General HACKETT. The pamphlet I am sure they were referring to, Mr. Ford, is the one you have before you, the revised Department of Defense pamphlet, that I had no input into. Mr. FORD. No, they said that in addition to the revised pamphlet The Office of the Surgeon General planned a completely rewritten. pamphlet. General HACKETT. We recognize there are some deficiencies and some lack of clarity as the pamphlet is now written, without meaning to be too critical of those who offered it. We had prepared in our own office an information bulletin, which we sent out by the thousands of copies to beneficiaries and correspondents. We will be revising as we see fit the information materials that we make available both to correspondents and to the services for their further distribution. Mr. FORD. In other words, your staff, though, is not working on any new particular pamphlet right now. This is still it, the revised pamphlet? General HACKETT. It is just in the process of being distributed right now, Mr. Ford; yes, sir. Mr. FORD. OK. Would you tell us how large a staff you have to work on this information function? General HACKETT. At the moment I have one lieutenant colonel, Medical Service Corps, with one civilian who is due to come aboard January 1, 1970. Mr. FORD. I see. We asked the Secretary of Defense for a chronology of action taken on this CHAMPUS information booklet, Mr. Chairman, and I will put the chronology in the record in a moment. We have here Mr. John C. Broger, from the Office of Information and Education of the Department of Defense. I wonder if perhaps Mr. Broger could sit at the witness table while we discuss this one matter? Is Mr. Broger here? TESTIMONY OF JOHN C. BROGER, OFFICE OF INFORMATION AND EDUCATION, DOD Mr. BROGER. Mr. Chairman. Mr. HAGAN. Mr. Broger, we are delighted to have you with us. Mr. FORD. In this chronology there was approximately 2 months' delay in the distribution of the CHAMPUS pamphlet, which is attributed to the Army's funding problem. Do you or does Mr. Broger have any information as to what that funding problem was and how it was resolved? Mr. BROGER. Yes, sir; I think I can answer that, Mr. Ford. May I give you just a little chronology leading up to this point which I think is important to the understanding of the problem? Mr. FORD. (Nods.) Mr. BROGER. The first edition of this medicare pamphlet was issued in November of 1956. Four separate issues subsequently followed, called military medical benefits, and expanded uniform services health benefits program. Concerning the revised pamphlet presently under discussion, we were first asked to put out the entire study on medical care. This would have been a tremendous job since the printing could run as high as 5 million copies. Our entire publication budget could have been used on this one study alone. Obviously, we couldn't do that. The alternative was to print the smaller version. Therefore, the Army Surgeon General's Office and the CHAMPUS organization asked us to undertake this project, we did it on the same basis as the other materials, the condensed version. We have only a small amount of money to cover all of our publications, and in many cases we must inform the services that if they have additional requirements for the publication or the motion picture, they will have to fund for them. This was the case in this particular instance. The Army wanted an additional 4 million copies of this pamphlet. But they were having budget troubles just like we were. This was a part of the holdup. The Army was trying to find additional moneys to print additional copies of the pamphlet. Mr. FORD. How much would that 4 million copies have cost them? Mr. BROGER. There was a total of 5.6 million copies. The Army took 4 million. I can't tell you exactly what the cost would have been, but I would estimate that it is somewhere in the neighborhood of $100,000. Mr. FORD. $100.000; so you are telling me on a pamphlet for the dependent medical care program costing $187 million, that for $100,000 you held up for 7 months an effort to explain the program adequately to those who are living by it? Mr. BROGER. That was only a part of the reason. You will also note that during this writing there was a tremendous number of manuscript changes with OCHAMPUS, with the Surgeon General and with the services. All we can do is serve as a means of coordinating the professional information. We try wherever possible to simplify the language, but we don't always succeed. Mr. FORD. Mr. Broger, from the time you received the revised manuscript from the Army Surgeon General's Office-which was about October 31, 1968 if I read the chronology correctly—to the time it was distributed in August of 1969, was about 10 months. Mr. BROGER. (Nods). Mr. FORD. Now does that 10 months that it took from the receipt of the manuscript to the distribution, is that typical of the time it takes your office to publish something? Mr. BROGER. It is not typical. This was an unusually slow project. As I understand it, a good many administrative changes were made during this 10 months and each time we had to go back and coordinate the changes. In some cases by the time we got to the page proof stage, we still had to go back and make changes. That means we have to go through the whole printing and proofing process again. That