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STATEMENT OF DR. PAUL Q. PETERSON, ASSOCIATE CHIEF FOR

OPERATIONS, BUREAU OF STATE SERVICES, PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE

Mr. ROGERS of Florida. Now we would like for Dr. Paul Q. Peterson, Associate Chief of Operations for the Bureau of State Services, Public Health Service, to come forward and testify.

Glad to have you with us, Dr. Peterson.
Dr. PETERSON. Thank you, Mr. Chairman.

. I have no prepared statement. I am here to testify and answer any questions that members of the committee might wish to ask with reference to the report that was submitted by the Secretary in his letter to the chairman of the committee.

Mr. ROGERS of Florida. I believe your report is unfavorable.

Dr. PETERSON. Yes, sir. The report of the Department is unfavorable.

Mr. ROGERS of Florida. Now, let me ask you this. What is the need for students as far as the Department of Health, Education, and Welfare is concerned, the need for optometrists!

Dr. PETERSON. The Department and the Public Health Service have recognized that in optometry, as well as in other health professions, we do have serious manpower problems.

Mr. ROGERS of Florida. What is the extent of it? I am going to be very brief if we can because we do not have much time.

Dr. PETERSON. I am unable to give you specific data which would indicate the extent of the shortage insofar as optometrists are concerned. The Optometry Association indicates that they feel they need 1 optometrist per 7,000 population whereas it has been testified this morning their present ratio is 1 to 11,000. The Public Health Service has no evidence in this area. We have not done studies on this subject.

Mr. ROGERS of Florida. I thought you gave this committee an unfavorable report.

Dr. PETERSON. The unfavorable report was with reference to the need for loans to students and, as was pointed out by the Secretary in his letter, on the basis of present costs of instruction, the present student body within the various schools, the availability of student loans under the National Defense Education Act and their present utilization, it was our feeling that the problem, so far as loans were concerned, was adequately

met under existing authorities. Mr. SCHENCK. Mr. Chairman, may I just interject a question there?

Now, I take it that the Secretary feels that there are ample funds under the National Defense Education Act for this

purpose. Dr. PETERSON. That is correct.

Mr. SCHENCK. And that his unfavorable report is based largely upon the assumption that he does not have at his disposal sufficient loan funds to meet the additional loans to the students covered by H.R. 8546.

Dr. PETERSON. That is correct. It was his feeling that the funds under the student loan provisions of the National Defense Education Act were eligible to be utilized by and appear to be adequate for the needs of optometry.

Mr. ROGERS of Florida. Well, I am rather at a loss to understand how you come to this conclusion if you do not know what the needs of the public would be.

Mr. PICKLE. That is what I was going to ask. Do you challenge their statement?

Mr. ROGERS of Florida. How do you come to this?

Dr. PETERSON. At the present time, so far as we are able to determine, the numbers of individuals going into schools of optometry would probably not be substantially increased by the addition of another loan provision to them. This is

Mr. ROGERS of Florida. It would not be, you say?
Dr. PETERSOX. Probably would not be.
Mr. Rogers of Florida. Well, now, what do you base that on?

Dr. PETERSON. We would base that on the evidence that at the present time in the National Defense Education Act there are students who are receiving loans that would amount to about 14 percent of the total student body attending optometry schools. Their average loan is about $628 a year. Thus, there is a larger proportion of students in optometry schools receiving loans than there is in the general student body of universities participating in National Defense Education Act.

Mr. ROGERS of Florida. And what does that show now?

Dr. PETERSON. We would assume that this is an indication that loan funds are available as required to meet the financial requirements of the students.

Mr. ROGERS of Florida. Because 14 percent of the students are getting loans from the National Defense Education Act.

Mr. PICKLE. Optometrist loans?
Dr. PETERSON. Loans to students of optometry.

Mr. NELSEN. Mr. Chairman, at that point, if there are, according to the letter, 174 students receiving loans, and if we have 500 taking optometry at this time, that is more than 14 percent. That is 34 percent.

