were eliminated, fire doors were installed, a new sprinkler system was constructed, fire detection devices were put in, and other improvements were made. I am told that a new survey would indicate that the hazards referred to by the Department have been removed.

It claimed that clinical laboratories and research facilities are urgently needed. For the great research potential of this hospital in heart and cancer programs, such expansion would probably be welcomed. It should be pointed out, however, that the entire seventh floor of the hospital is now devoted to laboratories and research. It is very clean with modern equipment. The hospital handles about 180,000 laboratory tests a year. I understand that Dr. Farber will be testifying before this committee in the next few weeks on another matter, and that he would like, at that time, to describe the research conditions, and potential of the hospital. I have great respect for Dr. Farber and his work with the Children's Cancer Research Foundation. The fact that he is working at Brighton Marine Hospital is significant testimony to the importance of this facility.

Mr. Chairman, in closing I should like to say that the Brighton Marine Hospital has a special and historic significance for New England. It was the Boston Marine Society in 1790, which initiated the idea that there should be Federal hospitals for sick and disabled seamen. This organization carried its petition to Congress, and thereafter, U.S. marine hospitals were established in all of our larger seaport cities. I was pleased during the past Congress to work for the inclusion of fishermen in this medical program. This is a very important program for New England fishermen.

The hospital is steeped in history, and we are proud of it, but it is also a modern hospital, with modern equipment, and a well-trained staff. It has a basic medical function, provided under law by this Congress. It offers a particular service to our area. It is an important source of Federal research and special treatment.

I was encouraged by the action taken by the House with respect to these hospital closings. There, sufficient funds were included in the appropriation to keep the hospitals in question functioning and continuing. More important, the House incorporated specific language in its report that it could see “no justification for closing any Public Health Service hospital under current conditions.” I, therefore, respectfully request that this committee study this important matter with equally serious concern, and provide the necessary recommendations and funds which will lead to the continuation of these hospitals, particularly where potential university training and research are involved.

Senator BARTLETT. The committee will stand in recess until the call of the Chair.

(Whereupon, at 1:10 p.m., the subcommittee was adjourned, subject to the call of the Chair.)

Hon. WARREN G. MAGNUSON,

AMERICAN MEDICAL ASSOCIATION,

Merchant Marine and Fisheries Subcommittee,
Senate Commerce Committee, Washington, D.C.

Chicago, Ill., June 11, 1965.

DEAR SENATOR MAGNUSON: The American Medical Association appreciates the opportunity to present its comments concerning S. 1917, 89th Congress, presently before your committee, and respectfully requests that this letter be made part of the record of the hearings on this bill.

S. 1917 deals specifically with the transfer of care from Public Health Service facilities to other Federal departments or agencies, and would prohibit termination of such care in any Public Health Service facility without congressional

consent.

Our comments will not be directed to these specific provisions, but rather to the more basic question, whether the Federal Government should have the responsibility of providing medical, surgical, and dental care, and hospitalization, to merchant seamen.

In 1963 and 1964, the Association's Council on Medical Service and its Committee on Federal Medical Services conducted a detailed review of this program. The historical background of the program, its justification when founded in the early years of our Nation, the arguments offered for its continuance today, its relationship to the merchant shipping industry, and the statistical data relating to the program all were considered.

It was the council's conclusion, approved in May 1964 by the American Medical Association board of trustees and later in 1964 by the house of delegates of the American Medical Association, that care of merchant seamen is no longer a logical Federal responsibility.

At present, neither the national interest nor the economic situation and working conditions of merchant seamen warrant the maintenance of Federal hospitals and outpatient clinics and of a large staff of medical and paramedical personnel to provide for their personal health services.

With the development of voluntary health insurance and prepayment plans, care for this segment of the population can be financed adequately and effectively. Accordingly, the American Medical Association respectfully urges your committee to take this opportunity to examine the basic issue involved-whether a program initiated in 1798 to encourage the growth of a young Nation's merchant fleet is still necessary or whether, as is the considered recommendation of this association, this special subsidy to a single national industry should now be terminated.

Sincerely,

F. J. L. BLASINGAME, M.D.

STATEMENT SUBMITTED BY JOHN J. CORCORAN, DIRECTOR, NATIONAL REHABILITATION COMMISSION, THE AMERICAN LEGION ON S. 1917

Mr. Chairman and members of the subcommittee, the American Legion appreciates the opportunity to express its views on S. 1917, a bill to amend the Merchant Marine Act, 1936, in order to protect and promote the health of seamen on vessels of the United States, and for other purposes.

