UNITED STATES OF AMERICA

tb PROCEEDINGS AND DEBATES OF THE 90 CONGRESS FIRST SESSION

VOLUME 113-PART 22

OCTOBER 18, 1967, TO OcrOBER 31, 1967 (PAGES 29209 TO 30688)

UNITED STATES GOVERNMENT PRINTING OFFICE, WASHINGTON, 1967 October 80, 1967' CONGRESSIONAL RECORD - SENATE 30427 pire. The rest of the press took a dim view In short, the Koreans have taken U.S. ory; his party and historians of the Eisen­ of this. ideas and modified 'them to fit local circum­ hower administration would rightly acknowl­ Some things the press can't do. "lost im­ stances. Most have worked. edge subsUmtial debts to Alexander Wiley of portantly, it can't violate the anti-Commu­ Wisconsin. nism Jaw, which is an extremely broad stat­ ute. I was told, as an example, that a local SENATOR ALEXANDER WILEY dealer handling a Time or Newsweek issue FOREIGN MEDICAL PERSONNEL containing "pretty pictures" of North Korea Mr. PROXI-.1:IRE. Mr. President, I ask or China had better rip them out or expect unanimous consent that an eloquent edi­ Mr. MONDALE. Mr. President, Mr. a ban on distribution. torial on the career of the late Senator Richard D. Lyons- wrote an excellent Highly blatant or exceedingly reckless crit­ Alexander Wiley, who died last week, article on the brain drain involving for­ icism of the government is almost sure to published in the Milwaukee Journal, be .eign medical personnel. bring action. Exanlple: a magazine editor printed in the RECORD. The situation Mr. Lyons outlines would was jailed for falsely calling the President There being no objection, the editorial be serious indeed if the only ramifica­ the mastermind of a smuggling ring. tions were on the quality and compe­ Too often, several sources observed to me, was ordered to be printed in the RECORD, some Korean newspapers will print rumors as follows: tence of medical care in the United without chceking tllCJn out. Since adYertis­ ALEXANDER 'VILEY States. But it involves :ar more than ing revenue is small, n10st papers depend on The distinction that Wisconsin voters ac­ that. Each one of the foreign doctors who circulation income and tend toward sensa­ corded to Alexander Wiley, Who died Thurs­ comes to the United States and remains tionalism in news treatment. day in his 84th year, was to keep him in the here constitutes the loss of an extremely u.s. AID NOW CAN CUT BACK United States senate longer than any other valuable resource to his native country. U.S. aid to Korea has taken two forms­ senator in the history of the state-four full It is a loss, not only in terms of health money and advice. Both have been of great terms, 24 years. The Senators La Follette, sr. services and standards in his country, but help. and Jr., served 19V:, and 22 years. also a loss of a potential leader to a de­ From 1957 until 1966, the U.S. put in $200 Seniority thus made the proudly self­ veloping nation, which desperately needs to $250 million a year in direct economic styled country boy from Chippewa Falls the Wghest ranking senator Wisconsin ever had. every bit of its talent and leadership aid-on top of the substantial military aid working for national development. (exclusive of our own military costs there). He was the longtime ranking Republican on Now, direct economic grant aid has both the judiciary and the foreign relations Mr. President, I ask unanimous con­ dropped to $45 million a year and is declin­ committees of the senate and chaired each sent that this well-documented article be ing annually. Mllitary aid has dropped some, one at a different time of party ascendancy­ printed in the RECORD. but still enables Korea to support 28 divi­ the latter in the important early years of the There being no objection, the article sions. Korea has thus made up many millions Eisenhower administration. was ordered to be print.ed in the RECORD, a year that used to come from America. Sen. Wiley won two splendid distinctions as follows: (In 1956-60, for example, the country ex­ for himself. He became a conv.ert to high ported only $24 to $32 million annually, prineipledlnternationalist views that served FOREIGN PHYSICIANS, MANY UNQUALIFIED, FILL mostly such primary items as tungsten and his country well In the postwar era. And he VACUUM IN UNITED STATES other materials, seaweed and fish. Last year became officially a father of the St. Lawrence (By Richard D. Lyons) exports reached $250 million, with more than seaway, a great boon to his home state, by The national shortage of doct0rs and