took up a good deal of the time. Mr. FORD. Why was it necessary to make all of the changes? Mr. BROGER. I, really, am not competent to answer that question. I must assume that the services in their specialty area have the competence to determine the time limitations and the number of changes that are necessary. This was especially true in something as complicated and as difficult as this one. We felt that whatever time they needed to bring the manuscript as much up to date as possible should be given them. Mr. FORD. Now you had a memorandum from Dr. Rousselot's office asking you to give a high priority to this item, isn't that correct? Mr. BROGER. Which we did. Mr. FORD. Did? Mr. BROGER. We did give a high priority. Mr. FORD. How long would it have taken if you hadn't given it a high priority? Mr. BROGER. Probably another 6 months. You will note through the chronology here that every time we got the manuscript there was a short period of time of either getting this to the services for their review, getting it back to the Surgeon General's Office, getting it over to the Government Printing Office-wherever it went, you will notice there are short leadtimes here, all the way through. Mr. FORD. I didn't particularly notice that. Mr. BROGER. We did give it a high priority. Mr. FORD. Here is the chronology of actions we requested. (The following information was received for the record :) Hon. JAMES A. BYRNE, ASSISTANT SECRETARY OF DEFENSE, Chairman, Subcommittee on Supplemental Service Benefits, Committee on Armed Services, U.S. House of Representatives, Washington, D.C. DEAR MR. CHAIRMAN: This is in response to your letter of November 19, 1969 concerning the publication of DoD PA-3B, Uniformed Services Health Benefits Program (Revised). This is the third edition of this pamphlet, which was first published in 1964. Extensive planning and coordination were required by the Office of Information for the Armed Forces with the Office of the Army Surgeon General, the OCHAMPUS staff in Denver, and the Services in preparing and publishing each of these editions as they were needed. Enclosed is a chronology which shows the development of this pamphlet and the interim fact sheet in 1967. Also enclosed are copies of two memoranda which indicated requirement for IAF to support the Uniformed Services Health Benefits Program with published materials, such as the three editions of this pamphlet and fact sheet. I trust that this will provide the information you seek. If I can be of further assistance, please call on me. Sincerely, Enclosures. W. P. MACK, Vice Admiral, U.S. Navy, Acting. PUBLICATION HISTORY OF IAF PAMPHLETS ON UNIFORMED SERVICES HEALTH September 22, 1964-Dependents' Medical Care Program (DoD PA-3): Distributed September 22, 1964. Total of 3,342,110 copies: Army-1,200,000, Navy-1,000,000, Air Force 940,000, Marine Corps-200,000, IAF and others-2,000. Publication of this pamphlet requested by Army and Navy in a memo randum signed by Alfred B. Fitt, then Deputy Under Secretary of the Army (Manpower), January 29, 1963. (Copy of memorandum attached). February 20, 1967-Military Medical Benefits Expanded (DoD FS-38): Distributed February 20, 1967. Total of 137,000 copies: Army-55,000, Navy-31,000, Air Force 30,000, Marine Corps-9,000, IAF and others— 11,000. Reprinted 195,700 copies July 10, 1967. Army Surgeon General project officer requested this fact sheet as an interim measure, pending revision of pamphlet PA-3 to reflect improvements in program under P.L. 89-614, enacted September 30, 1966. Coordination of final manuscript took until December 30, 1966, as it had to reflect Service regulations and administrative procedures. August 8, 1967-Uniformed Services Health Benefits Program (DoD PA-3A): Distributed August 8, 1967. Total of 1,400,000 copies: Army-350,000, Navy-250,000, Air Force-700,000, Marine Corps-99,000, IAF and others 1,000. January 1, 1967-Draft manuscript received from Army Surgeon General. Rewriting and editing begun. Manuscript revision included coordination with Army Surgeon General. March 16, 1967-Manuscript to Services for comment. March 20, 1967-Final manuscript approved by Surgeon General and the Services in line-by-line review meeting of concerned officials. March 31, 1967-To Defense Printing Division for Service authentication and printing. May 29, 1967-Galley proofs received from printer. June 25, 1967-Page proofs corrected and returned. Army Surgeon General and Office of Civilian Health and Medical Program of the Uniformed Services in August 1968 asked IAF to modify its PA-3A pamphlet to help OCHAMPUS resolve some administrative problems. IAF agreed to make requested changes in next printing. August 12, 1968-Surgeon General's changes received. September 20, 1968-Manuscript with changes sent to Services for review. October 11, 1968-Manuscript with Services' changes sent to Surgeon General's office. October 31, 1968-Surgeon General returned manuscript, additional rewriting required. November 21, 1968-IAF sent coordinated revised manuscript to OCHAMPUS, Denver, Colorado for review. December 5, 1968-OCHAMPUS comments received. January 10, 1969-Authentication copies of manuscript sent to Services through Defense Printing Division. January 31, 1969-Manuscript sent to Defense Printing for printing. March 13, 1969-Galley proofs received. March 