maine Hospital Association, letter..

402
Birmingham (Ala.) Regional Hospital Council, Edward S. Ferrell, letter
and statement.

332
Bismarck (N. Dak.) Hospital, James P. Swenson, letter forwarded by
Senator Quentin N. Burdick -

448
Blue Cross Association, Bernard R. Tresnowski, statement.

333
Bonner, George A., M.D., New Haven County (Conn.) Medical Associa-
tion, letter

438

Boone, Charles C., Spartanburg (S.C.) General Hospital, letter and

statement.

478

Bowen, Charles E., Whittaker Memorial Hospital, letter forwarded by

Congressman Thomas N. Downing-

496

Brekke, Arvid B., Colorado Hospital Association, letter.

374
Briscoe County (Tex.) Medical Society, Mary D. Bublis, M.D., telegram.- 338

Page
460
338

458

474

310
374
374

451

Brooks, Sister Mary, St. John's Hickey Memorial Hospital, letter forwarded

by Congressman Elwood H. Hollis-
Bublis, Mary D., M.D., Briscoe County (Tex.) Medical Society, telegram.

Burgon, Grant C., Utah Valley Hospital, letter forwarded by Congressman

Gunn McKay

Busby, Dr. C. L., Plainview, Tex., telegram.

Butler, Patricia A., National Health Law Program, letter with enclosure -

Byers, Lyle W., Pittsburgh (Pa.) Eye & Ear Hospital, mailgram forwarded

by Congressman William S. Moorhead.

California, Hospital Council of Northern, L. G. Woodcock, statement.--

California Vedical Association, Carl Goetsch, M.D., letter and statement.

Carbon Hospital, Donald M. Fifield, letter.

Central New York Hospital Association, Inc., Richard E. Benoit, letter---

Central Vermont Hospital, Joel H. Walker, letter..

Chicago (III.) Hospital Council, Howard F. Cook, statement-

Childress Clinic & Hospital, M. A. Childress, M.D., letter forwarded by

Congressman Omar Burleson.

Chisago Lakes (Minn.) Hospital, Carlton R. Erickson, M.D., statement..

Church of the Brethren General Board, Rev. Larry K. Clrich, statement..

Clark, Richard E., Wentworth Douglas Hospital, letter forwarded by

Congressman Norman E. D'Amours

Clark, Sister M. Ferdinand, Pittsburgh (Pa.) Mercy Hospital, mailgram

forwarded by Congressman William S. Moorhead.

Clarkson, Edward H., Southern Baptist Hospital, letter forwarded by

Congresswoman Lindy (Mrs. Hale) Boggs -
Cobble, Sonny P., M.D., Southern California Orthopedic Surgical/Medical

Group, Inc., letter..

Cohen, Hon. William S., a Representative in Congress from the State of

Maine, letter
Cole, Elizabeth C., New York, N. Y., mailgram..
Colorado Hospital Association, Arvid B. Brekke, letter.
Community Hospital in Nelson County (N. Dak.), C. Gary Kopp, letter

forwarded by Senator Quentin N. Burdick...
Community Memorial Hospital, Joan Bachman, letter forwarded by

Senator Quentin N. Burdick.

Connelly, Warren E., Naples (Fla.) Community Hospital, letter.

Cook, Howard F., Chicago (Ill.) Hospital Council, statement.-

Cooper, Joe, Leake County (Miss.) Memorial Hospital, statement

Coopers & Lybrand, Philadelphia, Pa., letter.

Corona (Calif.) Community Hospital, Stanley M. Grube, letter.
Cramer, R. A., Northampton-Accomack Memorial Hospital, Nassawadox,
Va., letter to the Commissioner of Social Security forwarded by Con-

gressman Thomas N. Downing--

Crittenden, Wiley M., Jr., American Health Care Association, statement

Cunningham, Paul J., M.D., Galveston (Tex.) County Medical Society

letter.

Dakota Hospital, D. D. Wightman, letter forwarded by Senator Quentin N.

Burdick
Damian, Sister, Seton Medical Center, letter forwarded by Congressman

J. J. Pickle.
D'Amours, Hon. Norman E., a Representative in Congress from the

State of New Hampshire, statement-
Danner, C. Duane, Kansas City Area Hospital Association, Hospital

Association of Metropolitan St. Louis, and Missouri Hospital Associa-

tion, statement..

DeLange, George A., Redlands (Calif.) Community Hospital, letter

Dennis, Grace R., Bronx, N.Y., letter -

De Saussure, Richard L., M.D., American Association of Neurological

Surgeons, statement.---

Dunn, Donald W., Iowa Hospital Association, letter and statement.

