can get to talk about lymphoids and all of the items in the blood. Can we have that done? Dr. EGEBERG. This type of equipment is being put into smaller and smaller hospitals. There has to be a certain load, to make the hospital feel it could afford it, but once it gets over that threshold, it certainly makes ten tests available where only one used to be available. I can't think of many places that would not have a hospital where it could be done rather close at hand or a laboratory where these could be done rather close at hand. Certainly, that is where the great pressure of education is right now. The heart is a very proper organ to be associated with and in medicine this a great deal of stature or status in association with heart disease. Things go in medicine the way they do elsewhere, and I think much of this will happen in a combination between the doctors and industry and the hospitals. Mr. KYROS. Thank you very much. Dr. EGEBERG. Thank you. Mr. JARMAN. Any further questions? Doctor, we appreciate the able testimony that you and your colleagues have given to the committee this morning. The committee will stand adjourned until 10 o'clock tomorrow morning. (Whereupon, at 12 o'clock noon the subcommittee adjourned, to reconvene at 10 a.m., Tuesday, June 2, 1970.) COMPREHENSIVE HEALTH PLANNING AND REGIONAL MEDICAL PROGRAMS TUESDAY, JUNE 2, 1970 HOUSE OF REPRESENTATIVES, SUBCOMMITTEE ON PUBLIC HEALTH AND WELFARE, Washington, D.C. The subcommittee met at 10 a.m., pursuant to notice, in room 2322, Rayburn House Office Building, Hon. John Jarman (chairman) presiding. Mr. JARMAN. The subcommittee will please be in order. We will continue the hearings on H.R. 15960 and other bills relating to the heart, cancer, and stroke programs and the comprehensive health planning program. Congressman Biester, we are pleased to have you testify first this morning. STATEMENT OF HON. EDWARD G. BIESTER, JR., A REPRESENTATIVE IN CONGRESS FROM THE STATE OF PENNSYLVANIA Mr. BIESTER. Thank you, Mr. Chairman. I will not tax the time of the subcommittee greatly this morning. I know that you have a list of very distinguished and very expert witnesses prepared to testify in detail with respect to pending legislation. I simply wanted to be here to express the interest which is widespread, I believe, in the Congress with respect to action on the part of the Congress in the area of kidney disease. I was privileged to be one of the sponsors of a bill styled as the National Kidney Disease Act of 1970, in which over 110 of our colleagues were cosponsors. I believe that in addition to that legislation there has been other legislation submitted, both by the very distinguished ranking member, the gentleman from Minnesota, the gentleman from Kentucky, and other members of both your subcommittee and the full committee. I am simply here, not as an expert and not as one who can presume to discuss in detail the full problem in its national sense, but simply as one who, as a result of his work with other Members of Congress in this field, believes that the time has come to do something and to do something soon, that time is running out. And I wish to express my support for the chairman's bill here this morning. I feel it is important that the chairman and the committee support this bill. I request permission to file a statement for the record. (105) Mr. JARMAN. Without objection your statement will be placed at this point in the record. (Mr. Biester's prepared statement follows:) STATEMENT OF HON. EDWARD G. BIESTER, JR., A REPRESENTATIVE IN CONGRESS FROM THE STATE OF PENNSYLVANIA Mr. Chairman, I want to thank the members of the Subcommittee for the opportunity to present this statement. One of the major problems facing medicine and public health is the lack of trained personnel, available facilities, research and equipment for the diagnosis evaluation, treatment and prevention of kidney disease. No parallel situation exists in medicine; that is a situation in which successful techniques have been developed for the diagnosis and prevention of diseases which would save lives, and yet at the same time, people continue to die from kidney disease because of the lack of facilities to supply those techniques for diagnosis and treatment. Over 110 Congressmen, including myself, have introduced legislation entitled "The National Kidney Disease Act" which would authorize funds for five years to support cooperative arrangements among medical schools, research institutions and other institutions and agencies to develop and activate larger capacity to prevent and control kidney disease. Identical legislation has been introduced in the Senate. Physicians report that 10,000 of the kidney disease patients who die each year are considered medically to be good candidates for artificial kidney machine treatment and kidney transplantation. An additional 10,000 patients would benefit from such treatment. Only 3,000 patients have received artificial kidney machine therapy since 1960, including the 500 new patients treated in the past year. Many patients whose lives might be maintained for a significant number of years are now dying because treatment is not available. In spite of the fact that improvements in both dialysis and transplantation technology are needed, I believe, as