long term commitments. We felt that a 1-year commitment was reasonable for us and for them, and that, of course, was our desire, and our expressed opinion, with regard to the single-year maximum for the younger people.

Mr. FORD. That was a point made to us at the time of our hearing in February when I said to Mr. McKenzie or somebody, "Why are you requiring a minimum signup time, because the law simply said '$13,500 a year,' without any specification," and he said that the fear was-and the Surgeons General agreed-that if you set up a long period of time, the doctor would just react negatively because he knew what he was capable of getting on the outisde.

General PATTERSON. Yes, sir.

Mr. STRATTON. General, did you do anything to express your disapproval when you discovered, from the May 8 on, that there was going to be an effort in the Defense Department to undermine what you had supported? Did you go to the Secretary of the Army, the Chief of Staff, or anybody, to see if you couldn't beat this thing? General PATTERSON. After receiving the proposal that came to us officially, the May 8 proposal from OSD, H. & E., we transmitted through the Air Staff, our comments to the OSD, I believe, on May 28. I believe actually the letter of transmittal to OSD was on June 4, in which we expressed the attitudes of 1-year contracts and equitability in pay. That was our official input to this thing.

One other thing: As this developed, and as we saw that there were going to be problems that we hadn't anticipated, I initially briefed the Chief of Staff of the Air Force and various other people who were concerned with this to be sure that everybody on the Air Force side was informed, and it was my assurance that everybody supported this position in this regard at whatever opportunity they had.

We did engage in a number of informal discussions at the OSD, H. & E. level. On one occasion, when I was in OSD on another matter, I had the opportunity to participate in a 11⁄2 to 2-hour discussion with Mr. Srull in this matter, and expressed our attitudes and opinionssimilar to the ones that we gave before Congress.

I think that is about the total of our input.

Mr. STRATTON. Mr. Ford?

Mr. FORD. On that point, when you talked to Mr. Srull, or when you got this proposed reduced bonus draft that was prepared in the Office of the Assistant Secretary for Manpower, did they give you any rationale as to where they get the dollar figures that they usedwhy they picked $8,600, or $10,000, instead of $13,500?

General PATTERSON. I don't recall any specific rationale of exact dollar amount. The rationale that was presented for the sliding scale was the importance of encouraging long term contracts to stabilize the personnel structure of the physician force. I understand that logic, but I thought, and we expressed the opinion, that with the amount $13,500 being minimal in itself that reducing it below that for 1-year contracts, which we felt would be the most appealing to our young people, would be counterproductive. That opinion was put forth. The other opinion that we discussed at some considerable length was the main operative theme of General Benade's letter, that is, the question about the size of the military medical force not yet being determined.

It's been our position that we have requirements, they are current and valid, and we should support those requirements until such time as they are changed.

Mr. FORD. What was your perception of the reason for their proposal, since they didn't have any rationale, or we haven't been able to find any rationale, for these various dollar amounts that they picked out of the blue apparently? What was your perception of the rationale behind that proposal? Was it simply that they assumed the OMB study was going to come up with reduced requirements for doctors, based on a change in mission?

General PATTERSON. So far as sliding amounts, or the varying amounts, or varying year contracts are concerned, the only rationale that I could see was in the ceiling, trying to establish some stimulation for a longer term contract. The other aspect of delaying implementation of the bonus was because the eventual size of the force was not finalized. I think the rationale there was not getting a workforce on board that was bigger than was determined to be needed sometime downstream.

Mr. FORD. The only evidence they had for making the determination of what was needed sometime downstream was to presume findings of the OMB study; isn't that true?

General PATTERSON. If that assumption was made, that's quite

true.

Mr. FORD. Well, I mean they had no other basis for assumption that I can see.

We had testimony, for instance, that as members of the Steering Committee, the Surgeons General were not presented prior to July 8 with any preliminary findings of the OMB study.

Now, didn't you really believe in your heart at those meetings that they had or that somebody had presented them unofficially and that that's what they were basing their judgments on?

