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REVIEW OF THE HEALTH BENEFITS
PROGRAM OF THE ARMED FORCES

HEARINGS

BEFORE THE

SUBCOMMITTEE ON SUPPLEMENTAL

SERVICE BENEFITS

OF THE

COMMITTEE ON ARMED SERVICES
HOUSE OF REPRESENTATIVES
NINETY-FIRST CONGRESS

FIRST SESSION

DECEMBER 3, 4, 9, 1969

LAW LIBRARY
U. S. GOVT. DOCS. DEP.

JUL 1 5 1970

UNIVERSITY OF CALIFORNIA

DERKELEY

[Pages of all documents printed in behalf of the activities of the House
Committee on Armed Services are numbered cumulatively to
permit a comprehensive index at the end of the Con-
gress. Page numbers lower than those in
this document refer to other

subjects.]

U.S. GOVERNMENT PRINTING OFFICE

WASHINGTON : 1970

HOUSE COMMITTEE ON ARMED SERVICES

NINETY-FIRST CONGRESS, FIRST SESSION

L. MENDEL RIVERS, South Carolina, Chairman PHILIP J, PHILBIN, Massachusetts

LESLIE C. ARENDS, Illinois F. EDWARD HÉBERT, Louisiana

ALVIN E. O'KONSKI, Wisconsin MELVIN PRICE, Illinois

WILLIAM G. BRAY, Indiana 0. C. FISHER, Texas

BOB WILSON, California CHARLES E. BENNETT, Florida

CHARLES S. GUBSER, California JAMES A, BYRNE, Pennsylvania

ALEXANDER PIRNIE, New York SAMUEL S. STRATTON, New York

DURWARD G. HALL, Missouri OTIS G. PIKE, New York

DONALD D, CLANCY, Ohio RICHARD H. ICHORD, Missouri

ROBERT T. STAFFORD, Vermont LUCIEN N. NEDZI, Michigan

CARLETONJ, KING, New York ALTON LENNON, North Carolina

WILLIAM L. DICKINSON, Alabama WILLIAM J. RANDALL, Missouri

CHARLES W. WHALEN, JR., Ohio G. ELLIOTT HAGAN, Georgia

ED FOREMAN, New Mexico CHARLES H. WILSON, California

JOHN E. HUNT, New Jersey ROBERT L. LEGGETT, California

G. WILLIAM WHITEHURST, Virginia FLOYD V. HICKS, Washington

ROBERT J. CORBETT, Pennsylvania SPEEDY O. LONG, Louisiana

J. GLENN BEALL, JR., Maryland
RICHARD C. WHITE, Texas
BILL NICHOLS, Alabama
JACK BRINKLEY, Georgia
ROBERT H. MOLLOHAN, West Virginia
W.C. (DAN) DANIEL, Virginia
JORGE L. CÓRDOVA, Puerto Rico

JOHN R. BLANDFORD, Chief Counsel

SUBCOMMITTEE ON SUPPLEMENTAL SERVICE BENEFITS

JAMES A. BYRNE, Pennsylvania, Chairman RICHARD H, ICHORD, Missouri

DURWARD G. HALL, Missouri G. ELLIOTT HAGAN, Georgia

CARLETON J, KING, New York CHARLES H. WILSON, California

WILLIAM L. DICKINSON, Alabama JACK BRINKLEY, Georgia

JOHN E. HUNT, New Jersey

J. GLENN BEALL, JR., Maryland
JOHN J. FORD, Professional Staf Member

[H.A.S.C. No. 91-36]

HEARINGS ON REVIEW OF THE HEALTH BENEFITS PROGRAM

OF THE ARMED FORCES

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HOUSE OF REPRESENTATIVES,

COMMITTEE ON ARMED SERVICES,
SUBCOMMITTEE ON SUPPLEMENTAL SERVICE BENEFITS,

Washington, D.C., Wednesday, December 3, 1969.
The subcommittee met, pursuant to notice, at 10:12 a.m., in room
2212, Rayburn House Office Building, Hon. James A. Byrne (chair-
man of the subcommittee) presiding.
Mr. BYRNE. The committee will now come to order.
The Chair

, on behalf of the committee, wishes to thank each and every one of you for coming here to help us solve some of these problems. With your help I believe we can do it. I am going to ask Mr. Ford to read my statement because of my bad throat.

OPENING STATEMENT OF HON. JAMES A. BYRNE, CHAIRMAN OF
THE SUBCOMMITTEE ON SUPPLEMENTAL SERVICE BENEFITS

Mr. BYRNE. This committee was appointed by Chairman Rivers to review the supplemental benefits available to members of the uniformed services. Today

, the subcommittee begins its first hearings, a review of the health benefits program of the Armed Forces. In this hearing we shall review the overall health benefits programs of the Department of Defense

, including care in uniformed service facilities and care provided by the private sector for servicemen and their dependents, retirees and their dependents, and dependents of deceased personnel.

DEPENDENT MEDICAL CARE

The Dependents Medical Care Act of 1956, drafted in this committee, established the legal basis for providing care for dependents of military personnel in civilian hospitals. In 1966, in Public Law 89–614, the Congress expanded the medical care benefits significantly. It increased the types of care available, principally by providing outpatient care from civilian doctors, and extended coverage by civilian sources to retirees and their dependents and dependents of deceased personnel. It is estimated that the amendments made by Public Law 89-614 increased the potential beneficiaries in the dependent medical care program from 3.9 million to 6.2 million people.