The intent of S. 1917 is to prohibit the partial or total transfer or assignment of the responsibility and function of providing medical, surgical, and dental treatment and hospitalization for seamen and other Public Health Service beneficiaries to any other department or Government agency, or the termination of such service at any Public Health Service institution, hospital, or station without the consent of the appropriate committees of the Congress.

The announcement on January 19, 1965, by the Secretary of Health, Education, and Welfare, that he intends to close seven Public Health Service hospitals revealed that merchant seamen previously hospitalized in those facilities would, in the future, be provided care in the Veterans' Administration hospital system. The announcement also revealed that a study would be conducted for the purpose of determining the merits of transferring the health care program for American seamen and the operation of the five modernized hospitals from the Public Health Service to the Veterans' Administration.

Subsequently, it was learned that commercial fishermen, being Public Health Service beneficiaries, would be entitled also to care in Veterans' Administration hospitals. As a part of the transfer plan, the Veterans' Administration agreed to assign both the seamen and the fishermen an admission priority second only to the service-connected disabled.

The American Legion opposes this so-called cross-servicing agreement for several reasons. Our paramount reason is that such an arrangement will substantially reduce the Veterans' Administration's ability to provide needed care to eligible veterans. One need only look at the number of veterans on the Veterans' Administration's national waiting list to recognize that our contention is well founded.

At present there are 18.000 veterans on the Veterans' Administration national waiting list-veterans who have already been declared by the Veterans' Administration to be medically and legally eligible for hospital care but who cannot he admitted because of the shortage of beds. A specific illustration of the hardship that will be inflicted upon veterans is the plan announced for the care of 9 active duty personnel and 95 seamen from the Galveston Public Health Service hospital. It was announced that those persons would be transferred to the Houston Veterans' Administration hospital. Yet, on March 31, 1965. the Houston Veterans' Administration facility had a waiting list of 388 veterans. Aggravating the national situation was the decision by the Veterans' Administration to close 6 hospitals containing 1,796 beds. That reduction will leave the capacity of the hospital system at 117.121 beds, a figure far below the authorized 125.000. Further, the House recently reduced by $9,421,000 the funds requested by the Veterans' Administration for construction of hospital facilities. Our two main objections to the announced transfer of the care of Public Health Service beneficiaries to Veterans' Administration and the concomitant Health,

Education, and Welfare study aimed at assigning to Veterans' Administration the balance of the marine hospitalization program are as follows: First, such an action would constitute an abdication by the Surgeon General of the responsibility imposed upon him by Congress, and would involve an assumption by the Administrator of Veterans' Affairs of an unwarranted and unauthorized power. Second, the admission-to-hospital priority granted Public Health Service beneficiaries delays and, perhaps, prevents the treatment of veterans eligible and waiting for medical care.

In view of these convictions, we are deeply interested in S. 1917 as its enactment would insure that the appropriate jurisdictional committees of Congress would be given the opportunity to examine the propriety of actions such as proposed by the Secretary of Health, Education, and Welfare on January 19, 1965. In our judgment, the need for this legislation is further evidenced by the opinion, rendered June 7, 1965, by the Comptroller General of the United States on the legality of the cross-servicing agreement and transmitted to the chairman of the House Committee on Merchant Marine and Fisheries.

First, the Comptroller General held that, despite the broad discretion granted the Surgeon General, the transfer of the remaining five Public Health Service hospitals to Veterans' Administration would be unauthorized. Thus, he supported the view that the Surgeon General has a responsibility for the care of Public Health Service beneficiaries which he fails to fulfill when he transfers to another Federal agency the actual operation of his hospital program.

Next, the Comptroller General considered the admission-to-hospital priority the VA had granted to PHS beneficiaries. He ruled that 31 United States Code 686 did, under appropriate circumstances, permit the Veterans' Administration to furnish hospital care on a reimbursable basis to beneficiaries of other Federal agencies. He ruled, however, that "the use of section 686" would require the Veterans' Administration to be in a position to supply or be equipped to render the requested services (see 23 Comp. Gen. 935). And we are of the opinion that the situation of being in a position to render service cannot be artificially created by the promulgation of an administrative regulation under 38 United States Code 621, which would subordinate statutory beneficiaries of the Veterans' Administration to beneficiaries of other agencies and constitute a relinquishment of the Veterans' Administration's primary responsibility."