General PATTERSON. Well, all of us involved in this are participating in the OMB study, in the various phases of the OMB study, so this information from OMB is generated by the Air Force, OSĎ, all the people who are involved. Everyone in this particular thing is also involved in that. So any information developed in the OMB study is available to anybody who wants to look at it.

Whether assumptions were made that the force was going to be smaller and therefore it was desired to make it smaller now, or whether it was just a reluctance to spend money until they had absolute positive proof of the final study, I don't know.

I tried to convince them of the urgency of not losing too many doctors between now and the time we made the final determination. That, of course, is my great concern in the Air Force because we are currently 400 men short, and we're embarrassed in trying to accomplish the mission that we have today, and that mission has not now changed.

Mr. FORD. In the June 27th memorandum of the Office of the Assistant Secretary for Manpower, they said they had reason to believe that the requirements for doctors were overstated.

General PATTERSON. Yes.

Mr. FORD. I don't see how anybody could arrive at that conclusion that the requirements were overstated unless they concluded some

where down the road they would need less doctors by reducing the amount of patients they would take care of.

The only thing I ever heard come out, where you reduce the amount of patients you take care of, was a proposal that was advanced in some part of the OMB study, to take the dependent and retiree care away from the military.

I don't know of any other basis they would have for determining a reduction of requirements, and I don't know of any other basis for presuming a reduction of requirements would lead to a much lower bonus.

General PATTERSON. All the studies that we have accomplished in the Air Force, all the inputs that we have made to the OMB study, have shown that our current requirements are valid and appropriate to our military requirements and our requirement to provide an ongoing peacetime military medical service is compatible with our eventual wartime requirements and cost-effective medical service to our dependents. We have to maintain a capability for wartime medical service, a standby contingency for wartime. As we're doing that, we're able to provide medical care to dependents and retired at a very favorable cost-effectiveness ratio, because once we're established the basis for military standby, we provide the additional care at marginal cost and by using our physicians who are on board for wartime contingency.

So as our study, all our studies, show, that our present structure is reasonable and desirable.

Mr. FORD. Thank you, General.

Mr. STRATTON. General, one of the things that I still find somewhat difficult to understand, you said a moment ago that you sent a memorandum back to, I guess, H. & E. on the 8th of June, or something to that effect, responding to what was sent out on the 8th of May. I can't understand the reason for this delay.

Here was legislation, which everybody in the medical fraternity agreed was urgently needed; June was the critical date; and you found out on the 8th of May that someone was sabotaging the kind of legislation that you wanted, and it's hard for me to see how you could sit still for a whole month writing and drafting memoranda and that sort of stuff in responding to them.

I would have thought you would have gotten on the phone and said, "What in heaven's name is going on here? If you guys are going to start changing this, like this proposal, we're not even going to have a bonus before June, and the whole impact of this is going to completely nullify the effect of the legislation. What's going on?"

To me this is like-and I gave this example yesterday- somebody going to a fire and getting into an academic discussion of whether you should put the chemical foam on it or water, and you're sending memorandums back and forth on which one you should use while the house is burning down.

Didn't you feel a sense of urgency, where you wanted to get on the phone and say, "What is going on here?"

General PATTERSON. There were numerous informal contacts between the three Surgeons General, certainly between myself and the people in H. & E. who were working on this problem, immediately after we got that memorandum.

Mr. STRATTON. You really knew beforehand that somebody was going to give this the "deep six," and you figured that it was a lost cause, is that about it?

General PATTERSON. No, sir. I think that prior to the passage of the legislation and at the time of the passage of the legislation we expected to implement it rapidly and smoothly. That was my expectation.

Mr. STRATTON. When did you first suspect that it wasn't going to be implemented rapidly and smoothly?

General PATTERSON. My first realization of this was at the time we received the memorandum from H. & E., which was dated the 8th of May. Now, I can't tell you at the moment, exactly the date we received that in our office, but it should have been very close to that.

Mr. STRATTON. We had testimony yesterday that the reason that that memorandum was drafted as it was by the people in H. & E. was because they knew that Secretary Brehm was opposed to the bill itself, and therefore they tried to compromise with his views.