do many experts (and I am not an expert), that these two forms of therapy are sufficiently well advanced to warrant launching a national program to provide such treatment for those medically suitable patients for whom it is not available today. Dialysis and transportation are both extremely expensive and many individuals whose lives depend upon receiving one of these methods of treatment simply are not able to afford it. I don't think we can justify any longer the selection of candidates for treatment on the basis of ability to pay. A physician should not be forced to choose among his patients as to who shall receive the life-saving treatments, but should be in the position of offering these treatments to all of his patients who might significantly benefit from them and would die without them. In presenting the 1967 report of the Committee on Chronic Kidney Disease, which had been charged by the Bureau of the Budget with the responsibility of considering all aspects of the problems posed by chronic kidney disease, the committee chairman, Carl Gottschalk, M.D. stated: "If a national treatment program is adopted, the Committee wishes to emphasize that it must be a continuing program that has as its objective the provision of these treatment modalities at the earliest possible date for all who require them. Until treatment capability meets demand, agonizing decisions concerning patient selection are inevitable at both the local and national level." I believe it is time for Congress to give immediate consideration to legislation providing for a comprehensive approach to kidney disease. I consider this one of the most pressing health problems in the United States, because we can and must take advantage of the discoveries of medical research to provide the proven life-saving treatment to the sufferers of kidney disease. Failure to take this step would be a demonstration of a cruel performance gap, a gap which lies between our known and proven capability and our inadequate performance. This legislation addresses a matter of human concern no less than the very lives of thousands of American people each year. I urge your favorable consideration. Mr. JARMAN. Thank you very much, Mr. Biester. Are there any questions? Mr. NELSEN. I have no question, except to thank my colleague for his appearance here and also to point out, as he had already mentioned, I am one of the sponsors of a kidney disease bill. This first came to my attention from a Legionnaire in Fairmont, Minn., who has a relative that had been forced to make use of the equipment, if you can call it that, and was very concerned about it. And I think there is great merit in your testimony. And I thank you for your statement. Mr. BIESTER. Thank you very much. Mr. JARMAN. Thank you very much for being with us. Mr. BIESTER. Thank you, Mr. Chairman. Mr. JARMAN. Next we have with us this morning the Honorable Howard W. Robison, our colleague from New York. Mr. Robison has a statement he would like to present to the committee. Proceed as you see fit, sir. STATEMENT OF HON. HOWARD W. ROBISON, A REPRESENTATIVE IN CONGRESS FROM THE STATE OF NEW YORK Mr. ROBISON. Mr. Chairman, I appreciate the opportunity to express to this subcommittee my views on the question of public health for I believe that this subject is of vital interest to all Americans. Our attention must not only turn to the question of how to provide adequate medical services to American families, but also how to do so in such a way that these families can afford to participate. Just as other costs are increasing, so too are costs of medical services. Anyone who has had the misfortune to suffer a recent illness can readily testify to the high cost of doctor bills, operations, medicine and hospital care. These costs are most relevant to these hearings because often the cost of medical care absorbs a major portion of one's income during a time of serious illness. The result for one with limited insurance coverage, or no coverage, can be financially disastrous, bringing about bankruptcy in some cases and a lowering of the family's standard of living in many others. Some of the increased cost of medical care comes from normal costof-living increases, but much of it is due to other, more complicated factors. Some have suggested that the costs of medical care are directly related to the benefits paid by medical insurance policies and that as one increases so too does the other, in an ever-increasing spiral fashion. Others have suggested that the increased costs are directly related to the shortages of doctors and facilities. No doubt there are many reasons for the rise in costs, but increasingly the argument is being made, and logically so, that duplication of effort and equipment is a cause for much of the increase. Duplication of effort is always a cause for concern, but when it involves the lives and health of people, such counterproductive efforts become dangerous and costly. In this perspective, my bill H.R. 16147 and the companion bills which establish integrated and regional medical programs, would take an important first step in determining the medical needs of a community-now and in the future-and then combine all available resources to provide for those needs. The concept of regional planning 46-566-70-8 |