the half in manufactured goods). assuming the leadership for it at the time of rising demand for health services has led to U.S. economic aid has been going through ripening. His name is perpetuated in one of the immigration of thousands of foreign phy­ several phases, similar to the program in the seaway works, the Wiley-Dondelo canal. sicians, many of doubtful ability who may Taiwan, which phased out two years ago this After a warmup run for governor' in 1936, arrive to practice in American medical in­ JUly. Wiley became a party hero two years later by stitutions sight unseen and quality untested. The first step involves grants for the recapturing a senate seat from the New Deal, The infiux of doctors from overseas has be­ "foundation"-harbors, railroads, power, defeating F. Ryan Duffy, sr. Three terms come so great in the last 20 years that as agriculture. later. in 1956, he was the central figure in one many foreign-trained physicians enter the Next come "soft loans"-that is, long­ of Wisconsin's most memorable political health care system of the United States each term, extremely low-int£rest loans, both to dramas, from which he came out bruised but year as are graduated from American medicai government and private enterprise. Gradu­ triumphant. sohools. ally, as private investment grows, loans get In a bitter irony, he was the intended About 45,000 doctors who were trained in "harder," shorter terms and higher interest victim of his own loyalty to the first Republi­ foreign medical schools now reside in this rates. At some point, the local government can national administration in 20 years. The country, and the number is increasing at the and industry can do just as well obtaining party still had its Eisenhower and Taft wings, rate of 10 per cent a year. money elsewhere. and Taftites were in command of a strong Many of the foreign doctors, possibly as (When Taiwan p!1ased out, its credit rating Wisconsin machine. Shabbily and cruelly many as 5,000, have been unable to pass tests was such that It could go to the World Bank they set out to get rid of Alex Wiley for of basic medical knowledge and are practic­ or other world financing sources for loans). his "betrayal" of isolationism and his inde­ ing medicine Without llcenses, sometimes be­ Presently, Korea Is still in the "soft loan" pendence of bossism. An apparently doomed, cause of loopholes in state certification rules stage, but it's clear the loans will get almost pathetic figure, he found a majority and sometimes with the knowledge of the "harder." of Republican primary voters still with him; hospitals in which they work. A few years from now, one high Korean they turned aside the grab for his seat by Interviews with medical educators, hospi­ official said to me, the half-billlon dollars in the organization man, Congressman Glenn tal executives and public officials showed that foreign aid on which they used to depend Davis. some American hospitals were so short-staffed will gradually be cut to zero. When he tried for still another term In that they were advertising for doctors o\'er­ 1962 he was overtaken by his irascible old "presiden~. seas and paying their travel expenses to come Park has urged the people to age and by Gaylord Nelson. Wisconsin knew find their own way. The people and govern­ here, ostensibly for post-graduate study but him no more; he lived out his last years a often for use as cheap help. ment must work together." recluse in ",rashin"ton. For a populatJon of Korea's siz~, there are Sen. Wiley macle up for a lack of intellec­ MORE FROM POO!! NATIONS many competent technical people for gov­ tual pretensions with wisdom to be a learner The paradox of the migrant doctor problem ernment sen:ice. and with COUIa5;e of conviction. World War II is that the countries with the better medical At the same time, the Korean administra­ shook him conlpletely out of his instinctive schools and standards of health care have far tors have been eager for U.S. CO'.1p.sel, much rural midwestern isolationism. As a disciple fewer physicians migrating to the United of which they have put to gOOd use. of the great Se:l. Vandenberg he came to gi\'e States than those nations whose levels of Four years ago each gO\'~rnment depart­ both Presidents Truman and Eisenhower medical education and senices .arp poor. ment had its own set of statistics. The U.S. valiant a::d \'aluable bac!:ir;g in all manifes­ Engla1Id, France, Japan and the Scandina­ suggested 