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Health Care Crisis in America, 1971

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HEALTH CARE CRISIS IN AMERICA, 1971 HEARINGS BEFORE THU SUBCOMMITTEE ON HEA LTH OF THU COMMITTEE ON LABOR AND PUBLIC WELFARE UNITED STATES SENATE NINETY-SECOND CONGRESS FIRST SESSION ON EXAMINATION OF THE HEALTH CARE CRISIS IN AMERICA FEBRUARY 25, 1971 PART 2 Printed for the use of the Committee on Labor and Public Welfare U.S. GOVERNMENT PRINTING OFCE 59-010 WASHINGTON : 1971 COMMITTEE ON LABOR AND PUBLIC WELFARE HARRISON A. WILL1IAMS, JR., Now Jersey, Chairman. JENNINGS RANDOLPH!, West Virginia JACOB K. JAVITS, New York CLAIIIORNH PELL, Rhode Island WINSTON L. PROUTY, Vermont PI)WARD M. KENNEDY, Massachusetts, PETER 11. D)OMINICK, Colorado GAYLORD NELSON, Wisconsin RIICHIARD S. SCHWRIKE0R, Peonnsylvania WALTER F. MONDALE, Minnesota 11011 PACK WOOD, Oregon THOMAS F. BAGLETON. Missouri ROBEORT TAFT, JR., Ohio ALAN CRANSTON, California J. GLE4NN BE4.ALL, JR., Maryland HAROLD H. HUGHES, Iowa ADLAI E. STEVENSON 111, Illinois STEWART H. MCCLURE, Staff Director ROBERT R. NAGLE, General 0ounsel ROY 1H.MILLIONSON, Minority,Staff Director EUGENE MITTELMAN, Minority Counsel SlUBCOMMITTEE ON HEALTH EDWARD rs. KENNEDY, Massachusetts, Chairman HARRISON A. WILLIAMS, JR., Now Jersey PETER 1-I. D)OMINICK, Colorado GAYLORD NELSON, Wisconsin JACOB K. JAVITS, New York THOMAS F. EAGLIOTON, Missouri WINSTON L. PROUTY, Vermont ALAN CRANSTON, California RICHARD S. EPCHWEIKER, Pennsylvania HAROLD E. HUGHES, Iowa BOB PACK WOOD, Oregon CLAIBORNE PELL, Rhode Island J. GLENN BEALL, JR., Maryland WALTER F. MONDALE, Minnesota LEROY G.GOLDMAXY, ProjeaulonalSte.#f Member JAY B. CUTLER, Minority OcUA8e (11) CONTENTS CHRONOLOGICAL LIST OF WITNESSES TiHURsDAY, 4EBRUARY 25, 1971 Pago JEverist, JDr. Bruce W., Department of Pediatrics, Green Clinic, Rleston, La.; Dr. John Holloman, Jr., practicing physician, New York, N.Y.; and Dr. Mlichael DeBakey, president, Baylor College of Medicine, Houston, Tex., a lpanel----------------------------------------- 180 Breslow, D~r. Lester, chairman, Department of Preventive and Social Medicine, the University of California at Los Angeles; Dr. Arden Miller, professor of maternal and child health, University of North Carolina School of Public Health; Mrs. Lisbeth Bamberger Schorr, former Chief of Program Planning of Office of Health Affairs, Office of Economic Opportunity-panel composed of the Citizens' Board of Inquiry Into Health Services ----------------------------------------------- 222 STATEMENTS Breslow, Dr. Lester, chairman, Department of Preventive and Social Medicine, the University of California at Los Angeles; Dr. Arden Miller, professor of maternal and child health, University of North Carolina School of Public Health; Mrs. Lisbeth Bamberger Schorr, former Chief of Prograin Planning of Office of Health Affairs, Office of Economic Opplortunity-panel composed of the Citizens' Board of Inquiry Into Health Services ----------------------------------------------- 222 Prepared statement ----------------------------------------- 341 IDeBakey, Michael E., M.D., president, Baylor College of Medicine, prepared statement-------------------------------------------- 189 E41verist, Dr. Bruce W., D~epartmnent of Pediatrics, Green Clinic, Reston, La.; Dr. John Holleman, Jr., practicing physician, New York, N.Y.; and Dr. Michael DeBakey, president, Baylor College of Medicine, Houston, Tex., a panel ---------------------------------------- 180 Hlolloman, Dr. John, Jr., practicing physician, New York, N.Y., prepared statement --------------------------------------------------- 196 ADDITIONAL INFORMATION Articles, publications, etc.: "Heal Yourself," report of the Citizens' Board of Inquiry Into Health Services for Americans------------------------------------- 241 "Medical Care and the Black Community," by John L. S. Hollo- man, Jr., M.D., New York, N.Y------------------------------- 207 "Toward a National Health Program," reprinted from American Journal of Public Health, vol. 60, No, 9, September 1070 ----------- 204 (III) THIS PAGE INTENTIONALLY LEFT BLANK HEALTH CARE CRISIS IN AMERICA, 1971 T1HURSDAYp FEBRUARY 25, 1971 U.S. SENATE, SUBCOMMVIITEE ON HEALTH OF THE COMMITTEE ON LABOR AND) PUBLIC WELFARE, Wa8hington, D.C. The subcommittee met at 9 :30 a.m. pursuant to recess, in room 5302, Now Senate Office Building, Senator Edward M. Kennedy (chairman of the subcommittee) presiding. Present: Senators Kennedy, Eagleton, Javits, and Dominick. Committee staff members present; LeRoy G. Goldman, professional staff member to the subcommittee; and Jay B. Cutler, minority coun- sel to the subcommittee. Senator KENNEDY. The subcommittee will come to order. Today the Senate .Health Subcommittee resumes its hearings into tile health care crisis confronting America and the ways in which