We submit that under 38 United States Code 610 a war veteran in need of hospitalization for a non-service-connected disability, if unable to defray the expenses of necessary care, is a statutory beneficiary of the VA and cannot be subordinated to beneficiaries of other Federal agencies by promulgation of an administrative regulation under 38 United States Code 621.

It will be interesting to see what effect the Comptroller General's opinion will have on the "cross-servicing" agreement.

The Deputy Assistant Secretary for Administration, Department of Health. Education, and Welfare, when testifying before the House Committee on Government Operations, stated that the admission priority for Public Health Service beneficiaries was an essential element of the HEW plan to close PHS hospitals. He strongly indicated that if the admission priority could not be granted, HEW would have to reconsider and revise its proposal. Yet, we understand that for all practical purposes the PHS facilities at Chicago and Memphis have been closed. Had the provisions of S. 1917 been in effect, the appropriate committees of Congress would have had the authority to examine the propriety and legality of all aspects of the HEW proposal before action was instituted to phase out certain Public Health Service hospitals.

For the reasons stated above, the American Legion urges favorable action on S. 1917. Thank you.

STATEMENT SUBMITTED TO THE SENATE MERCHANT MARINE AND FISHERIES SUBCOMMITTEE OF THE SENATE COMMITTEE ON COMMERCE CONSIDERING S. 1917. ON BEHALF OF THE AMERICAN MARITIME ASSOCIATION

My name is Reginald A. Bourdon and I am assistant legislative director of the American Maritime Association. This association has a membership of approximately 150 shipping companies which operate in both the domestic and foreign commerce of the United States. As employers of seamen, these companies are vitally interested in marine hospitals and their continued operation. For that reason this association endorses S. 1917 and urges its speedy passage.

S. 1917 would amend the 1936 Merchant Marine Act by adding a new section which would prohibit the transfer of the responsibilities and functions of providing medical, surgical, and dental treatment and hospitalization for seamen, in whole or in part, to any other department or agency of the United States and would prohibit the termination of any such services of the Public Health Service without the consent of the appropriate committees of Congress. The American Maritime Association believes that such a measure merely reiterates the intent of Congress and the many declarations of congressional policy that have been expressed in the past.

One of the most recent expressions of this policy occurred during the 88th Congress and is recorded in Report 1923 accompanying H.R. 12711. At that time the Senate Committee on Appropriations for Independent Offices stated "that this hospital program has been in effect for well over a century and a half and that its continuance is a matter of congressional policy-not one of abstract executive discretion." Unfortunately the Bureau of the Budget has often hampered the administration of marine hospitals under the Public Health Service. With the advent of each new administration its refusal to provide adequate funds for capital improvements and major repairs has led to the deterioration of many facilities. The legislation under consideration would serve warning to the Bureau of the Budget that Congress has a vital interest in the continued operation of such hospitals and may serve to convince it of congressional determination to provide medical assistance to U.S. seamen.

This legislation would also prevent the initiation of plans to close seven Public Health Service hospitals and the transfer of seamen in other hospitals to Veterans' Administration installations. The testimony which has been presented before various committees of Congress during this session offered factual evidence that such closings and transfers are based on an unrealistic appraisal of current Veterans' Administration hospital capabilities and an apparent lack of understanding for the needs of merchant seamen.

The possible loss of medical care for U.S. seamen, which is threatened by administration plans to close seven Public Health Service hospitals, cannot be regarded lightly by the maritime industry. Should medical care and treatment be curtailed, the industry would be forced to provide substitutes. No program devised by the maritime industry, however, could equal or measure up to the medical care now provided by marine hospitals. Also of great significance is the fact that the maritime industry cannot afford to provide substitute programs.

The American Maritime Association believes that S. 1917 is the proper vehicle for overseeing the continued operation of marine hospitals under the Public Health Service. A system of marine hospitals is essential to the continued efficiency and health of America's seamen. This association does not believe that any substitute under consideration by this administration is lawful. No substitute should be permitted. We urge that this committee give favorable consideration to S. 1917 and hope that this measure will be acted upon favorably by both Houses of Congress.