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1028 CONNECTICUT AVENUE. N.W. e@ SUITE 1215 @ WASHINGTON 6, D.C. @e REPUBLIC 7.4398

CO-CHAIRMEN

Mrs. Albert D. Lasker
Mrs. Florence Mahoney
SECRETARY

Mrs. Allmon Fordyce

a GAINST {TIONAL COMMITTEE
MENTAL ILLNESS, INC.

Executive Director MIKE GORMAN
April 19, 1962

Editer

Letters to the Editer Page
The Washington Post

1515 L Street, N.W.
Washington, Dd. Cc.

Dear Sir:

Your editorial "Money to Burn" in the Washington Post of April 19th
really burns me up.

Your main charge is that the Congress over the years has voted the
National Institutes of Health far more than they could properly use.
The exact contrary is true, The record shows that at the end of each
fiecal year in which Congress appropriated monies in excess of the
Administration budget, there was always a sizable backlog of scientifically
approved researeh and training projects which could not be supported
because of lack ef funds.

Bach research and training request which comes into Bethesda goes
through the most rigorous type of screening by one of the 42 study
sections composed of hundreds of distinguished non-govermmental scientists.
If it survives this rigorous process, it then goes to one of the gight
Advisory Councils to the NIH for further sereening. It is important to
note that the present rate of rejection of research grants alone denies
support te more than half of all applications submitted toe Bethesda.

I sit as a member of the Advisory Council to the National Institute
of Mental Health. It has been my unhappy experience this year to join
my other 13 colleagues on that Council in turning down millions of dollars
in research and training applications which had already been approved after
the most rigorous screening by professional study sections.

Let me give you one of a number of examples I could choose. Because
of the critical shortage of psychiatrists in thie country - the state
mental hospitals have only 60% of the psychiatrists needed to meet even
minimum American Psychiatric Association etandards - the Congress four
years ago, despite Administration opposition, inaugurated a program to
train highly-qualified general practitioners in a thrée-year residency
leading to full certification as psychiatrists.
 

e oa ar fe

This year, because of Secretary Ribicoff's cut of 960 million last November
im the over-all budget of the Netional Imstitutes of Health, and because of an
inadequate amount for the general practitioner training program in the Executive
budget, we were forced to turn down more than 100 general practitioners who wanted
to become psychiatrists and had survived a screening precess which rejected nine
out of ten applications,

On April 6th of this year, letters went out to training institutions throughout
the country telling them that although their applications had survived the various
rigorous screening procedures, the Institute could not support the epplicants
because "we do not have the funds to make the recommended award."

In the State of Iowa, for example, eight of nine scienfifically spproved
general practitioner training grants were turned down. In a number of these cases,
the general practitioners had sold their homes and sold their practices because
they had been told they were among the chosen 10% who were scientifically qualified
to receive support.

You talk about money to burn! This rejection has burned up many people in
Iowa and I suggest you check the impact of this cut with Senator Bourke Hickenlooper,
who is a jealous and conscientious guardian of the public tax dollar.

In your editorial, you poian out that "the number of qualified researchers
puts limits to the quantity of research that can be efficiently undertaken at
one time." But how do you get more researchers? You get them by supporting, with
adequate appropriations, the faculties needed to train them and the stipends needed
to support then.

In the field of mental health alone, where we desperately need more research
workers, we were forced to turn dowm this year more than $1 million in approved
research fellowship applications because the Executive budget did not provide the
money to support them. And I might point out: A psychiatrist who has received
his M.D. degree, completed his internship, completed a three-year residency, and
usually acquired a family and debts in the process, is offered $5,500 the first
year as a research fellow.

Is this money to burn?

There was no reporter present from the Washington Post when Dr. James Shannon,
Director of the National Institutes of Health, and his associate appeared the
week of April 9th to testify before the Senate Appropriations Subcommittee on

Labor-H.E.W. In that hearing Dr. Shannon declared flatly that the “best professional
judgment of the Institutes" was that they could use $953.2 million in the coming
year in support of their various research and training programs. This compares

with the $780 million recommended by the Administration for the coming year, and
$840 million appropriated by the House. I want to emphasize that this testimony

was given by doctors generaly criticized by the Congress for their conservatism

in seeking funds.
page three

No reporter from the Washington Post was present the following week when
some of the most distinguished medical scientists in the country appeared before
the seme coumittee, at their own expense, to testify ae to what the scientific
ty needed to continue its fight during the coming year against the dread
diseases of our time. The printed yearings are not yet available, but having
attended both days ef the hearings, I can assure you that practically every
selentific witness pointed te large backlogs in research and training appltcations
which could not be paid because of the Ribicoff cut and the inadequate Administration
budget.

