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DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE
Statement by Director
Division of Regional Medical Programs
Public Health Service
on
Regional Medical Programs
Mr. Chairman and Members of the Committee:

It is my privilege to appear before you again on behalf of the Regional
Medical Programs for Heart Disease, Cancer, and Stroke which were authorized
by Public Law 89-239. On November 9, 1967, the President sent to the Congress
the Surgeon General's Report on Regional Medical Programs transmitted to the
President by the Secretary of Health, Education, and Welfare as required by
the Law. In that Report the goal of Regional Medical Programs is stated as
follows: ‘The ultimate objective of Regional Medical Programs is clear and
unequivocal. The focus is on the patient. The object is to influence the
present arrangements for health services in a manner that will permit the best

in modern medical care for heart disease, cancer, stroke, and related diseases

to be available to all."

Progress to Date
The Report describes in some detail the substantial and impressive

beginning which had already been made in achieving that goal up to June 1967,
its date of publication. In bringing those facts up to date we are pleased to
report that 54 Regional Medical Programs have been organized, covering all
areas and representing all the people of the Nation, including Puerto Rico.
Fach of these Programs represents a cooperative effort among the health
tesources of the Region they themselves have organized. In each the purpose
has been to develop and implement a program of action that will contribute to

and capitalize on new medical knowledge and techniques, undertake needed

research, create new diagnositc and treatment capabilities, and evolve a
wre effective organization of health resources that will improve their system
for delivering to all the people of their Region the full benefits of currently
available knowledge and medical skills. Eight of the 54 Regional Medical

Programs are actually carrying out operational activities which involve the

care and treatment of people in their Region. From all indications, we expect
that virtually all of the 54 Regions will be engaged in these types of operational
activities by the end of fiscal year 1969.

| Operational Programs
| Activities already underway in the operational Programs which will improve
- diagnosis and care of those afflicted with these diseases are described in the
“Surgeon. General's Report. Many more innovative activities and projects were
@ described at the recent January Conference -Workshop on Regional Medical Programs
which brought together more than'700 persons directly involved in the 54 Regional
Medical Programs. They were able to exchange ideas and results not only on
specific improvements in diagnosis, treatment, and professional education, but
on ways to improve the cooperative organization of health resources in order to
apply those resources to the needs of people. In summing up the two-day ... =
Conference-Workshop, Dr. Lowell T. Coggeshali, Vice President Emeritus of the
University of Chicago, noted that he had found "substance" in the Programs.
"Tn medical science and practice--health care--the ultimate substance is
advancement of knowledge or method that makes some worthwhile difference in

the lives of people," he said in describing "substance."

The Challenge
@ The substantial activities covered in the Report to the President and the

Congress, documented further at the Conference-Workshop, and being demonstrated

in the Regions, are only the beginning of this important Program. .
As the foundation for action has been established, the extent of the challenge

| has also emerged more clearly. Since this program began only some two years
ago, the threats of death and disability from heart disease, cancer, and stroke
have remained strong and resistant to human skill and inventiveness. In these
two years it has also become more apparent that the solution of these and other.
major health problems will require significant improvements in the organization
and delivery of health services. Therefore, the great promise of Regional .
Medical Programs for the coming years lies in their demonstrating how medical
capabilities can be more effectively organized to help solve these problems

through new patterns of collaboration of all available health resources.

Regional Cooperative Arrangements

‘It is clear that a regional cooperative arrangement among the full array
of the available health resources is a necessary step in bringing the benefits
of scientific advances in medicine to people wherever they live in a region.
Because it provides a system of working relationships among health personnel
in the institutions and organizations in which they work, such an arrangement
enables patients to benefit from the inevitable specialization and division of
labor which accompany the expansion of medical knowledge. What is required to
achieve this is a commitment of individual and institutional resources which
must be worked out by each Regional Medical Program. When achieved, this
approach provides a means for sharing limited health manpower and facilities
to maximize the quality and quantity of care and service available to the
Region's population, and to do so as economically as possible.

Regional Medical Programs now have engaged the services of nearly 2,000
full-time or part-time staff; also involved are more than 1,900 members of

Regional Advisory Groups composed of voluntary representatives of a cross-section
4

o€ medical leaders and informed laymen; and all of the medical schocis, many
hospitals, voluntary and public health organizations, and most organizations

of health professionals. In addition, approximately 1,200 people are serving
on special task forces and subcommittees. To capitalize on these commitments
that individuals and institutions have already made to the development of their
own Regional Medical Programs, and to realize the promise of the planning
activities they represent in a1] parts of the Nation, the President has
recommended that the authorizing legislation be extended for a period of five
years. Sufficient funds must also be provided to enable the translation of
involvement into service, ideas into action, and cooperative planning into

collaborative operation.

Conclusion

The appropriation request for the Division of Regional Medical Programs
totals $68,922,000, which, when combined with $30,900 ,000 for grants carried
forward from 1968, provides a total of $99,822,000 for 1969 obligations, or
an increase of $46,036,000 over the 1968 operating level. The request includes
$62,900,000 for regional medical program grants, $3,314,000 for professional
and technical assistance, $905,000 for review and approval of grants, and
$1,803 ,000 for program direction.

1 shall be happy to answer any questions.