I was a little surprised myself that here's H. & E., which is carrying the ball in this thing, and Mr. McKenzie testified to us that they never had any other conception except to give the amount of the bonus to those who signed up for 1 year, and yet 2 days after the legislation is signed they're the ones that send out a memorandum which has already reduced the size of the first-year bonus and has only given the big bonus for those who signed up for 4 years, and they admitted that this was contrary to their own views, and testified that, well, they knew they had a problem with Brehm, so they were trying to adjust to it.

Weren't you aware of that problem, too, if they were aware of it? General PATTERSON. That's consistent with my memory of the situation.

Mr. STRATTON. I mean if someone's trying to cut up your program, what do you do over there in the Pentagon? Do you just sit still and send memorandums? You've got three stars on your shoulder. Can't you make a few waves, even if it's an Assistant Secretary who's trying to sabotage you?

General PATTERSON. We made as many waves as we could.

Mr. STRATTON. Where did you make them? This is what I'm trying to find out.

General PATTERSON. We made individual waves within the week after we got this memorandum. The three Surgeons General had numerous meetings together. I have a memorandum here dated the 17th of May in which we had agreed to the various aspects of this program that we disagreed with. We had started, through each of our service channels, to go back to H. & E., and it was from that time, within a week or 10 days after we got that memorandum, that we all three started to go back through service channels to bring every kind of influence we could to bear on the problem, both individually and informally with H. & E., which was our only chain of contact, and officially and formally through the secretarial channels of the Departments.

Mr. STRATTON. Did you go to the Secretary himself?

General PATTERSON. Yes; indeed.

The thing that I referred to before, which was dated June 4, was signed in the Secretary's office.

Mr. STRATTON. The house has already burned down by the 4th of June.

General PATTERSON. Yes, sir; that's right.

Mr. STRATTON. I'm really a little surprised at this, and I hope this doesn't happen when we have a war, that everybody is so respectful of everybody else that nobody really makes much of a fuss.

Nobody made enough waves so that we found out what was going on over here, and this has disturbed me. Once we found out, we were able to get this thing blasted out of the Pentagon in the middle of July, and then when we found out the shenanigans that were going on down in the White House we finally got the right thing singed. But if somebody had gotten in touch with Congress when this operation began, maybe we could have done something, but apparently nobody thought of that.

I'm not trying to place any blame, but I'm just a little surprised that in your own field and this to some extent seems to be true of all the Surgeons General, that nobody really screamed very loudly, in spite of the fact that your own shop was being gutted. I think if they were trying to do that to me, I would have let somebody know about it. No attempt to get any kind of outside pressure on the Secretary for Manpower, through the Secretaries of the services, or the Chiefs of Staff, or anything of that kind? Nobody went to the Secretary of Defense?

General PATTERSON. The official correspondence is that which I have enumerated to you.

Mr. STRATTON. I'm trying to find out whether there was any unofficial correspondence. The way we get things done here in Washington, as I think you know, is not always through the official memorandum, as we've just found out. The one that was sent down from H. & E. on the 8th of May was drafted because somebody already knew what was happening over in Manpower.

General PATTERSON. Yes, sir.

Mr. STRATTON. What I'm trying to find out is why there weren't a few unofficial actions.

Well, I don't want to belabor the point.

Mr. Ford, do you have any other questions?

Mr. FORD. No, Mr. Chairman.

I would say one thing. You obviously have a morale problem in the medical corps now, and in all of the services, which is not completely dissipated by getting the thing signed finally, and I would merely say that perhaps the Surgeons General, all three of you, have some suggestions as to positive actions that could be taken to implement good morale, and if you want to provide it, it would be very helpful.

General PATTERSON. Yes, sir.

Mr. FORD. Thank you, Mr. Chairman.

Mr. STRATTON. Thank you very much, General Patterson and General Taylor. We appreciate your testimony.

The committee will stand adjourned until Tuesday morning at 10 o'clock, when we will take up the subject of retirement.

This completes these hearings on implementation of the doctor bonus.

[Whereupon, the subcommittee was adjourned at 12:05 p.m., to reconvene at 10 a.m., on Tuesday, October 8, 1974.]

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