I take serious fault with your seeming refusal to get the facts before you
shoot, On November 22nd,of last year, a few weeks after Secretary Ribicoff
had cut $60 million frem the budget of the National Institutes of Health, you
remarked editorially that "even the most enthusiastic supporters of the NIH
must concede that they have money pouring out of their ears and can accomodate
even a large reduction without difficulty."

|

There is not one iota of truth in this wild generalization. Appearing before
the House Appropriations Subcommittee in February of this year, Secretary
Ribicoff admitted that $45 million of the $60 million he had cut "could have been
expended", His Budget Officer, Mr. James Kelly, admitted that the cut would mean
that $18 million in approved research grants could not be paid, $8 million in

training grants could not be paid and that many other programs would be
similarly affected. Dr. Shannon told the same committee that he could only spare
at the most $15 million out of the $738 millionappropriated by the Congress in
fiscal 1962 and this was because this sum could not be immediately spent, but
probably would be spent by the close of the year, as new programs developed,

Under further questioning, Secretary Ribicoff and Mr. Kelly admitted that
at the very time the cuts were instituted bringing the budget down to $678 million,
they had cleared a budget for the coming year of $780 million. This naturally
caused some lifted eyebrows in the House Appropriations Committee and Chairman
John Fogarty summarized the feeling of the committee in these words:

“This is a real puzzle to me, Mr. Secretary. Here you are recommending
imcreased appropriations under existing legislation and also recommending
new legislation to further increase authorization for appropriations in
the very areas where you are refusing to spend the money you have available

this year."

All of this material is accessible to your reportorial staff. And if this
material had been studied, I am absolutely confident that you would not have
published the editorial in question. On Sunday, April 8th, you published a very
moving article by Senator Maurina Neuberger, a victim of cancer herself, She
pointed out that her late husband, a trained journalist and a victim of cancer
himself, had spent hours upon hours visiting the National Institutes of Health
and listening to voluminous committee testimony before becomming a convert to
the cause iof medical research.
Having bean « science reporter for a number of years, and « political
1 writers, almost by job definiticn,
are hermetically sealed course ef life. However, I would
reepectfully suggest thet the auther of the editeriel under discussion go to
Pershing Square, just a block from the National Press Club, end visit the "Man
Against Cancer" exhibit ef the American Cancer Seciety and the National Cancer
Institute.

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He would learn that in 1900, 3,500 years after the original discovery and
identification of cancer, 19 out of every 20 Americans afflicted with this
disease died. Im 1937, when the National Cancer Institute was created by an
act of Congress, only one in seven Americans were saved. Today, according to
the American Cancer Seciety, one in every three Americans afflicted by cancer
is saved and this could be raised to one in every two if the American people
would submit themselves to routine detection exeminiations.

Im thie year of Our Lord 1962, there are 1,100,000 Americans who are alive
five or more years after having had cancer, What price do we put on the lives
of these peeple? The National Cancer Institute has been almost totally responsi-
ble for these major advances. Has it been burming money these last 25 years?

In the field of heart disease, as pointed out in lengthy testimony before
both House ‘and Senate Committees, there has been more progresse in the past decade
alone than in all the yeare of recorded history. Heart disease ie no longer viewed
es @ sentence of death, In this span of less than ten years, the prognosis in
most forms of congenital heart disease has been converted from "hopeless" to
“surgically curable", Hypertension, which afflicts several million Americans ‘
ueed to be regarded as irreversible. Today with new drugs at our disposal, we
have had a 30% reduction in deaths from hypertension and the majority of victims
of hypertension are now able to work, earn a living and pay taxes. Have ve
burmed money in this area?

In testimony before the Senate Appropriations Committee just this week,
Dr. Michael E. DeBakey of Houston, who flew all might from San Francisco to appear
befere the committee, presented the case of Dr. Arthur L. Miller, a distinguished
Nebrasken Congressman who served in the House of Representatives fer 16 years. A
little over two years ago, Dr. Miller became increasingly disabled by the onset
of oeeluding lesions in various parts of his body. He went to Houston to be
examined and Dr. BeBakey diagnosed heavy occlusive materials in both arteries
leading from his neck te his brain. Dr. Miller was operated on and two years
later he is in the best of health, He appeared before the Senate Appropriations
Committee and said:

"If it were not for Dr. DeBakey I would not be before this committee
teday. I would be dead.”

What price the life of Dr. Arthur Miller? Have we burned money through the
National Heart Institute in supporting a mejority of Dr. DeBakey's investigations?
 

