the quality and appropriateness of medical care through the establishment of a nationwide system of these physician-sponsored organizations. About half of the 203 proposed PSRO areas throughout the country will be covered by the end of 1976.

Health research and education.-Programs for health research and education include support for biomedical, behavioral, and health services research, as well as training and education of health care personnel.

Health research.-Outlays for NIH biomedical research will be nearly $1.7 billion in 1976-an increase of 15% since 1974. This funding level will maintain efforts in all significant research areas. Major emphasis will continue to be placed on cancer research, where outlays of $582 million are estimated for 1976.

Health education and training.-In 1976, total HEW outlays for training health professionals are estimated at $620 million. Measures undertaken since 1969 have assured major increases in the number of graduates of U.S. health professions schools. From 1965 to 1974, medical school enrollments and the number of graduates each grew by 56%. Medical school enrollments have grown from 32,428 to 50,477 and the annual number of graduates has increased from 7,409 to 11,580.

As in other fields of higher education, Federal assistance in 1976 will emphasize aid to students rather than to institutions. Unnecessary Federal institutional subsidies will be gradually phased out. Since students in the health professions can anticipate high earnings, they can be expected to finance a greater share of their own educational costs. Federally guaranteed private loans are available, and recently increased ceilings on such loans will heighten their usefulness to students in the health professions. Proposed legislation will reflect this appropriate Federal role in the support of health professions training. An expanded National Health Service Corps program of scholarships in return for service will both assist students financially and help meet Federal needs for health professionals. A total of 1,100 new postdoctoral fellowships for research training will be awarded in 1976 based upon merit as determined through national competition. No new predoctoral research training awards are proposed.

Prevention and control of health problems.-Programs will be expanded to prevent and control health problems in the areas of consumer safety, communicable disease control, and occupational safety and health. Outlays for these programs are expected to reach $920 million in 1976.

Outlays of $461 million are being requested for consumer safety. Priority will continue to be placed on the development of standards to assure the safety and efficacy of drugs, medical devices, vaccines, biological and other consumer products, as well as on the inspection of food and drug manufacturing firms, and blood banks. The Department of Agriculture's Animal and Plant Health Inspection Service will help to assure the wholesomeness of meat and poultry in interstate and foreign commerce.

Outlays of $459 million are proposed for disease prevention and control activities. Efforts will focus on the control of communicable diseases and the improvement of interstate clinical laboratories.

A total of $228 million will be spent for Federal occupational safety and health programs in 1976. The Department of Health, Education, and Welfare will continue to provide research in support of the efforts of the Departments of Labor and the Interior to safeguard workers through the establishment and enforcement of health and safety standards in the workplace.

Health planning and construction.-Programs for health planning and construction include support for State and sub-State planning bodies, health statistical activities, and construction of medical and research facilities.

Health planning.-Estimated outlays of $246 million in 1976 will assist health planning and related activities, including support to States and localities in establishing new consolidated planning agencies to replace and improve the present health planning entities. Continued development of the cooperative health statistics system will promote improved health planning at all levels of government.

Health facilities construction.-A revised construction assistance activity will focus Federal support on the modernization of existing facilities and the construction of outpatient facilities. Construction funds for cancer research facilities will be used primarily for alteration and renovation of existing research space in 1976.

Special Analysis K, "Federal Health Programs," discusses all Federal activities related to health including those outside this function such as programs for military personnel and veterans. See the Special Analyses volume of the budget.

INCOME SECURITY

Program Highlights

Raise average individual social security benefits from $185 a month in 1974 to $235 a month in 1976.

• Increase total social security cash outlays from $54.9 billion in 1974 to $70.1 billion in 1976, amounting to 20% of the Federal budget.

• Expand the supplemental security income program from 3.6 million recipients in 1974 to more than 5 million recipients in 1976.

• Increase average monthly food stamp coupon benefits per person from $17 in 1974 to more than $22 in 1976. • Expand grants to States for the Aid to Families with Dependent Children program from $4.4 billion in 1974, to $4.7 billion in 1976.

• Increase unemployment program outlays from $6.1 billion in 1974 to $18.2 billion in 1976.

Request $26 billion in budget authority to cover subsidy payments for 400,000 housing units.

The Federal income security programs mitigate the loss of family income when the wage earner is no longer in the work force because of unemployment, retirement, disability, or death. These programs also provide assistance to families when they are in financial need. More than 79% of the income security programs are funded out of trust funds and are paid without personal tests of need. Additionally, Federal revenues foregone (tax expenditures) constitute an important income supplement. For an explanation of tax expenditures, see pages 67 to 69 above, or Special Analysis F in the Special Analyses volume of the Budget.

This budget provides more than $17 billion in unemployment compensation, under both regular unemployment insurance laws and the temporary legislation enacted at the close of the 93d Congress.

The size of Federal income security programs is significant. Retirement system contributions make up 24% of all Federal receipts. Retirement system outlays make up 23% of all Federal outlays in 1976. Moreover, most of the payments are automatically increased as the cost-of-living rises. These automatic adjustments account for onethird of the total increase of $12 billion between 1975 and 1976.

1 Compares with budget authority for 1974 and 1975. as follows: 1974, $95.249 million: 1975. $156.126 million.

135, 339

Less than $500 thousand.

The Administration is proposing major legislation affecting all income security programs tied to increases in the Consumer Price Index (CPI). Until July 1, 1976, all CPI adjusted benefit increases will be limited to no more than 5%. The following programs will be affected by this modification: The old age, survivors, and disability insurance programs, the railroad retirement system, the Federal employees retirement and disability system, special benefits for disabled coal miners, the supplemental security income program, and the food stamp and child nutrition programs. Other civilian and military Federal employee pay and benefit programs, carried in other functional categories, would also be affected by this proposal.

General retirement and disability.-The social security cash benefit programs are the world's largest system of retirement, survivors, and disability insurance. In 1976, a total of 15.4 million retired workers will receive an average of $211 per month. The total number of beneficiaries, including dependents and survivors, is expected to be 32.2 million. Outlays for social security benefits in 1976 will increase by $6.6 billion, of which the 5% cost-of-living increase will account for $3.5 billion. Additional increases due to the rising proportion of elderly in the population and the steady rise in average wages, will account for $3.1 billion more.