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The costs of a medical or dental education exceed those of an optometric education by a substantial amount. The length of training for medicine and dentistry is much longer: 4 years of training after college, plus a year of internship for all physicians and an increasing number of dentists, and, for the majority of physicians an additional 2 to 4 years of residency. Optometry usually requires only 3 years of training after 2 years of college, and no internship or residency.

Furthermore, the medical and dental students not only spend a longer period of time in training, but also the annual tuition charges at schools of medicine and dentistry are considerably higher, on the average, than those at schools or optometry.

All 10 accredited schools of optometry are eligible to participate in the national defense student loan program, which provides for loans up to $1,000 a year, or a total of $5,000. In fiscal year 1963, 174 students in 7 of the schools of optometry received loans averaging $628 per student. These students represented about 14 percent of all optometry students, whereas only about 8 percent of the total full-time students at institutions participating in the student loan program received loans.

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 their requirements, we believe that the new loan program for medical and dental students should not now be extended to cover students of optometry. We therefore recommend against the enactment of H.R. 8522.

We are advised by the Bureau of the Budget that there is no objection to the presentation of this report from the standpoint of the administration's program, Sincerely,

ANTHONY J. CELEBREZZE, Secretary. Mr. ROGERS of Florida. At present, the ratio of optometrists to population is 1 to 11,000. Just to maintain the present ratio of 1 to every 11,000 in view of our rapidly expanding population would require graduation of over 1,000 students per year. Yet in recent years, the number of graduates of schools of optometry has declined to less than 500 per year.

Under the amendments made by these bills, the Secretary of Health, Education, and Welfare would be authorized to enter into agreements for the establishment and operation of student loan funds, permitting loans up to $2,000 for any academic year or its equivalent to full-time students of optometry. These loans would be made at a rate of interest not exceeding either 3 percent per annum or the going Federal rate and would be repayable over a 10-year period.

Our first witness this morning will be the Honorable Wright Patman, the distinguished chairman of the House Banking and Currency Committee.



Mr. PATMAN. Thank you, Mr. Chairman. There are times when the opinion of the average well-informed citizen on a particular subject to be as reliable as that of the acknowledged specialists and experts. This may be particularly true with respect to what is attempted in H.R. 8522 and its companion bills, because the passage of time plus numerous hearings have encrusted the issue with both statistics and emotion, and I do not intend to add to your burden in either category.

However, there is no doubt in my mind that the man on the street is aware of two conditions—the increasing need for care of eyesight, the increasing need for people trained to protect eyesight. Public service programs of the TỶ industry remind us almost daily that modern living takes a heavy toll of our eyesight. A telephone call for an appointment with an optometrist in northeast Texas will elicit the fact that there is a fairly long waiting period, and this is no doubt the case elsewhere.

The bill I have introduced, H.R. 8522, authorizes a loan program for students of optometry. This type of educational assistance is, in

my opinion, financially sound, professionally proper and desirable, and wholly in the national interest. I respectfully request your favorable consideration.

Mr. ROGERS of Florida. Thank you, Mr. Patman.

Our next witness is our colleague from Wisconsin, the Honorable Vernon Thomson. Welcome back to the committee.



Mr. THOMSON. Mr. Chairman, it was my privilege in the 87th Congress to serve as a member of the Interstate and Foreign Commerce Committee of the House. Naturally, I am pleased to appear before you gentlemen today to urge favorable action on H.R. 8546. This bill is identical with H.R. 8658 which I sponsored.

As times passes we realize more and more the importance of vision in our own lives and in the welfare of our Nation. Optometrists are making a worthwhile contribution to conserving and improving the vision of citizens of all ages. We need more of them, and if by making available Federal loans both to prospective optometry students and those who have embarked on an optometric education we can increase the number of practicing optometrists, in my opinion, it is a sound investment.

In 1960, the population of Wisconsin was 3,952,000 and the projected population for the State in 1970, by the Census Bureau, will be 4,606,000, a 16-percent increase from 1960 to 1970. Right now in Wisconsin, there are 464 optometrists or a ratio of 1 for every 8,517 per capita which means that by 1970, if we take the normal growth pattern, we are going to need 240 more optometrists. However, in taking this into consideration we have to also realize the loss from death and retirement of those now in the practice of optometry. Therefore, the conclusion is that we are going to need more than the 240 to compensate for the growth rate and the loss of those now in practice.

The ratio of optometrists is figured on the basis of 1 to every 7,000 people, but if the trend is continued in Wisconsin, we will be below the minimum requirement with a ratio of 1 to every 10,000 per capita. Therefore, it is essential that consideration be given to encourage young people to go into the practice of optometry and I believe the benefits available under the student loan program should include the field of optometry. These are only loans which will be repaid with interest, but the real benefit to the country will be in providing more young men and women who are highly trained and dedicated to performing these greatly needed services for their fellow man.

Mr. ROGERS of Florida. Thank you for an excellent statement, Governor, and we certainly enjoyed having you with us once again.

Our next witness is the very able Congressman from Maryland, the Honorable Edward Garmatz. Please proceed, sir.



Mr. GARMATZ. Thank you, Mr. Chairman, and members of the committee. Through an oversight undoubtedly, H.R. 12, the Health Professions Educational Act, when originally drafted, did not include a provision for loans to students of optometry. This was not added when considered by the House and Senate, to prevent any delay in the passage of this important legislation.

Since the need for optometrists is as great as the need for medical, dental, and other professional health personnel, I introduced H.R. 8702, to extend the provisions of H.R. 12 to qualified schools of optometry and students of optometry.

