we are very deficient. We can devise worthwhile programs, we can establish foreign regional centers. A number of universities have done this with private funds. I am sure that we can develop a program but this is not the program. I hope that the committee will not give this sort of token encouragement, which would obviously result in plans and programs which would involve us in huge expenditures which I think we should not incur.

Mr. FLOOD. Mr. Michel.

Mr. MICHEL. Thank you, Mr. Chairman.

First, may I say we appreciate our colleague from Illinois coming before the committee to shed this additional light on a subject which has had a great deal of discussion both among the Members of the subcommittee here and in free dialogue with the witnesses who have appeared before us heretofore.

I think it is indeed unfortunate, as you pointed out, that the original legislative measure was not thoroughly aired and debated on the floor of the House for there is a great deal of misunderstanding about the real import and impact of this program. I must say that I made a comment during the hearing when the Government witnesses were testifying, that I thought their testimony this year was better than it was in prior years from the standpoint of shedding some light on just what they intended to do by way of a program. You mentioned a report. Was that by any chance Education and World Affairs? Mr. MCCLORY. Yes.

Mr. MICHEL. You made the point that this legislation came about as a recommendation of that particular organization?

Mr. McCLORY. Oh, yes, yes.

Mr. MICHEL. Now, is it not funny that that same organization is the one that was chosen by the Office of Education to make the study of international programs that we practically directed?

Mr. MCCLORY. Mr. Michel, I testified before the ad hoc committee. My recollection is there was one ad hoc committee member present at the time that I testified, but the staff member who was present was the staff member who was loaned by Education and World Affairs to assist the ad hoc committee.

I have their publication. I would be glad to produce them for the committee, which show that the draft of this legislation was the frontispiece of their issue of that particular time. It was their legislation, it was their staff that developed the legislation and, of course, they are the beneficiaries of this legislation.

It is an example of a lobby group from the area of higher education coming into the Congress developing a program, and then endeavoring to reap the benefits of that program which they have established. May I say that in one of their recent publications, this organization, Education and World Affairs, states on the very first line "The international education program enunciated by President Johnson in his message to the Congress on February 2, 1966, and the International Education Act of 1966 which was approved by large margins in both Houses of the Congress." Now, it passed 194 to 89. I figure that is about 12 votes more than enough, more than the two-thirds necessary. Mr. MICHEL. Under the procedures under which that bill was considered, suspension of the rules, two-thirds vote is required for passage.

Mr. McCLORY. It is required. So it passed by one and a half votes. In the Senate it passed on a voice vote.

Mr. MICHEL. I should make one other observation. It probably should better be made by our good friend, Mrs. Reid, who, during the discussion of this matter in the regular hearing, asked that all these additional programs that we are funding in international education be submitted for the record so that it would be clearly shown what is currently being done aside from this particular program.

Mr. MCCLORY. If you will permit, Mr. Michel, I would like to point out that on pages 42 and 43 of this publication, entitled "Higher Education and World Affairs," the author calls attention to the fact that while we have not funded the International Education Act they indicate other areas where you can go to get Federal funds so that you should not let your program or your interest in international education expire because of lack of Federal funds.

Mr. MICHEL. What are the pages of that particular report?

Mr. MCCLORY. Pages 42 and 43, entitled "Resources To Tap, Federal Funding."

Mr. MICHEL. If those are listed at that point we might very well have those for the record here, too, Mr. Chairman.

(The information follows:)

RESOURCES TO TAP

In spite of its relatively recent prominence in U.S. higher education, international education already suffers from a flood of information. As with most communications problems, however, the challenge to those involved in the field is how to stay abreast of developments, how to cut through to the relevant

resources.

What follows is a partially annotated listing of some resources which are available to those institutions interested in moving further into the international

area:

Federal funding.-The International Education Act of 1966, created by substantial majorities in both Houses by the 89th Congress, emerged stillborn when the 90th Congress-mindful of the competing priorities imposed by the Vietnam war and aware that U.S. Government-academic relationships were entangled in a jungle of inter-agency jurisdictions-refused to appropriate funds to implement the legislation. Instead, modest funds were provided for a study of all Federal Government activities bearing on international education-a reminder that there is as yet no coherence to the Government's efforts in this overlapping

area.

Failure to fund the IEA may prove to be more of a setback than a lost warprovided the time before the submission of a new, major program in international education is utilized both to take organizational steps toward unifying the gov ernmental effort and to persuade institutions of higher education to ready themselves for the challenge. As Paul A. Miller, former Assistant Secretary for Education, HEW, has put it, the delay can be "an advantage, the kind of interregnum you don't always get in Government-one which gives the opportunity to do careful, ingenious, imaginative planning in terms of how all this should work in the years ahead."

It is important to note that the failure to fund the IEA did not deprive higher learning institutions of funds previously enjoyed; the action of the 90th Congress did not subtract $1 of financing that had been available to colleges and universities. In fact, as far as undergraduate institutions are concerned, what they have accomplished to date in international education has been done with minimal foundation and Government-financial assistance.

