DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE
PUBLIC HEALTH SERVICE
WASHINGTON, D.C. 20201

 

BUREAU OF STATE SERVICES
REFER TO:

 

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Honorable John E. Fogarty
United States House of Representatives
Washington, D. ©. 20515

Dear Mr, Fogarty:

Thank you for your letter of January 19 in which you ask our
comments on the proposed health protection legislation of
Senator Harrison Williams.

First of all, as you may know, we were asked by the Senator to
provide professional and technical assistance to him and his staff
in the course of the development of this legislation.

Unrelated to this proposal, however, we have talked to many health
officers, professors of preventive medicine and other health
authorities who see prevention of long term illness and disability
through early disease identification and control as real foundations
for the improvement of the health of our citizens. I share this
view.

Specifically, my comments on the proposal are:

1, The basic concept is sound, The long range answer to
the health problems of the aging is in early identification
and control of disease and prevention of illness and
disability. This is the essence of health protection.

2. The ideal method for achieving this goal would be a
periodic health examination for everyone including all
appropriate laboratory tests. As an ideal we can strive
toward this goal, Realistically, we know that there are
not enough physicians now to accomplish a program on
this scale and that many people could not afford such
an examination even if physicians services were available.

3. However, it does seem entirely feasible to take the
proven automated testing techniques from Kaiser
Permanente and adapt them for further demonstration on
a communityewide basis in other areas of the country.
2.

The proposal provides that all test results be sent

to the participants physician and that all participants
be advised to visit their physicians for a physical
examination associated with the test findings, But,
where indications of disease or abnormality were
discovered, special follow-up action would be taken

by trained health personnel to strongly encourage
participants to secure medical attention. Considerable
attention will have to be given to the problems of
referral to the center and follow-up of the findings
obtained in order to successfully integrate this
facility into the overall health care services of the
community.

4. Proper attention has been given to the problems of
training and research, There are built in from the
beginning mechanisms for specialized training of
personnel and for operational research both of which
are geared completely to objectives of improving the
operation of the health protection centers.

5. The idea to computerize and automate Regional Centers
to the maximum degree and then to make their computer
facilities and general expertness, available to
Community Centers in the area is good. This would
insure efficient use of computers and provide a focal
point of activity in each area which would be sensitive
to Regional differences and problems.

Generally speaking, it appears to be a sensible plan. The total
system ultimately envisioned might do more for preventive medicine
and health protection than anything yet proposed, It's a new

and imaginative idea incorporating modern instrumentation and
computer use to a recognized growing health problem represented
by chronic illness and to the problem of scarce professional time.
Since it does represent a radical, but at the same time sensible,
departure from current practice, it would seem preferable that
any final proposal reflect a gradual deve Lopment-~allowing
sufficient opportunity for modification and improvement as experi~
ence dictates.

Above and beyond the merits of specific elements and methodology
of the proposal, the attention given to protection and maintenance
3.

of health through prevention of illness, disability, and, where
possible disease, is of extreme importance. I think that hearings
revolving around the bill devoted to this sadly neglected area

of health practice would be in the National interest.

Sincerely yours,

Eugene H, Guthrie, M. D.
Chief, Division of Chronic Diseases

Enclosure