0:1e set and they went to it. People tations of America's world role-:Marshall vian nations enjoy higher longe,'ity and lower in different departments working on the same plan. Atlp.nt:c treaty and all-'rel'Y nearly infant mortality rates than the United States, probiems met. in many cases, for the first earni:lg the name of st:i.tesrnan in that \vork. a reflection of national sYstems of health care time, a::ld this broke dO'"n, agency walls. He v:::tS a \varm hearted, high spirited. at least as good if not better, but relatively The cffice of National Taxation has been jm'ial man, yet a sturdy battler on occasion. few doctors from there come to this country. assisted by U.S. tax advisors. A new ?ccount­ He was a decel1t and honarable man. A pleas.. A much larger number enter from sucll un­ ing system was installed for railroads. 'YUh ant stor\' of him is how he once could have derdeveloped nations as India. Iran and tile U.S. adVice, Korea liberalized its exchange blocked im appointment of the man who had Dominican Republic, countries with lower rate and reorgan1zed Its credit system. In just been his election opponent, Thomas E. standards of health care and a doctor short­ agriCUlture, the latest U.S. techniques have Fairchild. He cordially endorsed the appoint­ age of their own, and these physicians may been demonstrated in soil testing and fertll1z­ ment instead. have only the sketchiest knowledge of both ing use and vocational training. Ris state owes him an affectionate mem- English and medicine. 30428 CONGRESSIONAL RECORD - SENATE Oetobe~' 30, 1967 "This Is a major national scandal and Federal surveys have shown that last year get the good jobs and the foreign medical there has been no policing of foreign doctors 3,000 foreign medical graduates entered the graduate gets what's left." because no central organization is respon­ United States, whlle 4,500 more came here on Council statistics showed a high failure sible for them," said Dr. Harold Margulies exchange visas. In addition, 500 United States rate among those foreign doctors takIng the of Washington, assistant director of the citizens returned home after receiving doc­ council's test, which Is gIven at United States American Medical Association's Division of torates of medicine at foreign schools. Thus, embassies and consulates. About 60 per cent Socio-Economic Activities. a total of 7.500 foreign medical graduates of those taking the test for the first time Dr. MargUlies, who has studied the prob­ entered tl}e United States last year while overseas fail. Dr. Hunt said, although 98 per lem for six years, estimated that from 2,000 American medical schools graduated 7,574. cent of Americans would pass It, to 5,000 foreign-trained doctors were prac­ The drain on medical manpower has be­ But Dr. Hunt pointed out that many of ticing medicine In the United States with­ come so acute In India that this month she those who failed took the examination again out licenses. refused to allow physIcIans to take an exam­ and that 65 per cent eventually passed. "Any­ St:BST.DIOARD CARE SEEN ination that would qualify them for practice one who has passed the ECFMG Is a person In the United stares. who has a degree of medical knOWledge com­ "I have personally seen unlicensed foreign As one Pennsylvania medical educator parable to 98 per cent of American medical medical graduates working in hospitals," he said: "This country is simply steallng talent graduates," he said. said. "We have been meeting our manpower and stealing it from countries that can least The councll's test Is a one-day examina­ shortage in the United States with substand­ afford it." tIon containing 360 questions taken from the ard people who are offering substandard care The doctDrs coming here, he saId, "are not National Board of Medical Examiners tests in our Institutions." being educated-they're being used" by hos­ that many AmerIcan medical stUdents take While some of the foreign doctors prac­ pitals that cannot "afford to hire competent in place of state licensing tests. The paSSing ticing medicine without licenses do so in doctors." score is 75. Yet only 12 per ~ent of foreigners violation of state laws, the shortage of phy­ A stUdy by the Association of American score above 80, as opposed to•.80 per cent of sicians has been so acute that many regu­ Medical Colleges seemed to bear him out. Americans. iatory groups have not moved against them. One-quarter of the positions open to