East Central Minnesota Medical Society, Carlton R. Erickson, M.D.,

statement

Ellington Memorial Clinic, T. K. Nichols, V.D., letter.

Erickson, Carlson R., Chisago Lakes (Minn.) Hospital, and East Central

Minnesota Medical Society, statement.-

Ernsdorff, John B., St. Joseph's Hospital, Inc., letter.

Esson, William B., Youngstown Hospital Association, letter forwarded by

Congressman Charles J. Carney --

452

320

451

211

204

332
343

306
461

325

338

382
453

Estaugh Corp., William R. Martin, statement..
Ferrell, Edward S., Birmingham (Ala.) Regional Hospital Council, letter

and statement.-
Fifield, Donald M., Carbon Hospital, letter.
Forsythe, Hon. Edwin B., a Representative in Congress from the State

of New Jersey, statement.-

Frances, Sister Helen, St. Joseph's Hospital, Inc., letter-

Galveston (Tex.) County Medical Society, Paul J. Cunningham, M.D.,

letter...

Garrison (N. Dak.) Memorial Hospital, Sister Madonna Waggendorf,

letter forwarded by Senator Quentin N. Burdick
Geiger, Leo, St. Aloisius Hospital, letter with enclosure forwarded by

Senator Quentin N. Burdick -
Gent, Donald I., American Protestant Hospital Association and Welborn

Baptist Hospital, letter...
Goetsch, Carl, M.D., California Medical Association, letter and statement.
Goldberg, Irwin, Montefiore Hospital Association of Western Pennsyl-

vania, mailgram forwarded by Congressman William S. Moorhead
Griggs County (N. Dak.) Hospital and Nursing Home, Gary M. Ryba,

letter forwarded by Senator Quentin N. Burdick..
Grosse, Alex H., Mason (Tex.) Memorial Hospital, Inc., letter forwarded

by Congressman Omar Burleson..

Grube, Stanley M., Corona (Calif.) Community Hospital, letter..

Guinn, Joseph M., St. David's Community Hospital, letter forwarded by

Congressman J.'J. Pickle.

Hagen, J. A., Lancaster (Calif.) Community Hospital, letter-

Haley, Curtis, M.D., San Augustine, Tex., letter -

Hallagan, Sister Mary Lawrence, Mercy Hospital, Cedar Rapids, Iowa,

letter and statement forwarded by Senator John C. Culver...

Hardin County (Tenn.) General Hospital, Phillip W. Langston, letter and

statement

Harmer, Harold, Payson (Utah) Hospital, letter..

Harrison, Samuel A., 11.D., Loudon County (Tenn.) Memorial Hospital,

statement.

Hayes, Jesse V., Holy Cross Hospital, letter forwarded by Congressman

J. J. Pickle

Hegarty, W. Kevin, Huntington Memorial Hospital, letter.

Heide, Robert K., M.D., Virginia Society of Internal Medicine, letter

forwarded by Congressman G. William Whitehurst -

Helen, Sister, Richardton (N. Dak.) Community Hospital, letter forwarded

by Senator Quentin N. Burdick-

Heyssel, Robert M., M.D., Johns Hopkins Hospital, letter--

Hitt, David H., Baylor University Medical Center, letter forwarded by

Congressman Olin E. Teague.

Hoefs, Gene, St. Gerard's Community Hospital, letter forwarded by

Senator Quentin N. Burdick -

Hofmann, Wayne, Mason (Tex.) Memorial Hospital, Inc., letter forwarded

by Congressman Omar Burleson...

Hoffman, Laurence J., Naples (Fla.) Community Hospital, letter -

Holbrook, Fred K., Montana Deaconess Hospital, letter..

Hollis, Ruth, R.N., Pembina County (N. Dak.) Memorial Hospital, letter

forwarded by Senator Quentin N. Burdick..

Holy Cross Hospital, Jesse V. Hayes, letter forwarded by Congressman

J. J. Pickle.

Hospital Council of Northern California, L. G. Woodcock, statement.--

Huffington, Herb L., M.D., American Academy of Family Physicians,

letter -

Huntington Memorial Hospital, W. Kevin Hegarty, letter..
Hurst, 0. Ray, Texas Hospital Association, statement.-
Hutchinson, John D., Idaho Hospital Association, statement-
Idaho Hospital Association, John D. Hutchinson, statement-
Indiana University Hospitals, Robert C. Terrill, letter-
Iowa Hospital Association, Donald W. Dunn, letter and statement-
Jackson, Henry X., Valley Presbyterian Hospital, statement.---
Jensen, Ronald L., Nebraska Hospital Association, letter and statement..
Joanne, Sister M., St. Alexius Hospital, letter forwarded by Senator

Quentin N. Burdick..

67

213

385

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