In addition to our older citizens whose lifespan is being lengthened and who require additional care and service for their vision, the number of younger persons and children in need of optometric services also is increasing, and the demand for trained optometrists is not being met

I am confident that assistance to help finance education in that field will do much to increase the enrollment of qualified candidates in that field. Therefore, I strongly urge approval of this legislation by your subcommittee and the full committee, to meet the needs for qualified personnel in that branch of health service.

Mr. ROGERS of Florida. Thank you, Mr. Garmatz.

Next we will hear Congressman William L. St. Onge, our good friend from Connecticut.



Mr. ST. ONGE. Mr. Chairman and members of the committee, I am delighted to know that your committee has scheduled hearings on the bill H.R. 8546 by the distinguished gentleman of Alabama, the Honorable Kenneth A. Roberts. This bill would amend the Public Health Service Act to make students of optometry eligible for Federal loans.

As you are well aware, the Health Professions Educational Assistance Act passed by Congress last year provided such loans to students of medicine, dentistry, and related professions, but unfortunately students of optometry were omitted. This is unfair and discriminatory against an honorable profession in the field of health, one that is as vital for the care of eyesight as dentistry is for the care of teeth.

Optometry is rendering a very important service in the complex age in which we live, and there is a steadily growing demand for such services. The Connecticut Optometric Society informs me that there is a serious shortage of optometrists in Connecticut and that all help should be given to young people to enter this profession. One of these ways is to provide loan funds to students who are unable to finance their schooling in optometry.

It is estimated that some 100 million people in the United States require some form of vision care, such as correction by glasses, visual training, or other treatment. Our present ratio of available service to the population is 1 optometrist per 9,500 people, which is regarded as being way below the required needs.

The bill under consideration would authorize the use of Federal funds for student loans to schools of optometry on the same basis as such loans are being extended to students of medicine and dentistry. These loans are subsequently to be repaid after the student will have completed the studies and established himself in the profession. The estimated cost is reported to be less than $1 million for the program.

Mr. Chairman, I strongly urge you and the members of your committee to take favorable action on this bill.

Mr. ROGERS of Florida. Thank you, Congressman, for your fine statement.

Now I would like to call on our friend from Illinois, the Honorable John B. Anderson.



Mr. ANDERSON. Mr. Chairman and members of the subcommittee, I am delighted to have the opportunity to make this statement for the record which you are preparing on the need for amending the Health Professions Assistance Act of 1963, to include optometry students in the group of students afforded the opportunity to receive loans to continue their studies under section 740.

My bill, H.R. 8758, would simply afford qualified optometry students the same opportunities accorded students of medicine, osteopathy, and dentistry under the provisions of the aforementioned act.

It is my belief that this is only fair and proper. Certainly, an optometry student faces the same financial problems, long years of study, and other difficulties encountered by every other student seeking a career in a major health profession. Thus it is grossly unfair to exclude them from the provisions of this act.

No one would, I think, claim that their profession is less vital than any other medical profession, thus I cannot conceive of any good reason for this omission. I, therefore, urge the subcommittee to take quick action on this bill so that just as soon as possible this oversight will be corrected and deserving optometry students given the opportunity to benefit under the provisions of Public Law 88–129.

Mr. ROGERS of Florida. Thank you, Congressman Anderson.

Our next witness will be the gentleman from Illinois, Congressman George E. Shipley.



Mr. SHIPLEY. Mr. Chairman, I'm very pleased to have the opportunity this morning to say a few words in support of my bill, H.R. 8794, which, like your own, would provide for loans under the Health Professions Educational Assistance Act of 1963 to schools and students of optometry.

As you know, optometry is a vitally important profession in small towns and rural areas like the ones I represent since ophthalmologists rarely locate there. For example, there are presently only 4 ophthalmologists in my district of more than 443,000 people. An adequate supply of trained optometrists, then, is essential if these people are to receive proper vision care. Unfortunately, however, the 21,000 optometrists in this country cannot begin to meet the demands for their services. It has been recommended by the American Optometric Association that a minimum ratio of 1 optometrist per every 7,000 persons be maintained, but the country as a whole falls far short of meeting this goal.

I know I need not belabor the importance of vision care when speaking to this committee. You are all well aware that good eyesight is vital to a child's progress in school, to a driver's safety on the road, or to a workman's efficiency on the job. You also know that it was estimated by the American Optometric Association in 1960 that as much as 58 percent of the American population-more than 100 million people-require some form of vision care such as correction by glasses or visual training. Nearly half of this group, however, has not received any vision care at all or is relying upon obsolete or improper glasses. Even more frightening is the prediction of health experts that three-quarters of a million persons now living will eventually become blind unless preventive efforts can be made more effective. Of course, we need to continue our research programs, and we need to educate the public to seek eye care. These efforts will mean little, however, if we do not have enough trained experts who can provide the necessary care and apply the research findings in their medical practice.

Training in optometry has become longer and more expensive in recent years. Practicing optometrists have provided a number of scholarships, but they have been unable to fill all of the many requests for financial assistance. As a result many prospective students have chosen other fields where aid was more readily obtained. Federal loans to students of optometry would undoubtedly be a major factor in reversing this trend and encouraging interested students to prepare for a career which would not only benefit them but the entire country as well. Therefore, Mr. Chairman, I strongly support a loan program for students of optometry and urge favorable action

Mr. ROGERS of Florida. Thank you for a fine statement, Mr. Shipley.

Next we have that charming Congresswoman from Washington, the Honorable Julia Butler Hansen.

Welcome to the subcommittee.

upon my bill.

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