 

PE EN ON San gee Seems ere pn a gee 3 Fae

page five

There ie much telk of the rapid expansion of medical research over the past
13 years. I agree thet thie expansion has accelerated, but may I point eut thet
federal support for medical research was practically non-existent 15 years ago.
We started out from sere and we have a great deal of eatching up to do.

As a jealous conservator of the tax dollar, you don't seem very concerned
about the astronomic appropriations for the civilien and military spece agencies.
In 1959, the Congress appropriated $485 million for a new agency ~- the National
Aeronautics and Space ddministration, For the coming year the Administration is
asking approximately $5 billion for various outer space activities. I have not
seen your editorial page emit eny cries of warning about the burning of American
dellers in the uncongenial atmosphere of outer space,

On page One of the same April 19th issue of the Washington Post, you report
that the House of Represeatatives passed a record peace time military apprppriation
bill of $47.8 billion by a vote of 388 to 0. This is $1,344,000,000 more than
was voted for the current year. Included in this bill is a 50% increase in army
chemical and biebogic warfare research, including greater emphasis on "incapacita-
ting agents." Who will be burned up with this money? - just people?

In the same bill is included $5.5 million for military research and develop-
ment, a billion dollars more than this year. Have you studied this increase of
$1 billion with your anti-burning editorial microscope?

By comparison with these figures, we are in the minor leagues in the field
of medical research. Medical research support is not only far less than 1% of
total federal eppropriations, but is a small segment indeed of the more than $10
billion which the federal government will spend during the coming year for research
of all types.

We have a great deal of unfinished business in the field of medical research.
In a series which Nate Haseltime did for your paper only three years ago, it was
pointed out that the incidence of cancer had doubled over the past generation,
and that six magor types of cancer showed alarming increases. I wish your editorial
writer would read his own paper occasionally.

The mortality from heart disease has also incressed sharply in the pest
generation, and it was Dr. Paul Dudley White, the noted cardiologist who treated
President Eisenhower when he fell victim to that disease, who told a Senate
Appropriations Committee several years ago that the alarming increase in heart
disease in America made this "one of the unhealthiest countries in the world."

It ie ironic that you should entitle your editorial "Money to Burn", because
no investment has reaped greater economic dividends than medical resesrch.
page six

As Vice President Jehmeon pointed out on the fleer of the Senate in 1959,
close te two million lives heave been saved due to medical research since the close
ef World War II. These people saved from death between 1945 and 1958 earned
approximately $3,600,000,000 in income in 1958 alene. On this income, these
people paid te the federal government in income, estate, gift and excise taxes
$623 million in 1958, more than three times that year's federal investment in
medical research.

In his Special Health Message to the Congress last year, President Kennedy
said:

“The next 10 years will require a vast expansion of this Nation's present
total effert in medical research if knowledge is to keep pace with human

progress.

“As long as people ere stricken by disease which we have the ability to
prevent, as long as people are chained by a disability which can be
reversed, as long as needless death takes its toll, then American health
will be unfinished business."

In sum, I submit that your editorial is not based upon easily accessible facts.
You have not covered the hearings and you are therefor guilty, regrettably, of an
atypical case of Know-nothingism.

One final point: You now join the chorus of dinosaurs who believe somehow
that the expenditure of fdéderal money is an evil thing. You also seem to suggest that
it is wilgar to equate financial support with high-level medical research. You
don't seem to find it difficult to equate money with the build-up of our national
defense. For example, a lot of research sophistication goes into the building of
a Polaris submarine, but what got Admiral Rickover and his dedicated colleagues
started? Was it an editorial in the Washington Post or was it hundreds of milMons
of dollars appropriated by the Congress?

How do you build research laboratories and how do you support thousands of
dedicated research workers, if you dom't provide the moneyyrfor them? k In essence,
an eppropriation is a yardstick which we use in evaluating the relative importance
of a program within the total spectrum of this democracy's needs, For example,
you have waxed eloquently in a number of editorials about the need for the strengthening
of the American educational system. How do you do this unless you provide a massive
injection of funds to build new schools and to raise teachers salaries? Is this
money to burn?

In your concluding paragraph you talk about burning money in the field of
medical research as “an act of propitiation."

I would agree that the spending of money for medical research is an act of
propitiation -- it is an offering up of some of the precious sinews of our
democracy to the presesvation and enhancement of human life.
 

page seven

I wish there was some way in which you could repair the damage you have
done by so ill-advised an editorial. We have the glittering precedent of U.S.
Steel which saw the light of day and rescinded an unwise action. It is my
sincere hope, as a devoted and affectionate reader of your fine newspaper,
that you will in a short period of time achieve the wisdom of Roger Blough.

Sincerely,

Mike Gorman

Executive Director
National Committee
Against Mental Illness