Interns "The ECFMG examination Is a meaningless, Penalties vary widely between jurisdictions. and residents in American hospitals were watered down test," said Dr. MargUlies of the Some hospital officials said that the em­ beIng filled by foreign medical graduates, but A.M.A. He contended that whlle the ques­ ployment of foreign medical graduates was most of the foreign doctors were not going tions were taken from the national hoard dictated through necessity as the demands to the best institutions, tests, "the most difficult questions are eHm­ Increased for the staffing of emergency rooms, "Most of those who do not have licenses inated to allow a larger percentage to pass." hospital wards and psychiatric institutions. disappear to state hospItals and some states The councll's annual report for 1965 says: "Patients in many state hospitals have grant special licenses to practice medicine "It must not be assumed, however, that pass­ no hope of getting out and many doctors only in that state and only in that instItu­ Ing tile ECFMG examinations means the are uninterested in drab surroundings and tion," he saId. same as passing National Board Examinations. uninteresting work," said one hospital execu­ Questions that have been jUdged to be very tive in Chicago, who added bluntly: "So why According to a list of state licensIng re­ quIrements printed in the Journal of the difficult for AmerIcan graduates have not not bring in doctors who have 'read' medi­ been included in the ECFMG examinations." cine for only six months?" American Medical AssocIation, 20 states have limited licensing arrangements allowing "To use 75 as a passing grade for thIs exam Dr. Edwin L. Crosby, director of the Amer­ would be okay if those who came here re­ ican Hospital Association In Chicago, at­ physicians to practIce medicine even though they have not been licensed to do so. turned home again after specialized train­ tributed the influx of foreign-trained phy­ lug," Dr. MargUlies said. "But giving them sicians to the Increased demand for medi­ But half of the 3,000 foreIgn medical grad­ uates who take state licensing examinations patient responsibility Is simply unsatisfac­ cal services that opened "thousands of more tory." internship and residency posts in Ameri­ every year fall the tests, according to the Association of American MedIcal Colleges. Fallure rates for graduates of foreign med­ can hospitals, along with the desire "of Ical schools vary Widely depending on the in­ many foreign graduates for training in the And passing the examinations may not be a true indication of a doctor's proficiency. stitutIon. Last year graduates of the Univer­ United States." sity of Santo Tomas In Manlla passed 170 Dr. Crosby stressed, however, that the NONE FAILED IN THREE STATES state !lcensin~ examinations and falled HO. hospital association "does not beHeve that Dr, Robert C. Derbyshire, past president of Istanbul University graduates took 158 tests the presence of the vacancies and the need the Federation of State Medical Boards and and failed more than half. University of for physieian coverage should be used to per­ Secretary of New Mexico's Board of Medical Bologna graduates passed 48 tests and failed mit the employment of Inadequately trained Examiners, conducted a stUdy of state li­ 44. Graduates of British and Scandinavian physicians or those with a substantial lan­ censing procedures between 1955 and 1965. guage barrier." medical schools passed 100 examinations and During that period, he said, the boards in failed only nine. An official of the American Medical Asso­ Oklahoma. Idaho and Tennessee "did not "We are pretending that every medical de­ ciation in Chicago said that according to as­ fall a single candidate" for a license to prac­ gree is the same." one medical educator said. sociation records almost 7,000 foreign doc­ tice medicine, In additIon. Kentucky, Wyo­ In many overseas medical schools, he added, tors enter the United States every year, yet ming. MichIgan, Minnesota, Alabama and students attend lectures for four years "and only half had passed a formal test of medi­ South CaroUna failed only 14 appllcants. never see a patient until they come to the cal knOWledge prepared by the Educational "The nine states with the lowest fallure United States to serve as Internes." Council for Foreign Medical Graduates in rates examined 10,455 candidates, with a fail­ The curriculum of American medical Philadelphia. ure rate of less than 