that crisis canl be brought under control. Earlier this week, the committee heard testimony from Secretary Richardson of Health, Education, and Welfare. The Secretary de- scribed the major elements in the President's health message, which had been sent to the Congress late last week. As I indicated at th e time. of the Secretary's testimony, there are important aspects of the President's program which are commend- able and which should be promptly enacted by the Congress, such as the merger of parts A and B of medicare, reforms in the organi- zation and delivery of health services, and the increase in the sup- ply of health manpower. With regard specifically to the area of health manpower, I, along with the distinguished cilairman of the Senate Labor and Public Welfare Committee, yesterday introduced two important health manl- p~ower~ bills, S. 9,34 and S. 935. The first of these bills,. S. 934, extends and improves. title VII of the Public Health Service Act, and is based in part upon the recommendations of the Carnegie Commis- sion onl Health Manpower and on the bicentennial report of the As- sociation of American Medical Colleges. S. 935 is specifically designed to assist medical centers in the es- tablishment and operation of health maintenance organizations. Subsequent to the testimony of Secretary Richardson, the com- mittee heard from the Health Security Action Council, as well as anl eminent health and medical economist, Dr. Rashi Fein. Both the council and Professor Fein were in general agreement that the whole system by which health care in the country. is organized, delivered, and financed is shot through with inadequacies and irrationalities. (179) 180 If that is the case, it is not reasonable to expect a "Patch up" to suffice. This subcommittee intends to explore that proposition in order that the public can know the validity of it. Today we will receive testimony from two panels of distinguished individuals. The first consists of three eminent physicians who will give us the benefit of their thoughts regarding this "system" problem in our health care industry. The second consists of individuals who will describe the activities of the Citizens Board of Inquiry Into Health Services for Americans. The report of the board was released yesterday. Several of these in- dividuals are also numbers of the prestigious committee for national health insurance, though it should be noted that they have not been asked to testify in that capacity. I would like to welcome each of you, and I look forward to your' testimony. Would you be kind enough to come forward, please? STATEMENT OF A PANEL COMPOSED OF DR. BRUCE W. EVERIST, DEPARTMENT OF PEDIATRICS, GREEN CLINIC, RESTON, LA.; DR. JOHN HOLLOMAN, JR., PRACTICING PHYSICIAN, NEW YORK, N.Y.; AND DR. MICHAEL DEBAKEY, PRESIDENT, BAYLOR COLLEGE OF MEDICINE, HOUSTON, TEX. Senator KENNEDY. Dr. DeBakey, would you proceed? Dr. DEBAKEY. Thank you very much, Senator Kennedy, I want to say, first that I do appreciate the opportunity and the privilege and pleasure of testifying-before this commit tee in support of the Health Security Act S 3 I would like *to say at the outset that I am deeply. grateful for the privilege and pleasure of appearing before his committee to testify in support of the Health Security Act, and to indicate the reasons why I believe that this is the best program that I have seen yet, and one that I think is long overdue in providing a means by which we can improve the health delivery system in this country. The first thing that I would emphasize about it is-well, before saying that, Senator Kennedy may I submit for the record a state- inent that I have prepared, and then I would like to give my remarks, also for the record, but without having to read my testimony. Senator KENNEDY. Your statement will be included in its entirety at the end of your testimony. Dr. DEJ3AKEY. First, I think there are two important purposes to any program that is developed. One is to provide a means of making adequate personal health services available to all residents of the country on an equal basis, and giving each resident and each citizen of this country an equal opportunity to the availability of health care. I think this is a very important principle, and not one that we should just pay lipservice to which we often do. I think everybody would agree that this is a desirable objective; and woul agree that it shoul-d be done but when it comes to pro- viding a method by which it is done, that often leaves much to be desired. 181 I think the Health Security Act does provide a good system. It does make health care available to every citizen in this country on an equal basis. This is an extremely important aspect of the Health Security Act. Second, I think that by providing :universal coverage it will affect the dynamics
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