Dr. PETERSON. I bout 1,500, Mr. Congressman.
Mr. NELSEN. I understood the previous testimony to indicate 500.
Mr. ROGERS of Florida. I think graduating 500.

Dr. PETERSON. But there are about 1,500, if I recall rightly, Mr. Congressman, that are presently enrolled.

Mr. Rogers of Florida. Well, now, the only thing that I would like for

your to clear up for me, and I think you had better go back to the Department and get this cleared up for this committee, all of your other programs have been presented where there is a need, and we have just gone through this with your medical people, your dentist people. We are going through it now with nurses. And the reason they want us to have additional loan programs, at least the Department has told us this, was that it would attract more people and enable more people to come into the field where there is a need.

Mr. SCHENCK. To fill a gap.

Mr. ROGERS of Florida. Exactly. This is the whole basis of the presentation for two or three bills we have already considered. Now, you come before the committee, and I am not speaking of you personally, Doctor, but your Department, it comes before this committee without any knowledge of the need or any presentation of the need and now tell us everything is fine because 14 percent of the students who are now in it are getting some loans.

Now, I cannot reconcile this testimony with the testimony that has been given on the other bills, and I am rather amazed the Department would come to us without knowing the extent of the need and be able to tell with some certainty whether there is a need that exists for more optometrists or not, more encouragement for students to be attracted to this field or not, and yet to take a position on the bill. And it is my feeling—I do not know whether it is shared yet by my colleagues-but I am amazed that the Department would come before this committee without better knowledge, and I think it would be well for the committee, if it meets with the feeling of my colleagues, to have you go back and tell the Secretary that we want this problem gone into and not to send up testimony that does not help the committee in its consideration of legislation. Mr. SCHENCK. Mr. Chairman, may I speak to that point?

Ι Mr. ROGERS of Florida. Yes.

Mr. SCHENCK. I share your views completely. I would not have expressed them nearly as diplomatically as you have, and I would insist absolutely on the Department justifying that unfavorable letter of facts, figures, and definite information.

Mr. ROGERS of Florida. Thank you.

Mr. PICKLE. Mr. Chairman, I certainly share your feelings, and I am likewise amazed that the Department would appear in opposition to a bill when they do not have any facts to show the need or lack of need for their position. I know from experience in Texas at the University of Houston, the optometrists of Texas started this school there. They have contributed well over $100,000 out of their own pockets for that school, and each year at their State convention they pledge again some $15,000 to $20,000 to keep that school going, and they have taken it from themselves when they needed the money individually for family obligations. But they have done it to keep that school going and to make it one of the strong schools of the United States.

There is a need for optometrists in my judgment, and there is a need for better schools, and I am surprised that the Department would come here taking a position so contrary to what they have been advocating in other similar fields. So I do share your feelings.

Mr. ROGERS of Florida. Thank you.

Mr. NELSEN. Mr. Chairman, it seems to me that the letter here does not argue the point that optometrists are needed, but it presents the position of the Department that funds are available and that 174 students are getting loans.

Now, the only point of difference I see here seems to be in the fact that it states:

Because of the relatively lower costs of education to optometry students, and because of the adequacy of the national defense student loan program to meet these requirements, we believe that the new loan program for medical and dental students should not be extended to cover students of optometry. We, therefore, recommend against the bill.

Previous testimony has indicated that $1,000 top is inadequate, that $2,000 is necessary. It seems to me that earlier testimony indicated that this was an expensive course. Now, is it cheaper than others—is it financially easier to become an optometrist than, shall we say, a nurse or doctor or

Mr. ROGERS of Florida. Dentist?

Dr. PETERSON. On the basis of the averages of tuition, it is known that in 1963–64 the tuition for private schools of optometry was about $825 a year as compared with $1,056 in private schools of dentistry and over $1,400 in private schools of medicine. This difference in tuition coupled with the differences in numbers of

years that are required, is an indication of the different costs that are involved. As was testified this morning, Florida has taken the very forward step of providing $4,000 scholarships for students of optometry. Under the National Defense Education Act now there would be available $5,000 per student during the present minimum number of years of academic training that is required. Should those years go up, there would be similar expansion of funds that would be available.