0.14 percent," he said. scl,ools devotes the first two years to instruc­ Without certification that he has passed Armand L, Bird, executive secretary of the tion in tile basic medical sciences, While the this test, a foreign doctor cannot enter a Idaho Board of Medical Examiners, saId that second two are used for clinical teaching in post-graduate training program in a good the fallure rate was low because "appUcants which the students work with patients under hospital, whIch was probably what attracted for licensure are screened well in advance of the tutelage of experIenced physicians. him to the United States In the first place. the test" to see if they are competent. But Most foreign-trained doctors entering this MAYBE LISTED AS ORDERLIES Mr. BIrd decUned to estimate how many ap­ country are tested to determine mInimum "We feel that a lot of these guys end up pllcants had been turned down before the competence, but there has apparently been by working in state institutions and mar­ formal test was given, only one attempt to rate their over-all per­ ginal hospitals," the A. M. A. official said. The Oklahoma Board of Medical Examiners formance as doctors. "They may be on the books as broom han­ reported that 20 appUcants failed In the last Dr. Erwin Hirsch, director of medical edu­ dlers and orderlies even though they may two years, and that some falled in previous cation at the Princeton (N.J.) Hospital, has be actually practicing medicine," years, but that the statistics had become been giving the same test of basic medical Several medical educators agreed. how­ garbled. knOWledge to American-traIned doctors and ever, that the instruction foreign doctors The administratIve assistant to the Ten­ physIcians traIned overseas for more than receive in this country produces many fine nessee board, Mrs. GertrUde Moore, said that a year. physicIans who practice high-quality medi­ 13 appllcants had failed sInce 1964 but that "The test does not pretend to prove that a cine Whether they choose to remain here or they were not Ilsted as "fallures." She said man is a good doctor because you can't rate return home. But no one knows how many do that the 13 were given a second chance to a doctor by an exam alone," Dr. Hirsch said. eventually leave the United States. pass the test and that most did. "But it is a devilishly clever test and the best According to A.l\I.A. records, there are Dr. G. Halsey Hunt, executive director of gauge we have of measuring cUnical compe­ 45,749 graduates of foreign medical schools the Educational Council for Foreign MecHcnl tence. The test takes a full day and comes residing In the United States. The figure in­ Graduates, said that "the llcensing each year pretty close to jUdging the art of being a doc­ cludes 5,722 graduates of Canadian schools, of close to 1,500 graduates of foreign schools tor. Actual cases and their management are Whose standards are as high as American is not a good thing for the United states." presented, including motion pictures of pa­ instItutions. The cou!l.tries of origin and "If these doctors stay In this country," Dr. tients." numbers of others are: the Philippines, Hunt said, "they drain something out of the Thus far 00 Americans and 129 Iore:gn 5.055; Gern1any, 4,150; Italy, 2,811; Switzer­ economy of their homeland. They come here doctors have taken the test, which has been land. 2,313; the UnIted Kingdom, 2,110; because it looks Ilke greener pastures With gIven at the beginning and end of their in­ Inclla. i,B33; MexIco, 1,201; Korea, 1,060, and interns making $400 a month and residents ternships. Dr. Hirsch said that there was only Iran, i,OOO. $600, even though the American graduates one American failure both times. One-third October 30, 1967 CONGRESSIONAL RECORD - SENATE 30429 of the foreign graduates passed the test the Subcommittee of the Committee on IMILWAUKEE SENTINEL SUPPORTS first time, he said, but after internship two­ Banking and Currency has devoted much PROPOSED NKW BUDGET thirds of them passed. Dr. Hirsch said that hospitals were using of its energy to the problem of develop­ Mr. PROXMIRE..LVlr. President, in a a variety of "recruiting drives" for foreign ing a broad program for homeownership recent editorial the Milwaukee Sentinel medical graduates. A director of medical ed­ for the lower income family. Until last writes: ucation in a nearby state said he received year this was one of the major -'issing Difficult as the budget reform