13, 1969-Army TAGO advised IAF of delay in authentication caused by funding problems on Army's "ride" for four million copies of pamphlet. March 17, 1969-Corrected galley proofs returned, with dummy layout and artwork. April 17, 1969-Page proofs received, corrected, and sent to Surgeon General for final review. Additional changes made in page proofs to reflect changes in administrative procedures. May 12, 1969-Army resolved funding problem. May 15, 1969-Sent final page proofs to printer, corrected and ready for printing. August 21, 1969-First increment of pamphlet distributed, second element distributed in September, and third increment distributed in October. ASSISTANT SECRETARY OF DEFENSE, Washington, D.C. November 6, 1969. Memorandum for Mr. David C. Stewart, DASD (special manpower programs). Subject: DoD PA-3. The Army, which acts as executive agent for the Department of Defense with respect to certain aspects of the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS), has recently prepared, in conjunction with the Office of Information for the Armed Forces, certain revisions to subject pamphlet. We have been experiencing many administrative difficulties in the operation of the CHAMPUS over the past year, some of which are attributable to a lack of or incomplete information regarding the program on the part of many of our six million beneficiaries. Mr. Fitt has taken a great interest in the CHAMPUS problem and periodically reviews various actions which are underway in an effort to overcome them. We would appreciate it if you could reevaluate the pending projects within Mr. Broger's office to see if you could reasonably give a high priority to the above item. LOUIS M. ROUSSELOT, M.D., Deputy Assistant Secretary (Health and Medical). DEPENDENTS' MEDICAL CARE PROGRAM, PAMPHLET (DOD PAM 64A) PURPOSE To obtain signature of the Deputy Under Secretary of the Army (Manpower) on a joint Army-Navy memorandum to the Assistant Secretary of Defense (Manpower) requesting Department of Defense to provide a Medicare pamphlet in sufficient quantity to meet requirements of the Services. DISCUSSION 1. The Bendetsen Committee recommended that Department of Defense provide common-use materials to the Services whenever two or more Services requested their preparation. 2. "Medical Care for Service Dependents," (DOD Pam 6-4A), is the best example of common-use material essential to the morale of all Service personnel and their dependents. Quantity distribution of this pamphlet by DOD is considered essential. 3. (a) The first edition of the Medicare pamphlet was published by DOD in November, 1956. Sufficient copies were provided to permit distribution of one per individual with dependents in all the Services. Cost of printing was borne by the Directorate for Armed Forces Information and Education (AFIE) in DOD. (b) Changes to the program necessitated publication of a Fact Sheet on 8 September 1958. DOD furnished only a limited number for Service distribution. (c) Additional changes to the program required publication of a second Fact Sheet on 4 January 1960. Again the Services received only a limited quantity with the notation that additional copies could be reproduced locally. Because of the pressing need, the Army was forced to reproduce sufficient copies for its own use. (d) In November, 1961, DA forwarded to AFIE a revised manuscript of DOD Pam 6-4, "Medical Care for Service Dependents," for publication as a current DOD publication. Approximately 4 May 1962, AFIE published 1,000 copies of the revised pamphlet. A token distribution was made to each Service with the recommendation that the individual Services print and distribute copies on the basis of one per serviceman. Only the Air Force had funds available and reproduced copies for its own use. 4. Subsequent attempts by the Army and Navy to secure quantity publication of the pamphlet by DOD have been unsuccessful. The reason given was that DOD funds had been committed to production of other materials. 5. Publication of the Bendetsen Committee report offers a new opportunity for the Army and Navy to seek DOD assistance in production of essential common-use materials. Accordingly, a memorandum has been prepared in coordination with the Navy Staff for joint signature by appropriate echelons of the Army and Navy Secretariat (Inclosure). Request is made therein for DOD to publish a Medicare pamphlet in sufficient quantity to meet Army, Navy and Marine Corps requirements. The number requested will meet initial distribution and stockage requirements for approximately a year. The Army signature block has been prepared for the Deputy Under Secretary of the Army (Manpower). 6. Office of the Bureau of Naval Personnel is simultaneously staffing a copy of the proposed memorandum. However, presentation to the Secretariat level will be delayed until the Inclosure is signed by the Army representative. Deci. sion will be made at that time as to who will sign for the Navy. It is recommended that: RECOMMENDATIONS (a) The inclosed memorandum for the Assistant Secretary of Defense (Manpower) be signed by the Deputy Under Secretary of the Army (Manpower). (b) The signed memorandum be returned to Office of the Chief of Information for transmittal to the Navy Staff. COORDINATION ODCSPER-Concur-Colonel F. E. Ball-53847. C. G. DODGE, |