Mr. ROGERS of Florida. If the gentleman would yield a minute
Mr. NELSEN. Yes.

Mr. ROGERS of Florida (continuing). What is the comparison of the cost of optometry to a regular undergraduate course? This is what National Defense Education Act is. How does it compare with that? Is optometry more expensive than the 4-year undergraduate course?

Dr. PETERSON. Yes, it is more expensive, Mr. Chairman. There is an additional year that is required which certainly is an addition which is taken care of under the present authority of National Defense Education Act. It is also, as has been testified here this morning, more expensive. The tuition costs are higher in optometry than in the regular academic liberal arts curriculums in general. However, when we look at the average loan figures as provided by the Office of Education, the average loan for academic students in liberal arts is under that that is presently being used by the students in optometry.

Mr. ROGERS of Florida. Well, you could probably say that is probably true with medical students, nurses, every one of the health fields. I feel sure the facts that you have used here could probably be developed also in those fields. But what I cannot understand is where the testimony that is presented says that we are now graduating 500 and just to keep up we need 1,000 graduates a year. Now, is any National Defense Education Act meeting this problem?

Dr. PETERSON. Mr. Chairman, we did not say-neither the Public Health Service nor the Department has said that we have any evidence with reference to the need for optometrists and ophthalmologists to meet the requirements for care of the eyes and health of eyes of our Nation. We have not been able to get this type of information as yet to the extent that we have been able to get it for medicine, denistry, and nursing.

Now, with reference to the costs of professional education

Mr. ROGERS of Florida. Well, let me interrupt you here. I do not think your testimony has any value until you know what the need

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is, and I would ask on behalf of this subcommittee that you return to the Department and advise the Secretary of this, that this should be developed, what the need is, and how this is going to affect it, whether it is being handled by the National Defense Education Act. How can you say it is being handled when you do not know what the need is? I just do not see how we can develop testimony from the Department without substantial information.

Mr. SCHENCK. Neither do I, Mr. Chairman, see how you can compare liberal arts with a health science.

Mr. ROGERS of Florida. And this is not a rebuff to you personally, but to the Department. I am amazed frankly that they would come here without any background of knowledge of need in this whole field or whether it is being met, the problem of the American people in the eye problem.

Mr. NELSEN. Mr. Chairman, before the bell rings, I would like to just pursue this a bit further.

Now, the average loan that has been extended to the students of optometry has been $628. The maximum under the law is $1,000. The total has been $5,000. In the event of the course being extended longer than the regular collegiate course in other fields, it is possibly true that that $5,000 figure could be raised, is it not?

Dr. PETERSEN. Yes, it is.

Mr. NELSEN. Now, are there any provisions in the budget for this bill that we are talking about now? I believe not.

Dr. PETERSEN. No, sir. There is no provision.

Mr. ROGERS of Florida. Now, just a minute. On that, this simply would amend present legislation so that moneys that are already available would also be included for this program. Isn't that true?

Mr. NELSEN. But it does not anticipate additional students by virtue of the amendment.

Mr. ROGERS of Florida. Well, we do not know how these funds are going to be used because they also may not all be used for the medical field or the dentistry field or the nursing field. All of this is still in the state of being allocated, will be over the next fiscal year or so, next 5 in some cases.

Dr. PETERSEN. The bill that this amends includes only the medicine, dentistry, and osteopathy. The nursing bill is a separate piece of legislation as you are aware, Mr. Rogers, and we would point out that in the development of that legislation, the Department recognized the differences in costs with reference to education of this professional group, and there is a lesser amount, much less, that is proposed in that legislation than is in the health professions assistance loan program.

Mr. NELSEN. Mr. Chairman, I would like to point out that in the debate on H.R. 12, you will recall that in the Committee on Education and Labor, many of them did not support us on that bill on the basis that we were fragmenting the educational program by putting some under another act. Without question we have run into that problem on this bill in view of the fact that presently loans are being made to students of optometry under the terms of the National Defense Education Act.

So I just point out that we might be interpreted to be rather unkind to the witness because, as I read this letter, they do point out

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