The expanded benefits for dependents of active duty personnel went into effect on October 1, 1966. Essentially the same benefits were extended to retirees and their dependents and dependents of deceased personnel on January 1, 1967.

This hearing constitutes the first congressional review made of the program since these increased benefits went into effect. We want to examine what problems have resulted from this major extension of the program and what steps have been taken to overcome these problems.

There have been complaints about undue delay in processing claims, about confusion and red tape for service families, and about the adequacy of information provided to service families on benefits available.

We shall look closely at the cost experience of the program. We want to know how present costs compare with estimates made in 1966.

In other words, the subcommittee intends to look not just at the level of benefits but at the functioning of the program. And we shall be prepared to make such recommendations to the full committee or to the Department of Defense as appropriate for legislative or other actions which we determine should be taken to solve existing problems.

A number of studies have been made of the civilian health and medical program over the past year, including a study by the School of Public Health and Administrative Medicine at Columbia University under a contract with the Department of Defense. I have asked that the findings of this study be explained to the subcommittee.

DENTAL CARE

A subcommittee in the 90th Congress, of which I was chairman and on which our colleagues Mr. King and Mr. Dickinson served, recommended a program of dental care for dependents of uniformed service personnel. At that time the Department of Defense reserved its position on such a program and indicated that it was conducting a survey to determine the extent to which dental care was required.

While I am generally aware of the findings of that survey, I will ask that the Defense Department be prepared in these hearings to make a comparison of the findings of their survey with the findings and recommendations of the subcommittee. Our recommended dental care program was not considered in the 90th Congress due to a combination of budgetary pressures and footdragging by the Department of Defense. I have again introduced our recommended dental care program in the present Congress as H.R. 10794.

The Department of Defense has recently submitted an unfavorable report on this legislation. I shall expect representatives of the Office of the Assistant Secretary of Defense for Manpower to be prepared to explain this position.

I think the question of providing dental care is particularly appropriate at this time in view of the expressed intention of the present administration to move as rapidly as possible to an all-volunteer force.

PHYSICIANS' COMPLAINTS

A relatively small portion of the medical care budget involves care for active duty service personnel from civilian sources while on leave or traveling to a new duty station. A number of complaints have reached the committee regarding the difficulties which civilian physicians encounter in attempting to have these bills paid. We shall look briefly at procedures for financing this kind of care.

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We will now hear from our first witness, Brig. Gen, George Hayes,
the staff director in the Office of the Assistant Secretary of Defense
for Health Affairs.
General Haves.
Mr. HUNT. Mr. Chairman.
Mr. BYRNE. Yes, Mr. Hunt.
Mr. Hunt. Will you excuse me for a few moments? I am due next
door at another subcommittee hearing, by 18 minutes ago, and I will

go over.

Mr. BYRNE. Be back 25 after.
Mr. Hunt. All right. Thank you.
Mr. BYRNE. General Hayes.
General Hayes. Good morning. I hope your cold improves
promptly.
Mr Byrne. Thank you, General. So do I. Go ahead.

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BIOGRAPHICAL SKETCH OF BRIG. GEN. GEORGE J. HAYES

Date and place of birth: July 10, 1918_Washington, D.C.
Pre-medical education: Catholic University of America, Washington, D.C.,
B.S.-June 1940.

Medical Education: Johns Hopkins University Medical School, Baltimore,
Maryland, MD_November 25, 1943.

Internship: Johns Hopkins Hospital, Baltimore, Maryland, January 1, 1944
to September 30, 1944.

Residency: Lahey Clinic, Boston, Massachusetts, October 1, 1944 to February
12, 1946; Duke University Hospital, Durham, North Carolina, July 1949 to June
1950; Georgetown University (Gallinger Hospital Service), July-December 1951.

Board certification : American Board of Neurological Surgery, June 1952.
Given the 1965 Annual Alumni Achievement Award in the field of Medicine by
The Catholic University of America at the Homecoming Banquet held Saturday,
13 November 1965 at the Sheraton Park Hotel in Washington, D.C.
Military or Government Service:

Entered the U.S. Army on 13 February 1946, rank of 1 Lt. Promoted to BG
effective 1 February 1966.

There has been continuous active military duty since entering in 1946.
Chief, Neurosurgery Service, Walter Reed Army Hospital May 1947 to
June 1949 (Captain).

Chief, Neurosurgery Service, Walter Reed Army Hospital June 1950 to
August 1951 (Major).
Commanding Officer, 160th Neurosurgical Detachment, Korea; February
1952 to October 1952 (Lieutenant Colonel).

Commanding Officer, 46th Surgical Hospital, Korea; October 1952 to
September 1953 (Lieutenant Colonel).

Chief, Neurosurgery Service, Brooke General Hospital, Texas; September
1953 to July 1953 (Lieutenant Colonel).

Chief, Neurosurgery Service, Walter Reed General Hospital, July 1955 to 1
February 1966 (Lieutenant Colonel and Colonel).
Consultant, Neurosurgery to The Surgeon General of the Army, January
1956 to February 1966 (Colonel).

Director, Professional Service, Office of The Surgeon General, 1 February
1966 to August 1968 (Brigadier General).

Commanding General, U.S. Army Medical Command, Japan; 20 August
1968 to 30 June 1969 (Brigadier General).

Staff Director, Office of the Deputy Assistant Secretary of Defense (HA)
1 August 1969 to present (Brigadier General).
Hospital Appointments: (see under "Military or Government Service") Con-
sultant in Neurosurgery at Mt. Alto Hospital (See 213, Title 58 USC); Ap-
pointed 20 October 1959 to June 1968.

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