Such institutions, instead of marking the time until a new Federal program in international education takes shape, may now need to show more imagination and resource in establishing potential funding sources within the array of other Federal education programs, with the smaller, regional and local philanthropic foundations, and with corporate givers.

For instance, the Federal Government in 1967 obligated some $40,600,000 in the form of contracts and grants for social and behavioral research on foreign areas and international affairs. The problems in obtaining Federal funding are largely procedural-first, knowing where the money is, then determining which funds can be used for international programs, learning which Government personnel to contact with specific questions and, finally, submitting the proper proposals.1

Mr. FLOOD. There are many communities who are now creating the very important local job of Federal coordinator on the payroll of the city or county, to be sure that the natives are fully aware of all the potentials and all the sources to tap.

Mr. Smith?

Mr. SMITH. My colleague, I understood you to say-and maybe I was incorrect that appropriating this $2 million might be harmful rather than helpful. Would you elaborate on why?

Mr. McCLORY. I think appropriating the $2 million would enable a planning group or whatever is designated to utilize this money, to develop programs which would be expensive, which might be persuasive of a future Congress.

Mr. SMITH. I thought you said it might be harmful to the goal of educating people in international affairs..

Mr. McCLORY. I feel that it might, because if the programs are planned in accordance with the International Education Act, I think it would be harmful to the whole subject of international education. Let me just emphasize, I think that the only way we can learn about other peoples and other societies and languages is in the foreign countries under study. We cannot learn much about them here. Peace Corps volunteers obtain a wealth of information that they have gained about other people because they have gone and lived with the people and spent a couple of years there. That is a most useful expenditure of funds. These are private funds that are being used in these regional centers. These are valuable educational programs. Indeed, most of the Peace Corps volunteers are involved in education.

Mr. SMITH. Then you are saying the basis of this program will reach the wrong goal?

Mr. McCLORY. Exactly, exactly.

Mr. SMITH. That is all.

Mr. FLOOD. Mr. Shriver.

Mr. SHRIVER. I want to commend our colleague, Mr. McClory, for his fine statement. It is very helpful. I compliment him on his sincerity. It is obvious that you know considerable about this subject. You did not come with any prepared statement and yet you have talked for quite some time from information that you have. This is the kind of help that we appreciate.

Mr. FLOOD. Mr. Hull?

Mr. HULL. No questions.

Mr. FLOOD. Mrs. Reid?

Mrs. REID. I would just like to welcome my colleague from Illinois. and commend him also for his statement, which certainly makes sense to me. As Mr. Michel pointed out, I was impressed with this volume of information concerning other programs on international studies, a

1 In this connection, see A Manual for the Preparation of Proposals: Summer 1968 and During the Academic Year 1968-69, published by the Government Printing Office, 1967.

listing of which I did have inserted in the record. I feel that your statement today certainly emphasizes the fact that this program, as far as I am concerned, is not necessary.

Mr. FLOOD. Mr. Casey?

Mr. CASEY. I have no questions, Mr. Chairman.

Mr. FLOOD. Thank you.

WEDNESDAY, MAY 14, 1969.

PROPOSED CLOSING OF THE DETROIT PUBLIC HEALTH SERVICE HOSPITAL

WITNESS

HON. JOHN D. DINGELL, A REPRESENTATIVE IN CONGRESS FROM THE STATE OF MICHIGAN

Mr. FLOOD. We now have the privilege of having with us our friend and distinguished colleague who has appeared before us on several occasions, the distinguished gentleman from Michigan, Mr. Dingell, who is knowledgeable on many of the subjects within the jurisdiction of this subcommittee because of his service upon the legislative committees having a great deal of the same jurisdiction.

Mr. Dingell, how do you wish to proceed?

Mr. DINGELL. I have a prepared statement. I would like to summarize it very briefly, and ask that the whole of the statement be inserted in the record, if that would be appropriate.

Mr. FLOOD. We will do it your way.

(Mr. Dingell's prepared statement follows:)

STATEMENT OF HON. JOHN D. DINGELL, DEMOCRAT, MICHIGAN, TO THE HOUSE APPROPRIATIONS SUBCOMMITTEE ON LABOR AND HEALTH, EDUCATION, AND WELFARE, ON PROPOSED CLOSING OF THE DETROIT PUBLIC HEALTH SERVICE HOSPITAL Mr. Chairman and members of the subcommittee, for the record, my name is John D. Dingell and I am a Member of Congress from the 16th District of Michigan. I wish to thank the Chair and the subcommittee for the privilege of presenting testimony concerning the proposed phasing out of inpatient services at the Public Health Service general hospital in Detroit, Mich.

The Public Health Service general hospital in Detroit has a constructed inpatient capacity of 177 beds and an operating capacity of 147 beds. During the July-September 1968 period it had an average daily patient load of 96.