task is said monthly letters from travel agencies in New links in our housing policy. Representa­ to be, every effort ought to be made to put York offering to arrange delivery of foreign tive SULLIVAN established the first such the single-bUdget concept into effect as soon medical graduates. One of these agencies Is program with the 221fhl program which as possible. the Korea Travel Service In l\lanhattan, di­ is now being implemented in st. Louis, The prospect of bringing the federal budg­ rected by Peter Ohm. Milwaukee, Philadelphia, and other et under control, making it structurally "Business is booming," Mr. 011m told a sound as well as financially sound, ought to recent visitor. He estimated that In the last cities. However, this is a small program, tied be started at least with the bUdget President three years he had placed 120 graduates of Johnson is to submit next January. South Korean medical schools In American to rehabilitation and requiring the use of hospitals. FNMA special assistance funds. There is This forthrightsupport for prompt use Mr. Ohm sa.ld that South Korean doctors still the need for a larger program. There of the new budget comes from a paper who want to come to the United States get has been a recognition of this need as which has been consistently critical of In touch with his office in Seoul "and we contact the hospitals here." The American exemplified by the large number of pro­ the administration's fiscal policies and hospitals advance the money for tickets to posals for homeownership which were has a deep concern for economy, his travel agency, he said, and the Seoul of­ introduced this session, The Housing and If the President is to propose his fi­ fice gives the tickets to the Korean doctors. Urban Affairs Subcommittee held over nancial plans next January in the new "Today if I call a hospital and say I have 2 weeks of hearings this session, and the budget form-and I join the Sentinel in a doctor for them they would pay me im­ vast majority of the testimony was about hoping that he does-then Congress has mediately," Mr. Ohm said. homeownership. The conclusion of this a great deal of homework ahead of it. Mr. Ohm said that internship "used to be testimony is that a program of home­ This is why the hearings of the Joint slavery, but it's not any more." He explained that some small hospitals will give the air ownership for the lower income family Economic Committee which will be un­ fare to the doctor as a bonus, as well as fur­ is a useful supplement to our existing derway shortly can be so useful to Con­ nishing him With an apartment and a salary housing legislation, It will offer one more gress in winning an understanding in de­ of $600 a month, alternative to tlle lower income family tail of the new budget proposals. He said that the Korean doctors seemed as it tries to better its housing condition. Mr. President, I ask unanimous con­ to be satisfied with their new jobs. "Most Upon completion of the hearings the sent that the Milwaukee Sentinel edi­ don't go back home once they get here," he distinguished chairman of the subcom­ torial supporting the single-budget idea said, even though the Government in Seoul be printed in the RECORD. has been trying to persuade them to return. mittee, the Senator from Alabama [Mr. Attempts to llmlt the influx of foreign SPARKMAN], submitted a plan for sales There being no objection, the editorial doctors have falled In part because of housing to the subcommittee which will was ordered to be printed in the RECORD, changes in the immigration regulations. be the basis for the final bill reported as follows: At one time ECFMG certification was al­ from the subcommittee. However, the SINGLE BUDGET most mandatory. Then the regulations were chairman also suggested that the jun­ Combining the federal government's three relaxed to let foreign doctors enter the coun­ ior Senator from Illinois [Mr. PERCY] budgets unto one bUdget would seem 50 try Without certification If they had a medi­ eminently sensible that one might think it cal degree and had practiced for at least two and I develop modifications that would shOUld be done forthwith. years in their own countries. This year the refiect our two positions. Such a com­ Unfortunately, as logical and desirable as law was changed again to allow in any grad­ promise has been developed, and it is the president's budget stUdy commission rec­ uate of a medical school. my hope that this compromise, along