ctiwis ave GOEN EE. FOGARTY IN SUPPORT OF

TER PUBLIC HEALTH SERVICE ACT TO ASSIST

, CANCER, STROKE AND OTHER MAJOR

MITTER ON INTERSTATE AND FOREIGN COMMERCE
embers of the Committee: JULY 20, 1965

    

 

Mr. Chairman and

Last March I had the honor to introduce into the Congress a
bill - H.R. 5999 - to amend the Public Health Service Act to assist
in combating heart disease, cancer, and stroke, and other major diseases.
As members of this Committee know, and indeed, as all members
of the Congress know, I have spent the major part of my legislative
life in efforts to support medical research and research training because
I believed, and still believe, that such research is necessary to bring
better health to all my countrymen. It has been heartening to me to
see these efforts bear fruit and to see this research lead to discoveries
of better ways of fighting disease.
Yet the discoveries by themselves are not enough. They must -
be put into practice and actually applied to saving life, relieving
suffering, and preventing disability. To some extent., I am happy
to say, the accomplishments of our great national program of medical
research have been applied in practice. But when we consider the
terrible and rising toll of deaths, suffering and disability from
heart disease, cancer, and stroke, we know that more must be done.
We must continue, as a Nation, to support medical and health research.
We must, at the same time, find means to apply more fully and widely
the results of research.
T am sure this Committee and the Congress knows that there are v
in this Nation centers of excellence in medical practice, training
and research, where patients can have defective and worn hearts
repaired surgically; where they can have clogged parts of blood

vessels removed and replaced with smooth-bored vessels through which
~ 2 -
plood can flow again; where stroke victims can be treated and retrained
to overcome their disability. JI am happy about this, and I am proud
that I have had some part in it through my efforts to see that there
was support for the research which led to these accomplishments.

But I am not happy when I consider the fact that these brilliant
achievements in modern medicine, resulting from our modern research are
available only to the fortunate few -- those ‘lucky ones who happen to v
live near one of these centers or to have the means to travel to them
for treatment. And even those with the means for the necessary travel
and other expense cannot always benefit from the resources of the few
pig centers. Too often, they cannot survive long enough to reach
and be admitted to these centers, whereas if the resources were available
in their own communities, their lives could be spared.

The resources for our most modern, sophisticated diagnostic
and treatment methods, however, involve very costly equipment, such
as heart-lung machines for open heart surgery; tissue banks for
supplies of bits of arteries and veins for grafting; special blood-
panking facilities; many kinds of costly diagnostic reagents and
machines. In addition, there are required large numbers of specially
trained and skilled personnel - surgeons, anesthetists, radiologists,
nurses, and technicians. Ali of this is well beyond the current

capacity of most community hospitals and medical centers.
-~ 3 -

It was a review of this situation -- the great advances of
recent years in ability to save lives threatened by heart disease,
cancer and stroke and to reduce disability from these causes -- and
the need to bring these advances to people everywhere -- that led
the President's Commission to recommend establishment of regional
complexes for research and treatment in these three major diseases.

The bill now before you, H.R. 5999, like the counterpart S. 506
which has just passed the Senate, is intended to help toward establish-
ment of these regional complexes through Federal grants.

r understand that the Nation's physicians, as represented in the
American Medical Association, while in accord with the overall aims of
the bill, are again seeking that spectre, that ghost, they so often
raise, namely state medicine and Federal control of medical practice.
If they will read the bill carefully, they will see that one of its
purposes is to accomplish its noble ends, “without interfering with
the patterns, or the methods of financing, of patient care or profes-
sional practice, or with the administration of hospital practice.”

For my part, it was heartening to learn through hearings before
my subcommittee on appropriations on the supplemental appropriation

for the first fiscal year on heart, cancer and stroke, t hat the

National Institutes of Health will administer the program this pill”

calls for. I can remember that this same ghost of Federal control
‘was raised when the NIH was first given authority to administer grants
for support of research, training and facilities -- primarily in our

medical schools. Over the years, the cries of Federal control of
~h o

medical education have changed to approbation of the NIH for its
superior ability to administer Federal funds without controlling
or directing research or the scientistsconducting this research.

I also remember -- when the Clinical Center was opened at
the NIH -- there was raised the same alarmed cry of Federal encroach
ment on the private practice of medicine. Yet ever since its opening,
patients have been referred there by the thousands by the practicing
physicians of the country, and the only criticism I hear from these
physicians who originally feared Federal control is that the Clinical
Center cannot handle all the research patients they would like to
refer.

There has been no criticism by the scientific commmity of
Federal control of funds administered by the NIH and quite recently
& committee of distinguished scientists appointed by the President to
study the NIH and its operations reported that its funds were spent
"wisely and well" and that "few Lf any, one-billion-dollar segments of
the Federal budget are buying more valuable services for the American
people than that administered by the NTH."

I understand, also, that some critics of the bill fear that
it seeks to go too far too fast. Again, careful reading will make
clear that, while its aim is to speed the benefits of the most modern
knowledge of patient care to all people, there is provision for wise
and careful planning at both the community and national level, so that
haste will be made without waste and with due regard for the needs of

the medical profession and the patients it serves.
-~5-

In conclusion, I wovld only like to say that the matter of
urgency develops real meaning when this national concern is reduced
to the individual instance: of the breadwinner who is suddenly the
victim of a paralyzing stroke; of the youngster who is diagnosed as
having cancer; or of the mother who requires immediate and extensive
cardiovascular repair -- and when the individual is a relative or
a dear friend. Thus, I urge this Committee's early and favorable
consideration of this bill which holds the potential for improving

the health, happiness, and productivity of the people of our country.