This hospital is the only Public Health Service general hospital which remains in operation in the Great Lakes area. In addition to primary beneficiaries, such as American seamen, it is available to military personnel and their dependents, veterans, and certain Federal employees on a reimbursable basis.

Going back a bit in time to January 1965, it was proposed that the Detroit hospital and various PHS facilities in other locations be closed down. However, as a result of findings developed during an extensive study of the proposal by three committees of the House-the Committee on Interstate and Foreign Commerce, the Committee on Merchant Marine and Fisheries, and the Committee on Government Operations-the decision to close the Detroit hospital was reversed. In a letter dated May 10, 1966, the then Secretary of Health, Education, and Welfare, John Gardner advised Chairman Staggers of the Committee on Interstate and Foreign Commerce that, "based on the findings of this study (within the departments involved) which was recently completed, the Department has made the following decisions: *** The hospital at Detroit should be modernized and continued in operation as a Public Health Service general hospital." Mr. Chairman, the Congress did make available to PHS funds for planning the modernization of the Detroit facility and continued to provide funds for its oper

ation. In fact, the fiscal year 1970 budget submitted to Congress by former President Johnson indicated that the Detroit facility would continue in operation.

In a routine press announcement for release at 3 p.m., Wednesday, April 2, 1969, from the Office of the Secretary of HEW, it was reported that plans were underway to convert the PHS hospital at Detroit to an outpatient clinic effective June 30, 1969. One of the reasons cited for this proposed action was "the declining caseload and the limited size of the hospital make it no longer feasible or economical to continue operating as an inpatient facility." It was proposed that the outpatient facility be continued in operation, but that inpatient services be provided at other hospitals-either on a contract basis in non-Federal hospitals or in other Federal hospitals.

Under date of April 16, 1969, I wrote the Secretary of HEW, Robert H. Finch, a four-page letter-a copy of which I submit for the record-setting forth my doubts about the wisdom of closing the Detroit hospital and concluding, "So that the committees (of Congress) may be able to exercise their legislative oversight responsibilities with regard to this matter, I respectfully request that you rescind the directive that inpatient services at the U.S. Marine Hospital in Detroit be ended as of June 30, 1969." A similar request was made to the Secretary of HEW by Chairman Staggers of the Committee on Interstate and Foreign Commerce. To date, I have not received a substantive response to my request. Subsequent study by the committee staff and by my own staff, based in large part on information provided by PHS, raised serious doubt about the contention that closing of the Detroit inpatient facility would result in an economy to the Public Health Service or to the Federal Government as a whole.

For fiscal year 1968, PHS data shows that it had cost a total of $1,581,100 to operate the Detroit inpatient facility, or $56.78 per diem based on the 27,846 inpatient days experienced during fiscal year 1968.

Dr. Robert van Hoek, Director, Federal Health Program Services, met with Committee staff persons and a member of my personal staff. During this meeting it was generally agreed that Federal facilities in the Detroit area would not be able to care for persons displaced by the closing of the inpatient facility at Detroit and that it probably would be necessary to utilize non-Federal hospitals on a contract basis in the case of patients requiring care in the Detroit area and to a considerable degree elsewhere in the Great Lakes area.

Mr. van Hoek said the PHS estimate of the cost of inpatient care on a contract basis was $98 per diem, $60 for hospital costs and $38 for medical services. For a caseload of 27,846 in fiscal year 1968 or a caseload of 30,400 as was estimated for fiscal year 1969, it is obvious that the overall cost of caring for this patient load on a contract basis would be approximately twice the cost of operating the Detroit inpatient facility-$1,581,100 for fiscal year 1968 and an estimated $1,666,200 for fiscal year 1969.

It is true, however, that about one-third of the persons treated on an inpatient basis at the Detroit hospital are not primary beneficiaries, and, therefore are not the direct responsibility of the PHS. But, generally, these persons are veterans, military personnel and their dependents, and so forth, who by law have the right to certain medical care at the expense of the Federal Government. When these nonprimary beneficiary persons are treated at a PHS hospital, some other agency of the Federal Government reimburses the PHS for its services. If these persons are not treated at a PHS facility, they will receive treatment at some other facility-and in the Detroit area this almost certainly will be a non-Federal facility-at a cost approximating $100 per day rather than the $55 to $60 a day it would cost the Federal Government at the Detroit facility.

I feel these points which I have raised make it clear that a thorough examination of the proposed action with regard to the PHS hospital in Detroit should be made by the committees of legislative jurisdiction in the House and in the Senate. Therefore, I strongly urge your subcommittee to recommend continued funding of the inpatient facility at the Detroit Public Health Service hospital until the full facts in the case can be ascertained through appropriate hearings.

Mr. Chairman, what the PHS proposes to do is shut down its only inpatient facility in the entire interior portion of the United States. This would mean that persons whom the Congress, since the earliest days of the Republic, has found are entitled to first-class medical care under Federal auspices will be forced into other hospitals, largely non-Federal hospitals where their admission will depend in large part on the ability of the hospital to take care of the additional caseload.