Dr. DOTTER. This might be well received. Mr. JARMAN. Thank you for contributing, gentlemen, to our hearing record. The committee stands adjourned until 10 o'clock tomorrow morning. (Whereupon, at 12:25 p.m., the subcommittee adjourned, to reconvene at 10 a.m., Thursday, June 4, 1970.) COMPREHENSIVE HEALTH PLANNING AND REGIONAL MEDICAL PROGRAMS THURSDAY, JUNE 4, 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 continue hearings on bills relating to the heart, cancer, and stroke program, also bills relating to the comprehensive health program. Let me now introduce our colleague from our own Interstate and Foreign Commerce Committee, Congressman Kuykendall, to introduce our first witness today. STATEMENT OF HON. DAN KUYKENDALL, A REPRESENTATIVE IN CONGRESS FROM THE STATE OF TENNESSEE Mr. KUYKENDALL. Chairman Jarman and Chairman Staggers and members of the committee, for the second time the first witness is testifying before this committee; in the 90th Congress I had the privilege of introducing him then on a different subject. I have a bill in on the subject that you have now under discussion. Dr. Bland Cannon from Memphis, Tenn., is widely known in the field of medical education and particularly known as a member of the National Advisory Council for Regional Medical Programs, Dr. Cannon's expertise in this area goes way back to his being one of the cofounders of the Mid-South Medical Center Council, which covers parts of the States of Tennessee, Arkansas, and Mississippi in a Regional Medical Center Council. I recommend the testimony of Dr. Cannon and I commend this very fine physician and citizen expert in the field of medical work, his education, in medical councils, as well as the medical profession itself; I commend you, Dr. Bland Cannon of Memphis, Tenn. Mr. JARMAN. Thank you very much, Congressman. (221) STATEMENT OF DR. BLAND CANNON, MEMBER, COUNCIL ON MEDICAL EDUCATION, AMERICAN MEDICAL ASSOCIATION; ACCOMPANIED BY DR. C. H. WILLIAM RUHE, DIRECTOR, DIVISION OF MEDICAL EDUCATION; AND HARRY N. PETERSON, ATTORNEY, LEGISLATIVE DEPARTMENT TAKES INCO Dr. CANNON. I want to thank Congressman Kuykendall for his introduction. I am Dr. Bland W. Cannon of Memphis, Tenn., a practicing neurological surgeon and a member of the American Medical Association's Council on Medical on Medical views of the Americansion. With me to present the extending the regional medical program and comprehensive health planning and public health services are Dr. C. H. William Ruhe, to my right, who is director of the AMA Division of Medical Education; and Dr. Harry N. Peterson, an attorney in our legislative department. Mr. Chairman, there are a number of bills before this committee for hearing. For ease in responding to them, I shall classify them broadly into two groups: one, those bills which would primarily extend, with some modifications, the regional medical programs and the program for comprehensive health planning and public health services; and second, those bills which would combine those programs along with a third program, health facilities and services research and development total ao two, motornello, wo soubortni won μm tal The AMA has been vitally interested in these programs since their inception, and has testified concerning them before this committee in the past. At the time of the adoption of the regional medical programs many amendments proposed by the association were incorporated in the legislation which resulted in the program, being more effective and more acceptable to the profession and to the public. In 1968, the association testified in of the extension of the program, eit recension medical profes ing the had the the support in suppor sion, including direct participation by some State medical associations as program grantees and active participation in lesser roles by others, In December of 1969 the AMA House of Delegates affirmed "its support of the concept of regional medical programs as enacted in Public Law 89-239" and urged AMA members to "participate at all levels in giving guidance to implementing regional medical programs in line with the highest tradition of the private practice of medicine, sai199 In addition to extending RMP, several of the bills before you would now provide for an expansion of the program to include diseases other than heart disease, cancer and stroke, and related diseases. One bill, H.R. 14486, would broaden the scope to include heart disease, cancer and stroke "and other major diseases." We support this modification of the program. The same bill would also require that before operational grants may be approved, an opportunity must be provided for consideration of the application by each public or nonprofit private agency or organization which has developed a comprehensive regional, metropolitan area, or other local area plan, covering any area in which the regional medical program for which the application is made will be located. On its face this requirement may seem to be beneficial. However, we view with some concern the imposition of any requirement, par ticularly a requirement nationwide, which might have the effect of impeding the development of some operational programs. Mr. Chairman, the American Medical Association has also endorsed the concept of comprehensive health planning-another subject of the legislation before you. For many years we have supported voluntary efforts in health planning-State, local and areawide. The association has encouraged physicians and their professional organizations to seek and to accept the responsibility of working in the planning group throughout all stages of planning, in order to provide guidance in choosing goals and programs which will realistically meet the community's health needs. Many groups have a legitimate interest in community health and should be involved in the planning process, but the medical profession has a particular expertise which it brings to a planning group. In extending the program we urge you to adopt a modification which will call for participation on the State health planning council of a greater number of practicing physicians.bd nor depeng a suppboke At the time of the adoption of the comprehensive health planning and public health services amendments we voiced our objection to portions of the legislation providing for public health services and project grants for health services without defining the services intended to be provided. We believe that this legislation should be clarified to indicate a limitation of the services to those which would be appropriate as public health services. if The other category of bills which I will now discuss, represented by H.R. 15960 and H.R. 16147, would incorporate under a single legislative act three programs: regional medical programs, comprehensive health planning and public health services, and health facilities and services research and development. In our opinion an amalgamation of these programs would not be in the best interest of the public and would not best serve to accomplish the goals originally sought by the enactment of the individual programs. In 1968, testifying for the AMA on the extension of RMP, I then stated, after voicing the profession's acceptance of the program because of changes which had been made in its original structure: RMP began auspiciously and, since that time, continues to promise a hopeful future. But there are still some who would like to see the Regional Medical Programs as an instrument by which the organization and delivery of health care to the American people could be changed in some revolutionary manner. We view with favor the early progress of RMP, its ability to build on existing patterns of medical care (sometimes adding new features or changing old ones as local demands and resources make possible) and the local flexibility allows the program to make a real contribution to the health care of our which ation. While it has been stated that a primary purpose of combining the programs is to achieve coordination and avoid duplication of effort, it is apparent from the legislation that a change in the thrust of the programs is intended. We believe that coordination and integration. can be developed best at the local or regional level. There is convincing evidence that this has already developed in some regions under the existing legislation, and effective coordination should be fostered and developed in other regions through local initiative. Since the two programs are under the same general jurisdiction, greater coordination can, and should, occur at the Federal level with 46-566 0-70-16 |