ommendation is, it is no simple and easy task "Something should be done about it," Dr. with the chairman's ideas, will be the to make the changeover. Consequently, it is Hunt of the educational council said. basis for a bill to be reported at this believed highly unllkely that the reform can Something is being done about it-in Can­ session. be instituted by next January, when the next ada. Medicaillcensure boards there are study­ bUdget is to be submitted. There just Isn't ing means of developing uniform require­ Mr. President, this morning I received enough time, we're being told. ments for medical llcenses that would apply a telegram from Mr. Walter Reuther, As Is all too well known, the federal budget in all 10 provinces, said Dr. J. C. C. Dawson, president of the United Automobile is out of control two ways. One of the ways Is registrar of the Ontario College of Physicians Workers, which supports this compro­ fiscally. The long spell of spending beyond and Surgeons. mise and recommends the inclusion of it our means has reached a point where the Dr. Dawson said that Canada's foreign doc­ in the 1967 omnibus housing bilL Mr. budget Is practically meaningless, with soar­ tor problem was more acute than America's ing deficits making a mockery of spending because "when your immigration people tell Reuther has been a leader in developing estimates. them [the foreign doctors] to move on they and supporting proposals to benefit The other way the federal bUdget is out of con1e here." America's poor. He is truly one of Amer­ control is structurally. Through many ad- , But Dr. Dawson, like his American col­ ica's leading citizens. It is indeed a com­ ministrations, the budgetary system has. leagues, did not envision any quick solution pliment to this proposal that Mr, Reu­ grown more and more compllcated, untll it because of the dilficulties of getting 10 pro­ has become a virtual shell game with the vincial or 50 state boards to agree on uni­ ther has seen fit to endorse and support spending pea lost to even the sharpest eyes form standards. it. Mr. President, I ask unanimous con­ during the shulfiing of the shells of the l\lany American private health groups are sent that the text of the telegram from administrative bUdget, the consolldated cash seeking to involve the Federal Go\'ernment, Walter Reuther be j:rinted in the bUdget and the national income accounts not only in the foreign doctor problem but budget. also in the whole range of troubles of the RECORD. Combining these three budgets into one American system of health care, including There being no objection, the telegram clearer package, it is important to note, will the financing of medical schools. was ordered to be printed in the RECORD, not automatically bring the bUdget under One panel of leading medical educators as follows: control fiscally. The only way this can be estimated in a report to the Federal Govern­ DETROIT. lI'lICH.. done is to quit spending more than is taken mf'nt that the cost of expanding medical October 27, 191)7. in year after year. schools to the point that they could start to Senator MONDALE. But consolidating three budgets into one produce as many new American doctors each Senate Olfice Building, \\ill go a long way toward bringing the fed­ year as are entering from overseas could be Washington, D.C.: eral budget under control structurally. This, as high as $1 billion. Yet many American Through the cooperation and support of in turn, could help bring the bUdget under medical schools are on the verge of bank­ Chairman Sparkman, a viable compromise control fiscally by giving the pUbllc a clearer ruptcy. orovlsion to establlsh sales housing program understanding of Washington's spending for the less advantaged based on proposals policies. To put It the other way around, it bv Senators Mondale and Percv can be in­ would be harder for an administration to sell WALTER REUTHER SUPPORTS A ciuded in the proposed Housing and Urban the public the notion that the nation can PROGRAM OF SALES HOUSING Development Act. On behalf of the United eat Its cake and hav'e it, too. FOR THE LOWER INCOME FAMILY Automobile Workers, I urge support for this Therefore, dilllcult as the budget reform provision In the Banking and Currency task is said to be, every effort ought to be Mr. MONDALE. Mr. President, at this Committee. made to put the single budget concept into session the Housing and Urban Affairs WALTER P. REUTHER. effect as soon as possible.