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NEED FOR SUPPLEMENTAL ESTIMATES
Mr. Mahon. Give some of the reasons why there is a need for supplementary budget requirements for the Medical and Hospital Department of the Army as the result of the Korean situation.
General ARMSTRONG. Our 1951 budget, now before the Senate, was based on the normal number of patients to be expected in our hospital system based on last year's experience. Obviously, when you put military personnel into an area like Korea, under combat conditions, you not only get combat casualties but you get an increase in your disease and nonbattle injuries as well. This situation, together with an increase in the size of the Army, necessitates an increase in the estimate of average occupied beds, which serves as the basis for estimating additional fund requirements.
Secondy, medical units will have to be equipped, increased supplies and equipment will be expended in Korea as a result of combat, and pipelines will have to be established to forward-using depots.
In addition, there will be increased medical activity at recruiting stations, due principally to the operations of selective service.
Mr. MAHON. Most of the technical services seem to have considerable increases in the supplemental budget. Yours is relatively small.
Did you ask for enough money to take care of the casualties that you may expect?
General ARMSTRONG. Mr. Chairman, I would like to answer that in this way: In computing the revised patient load for fiscal year 1951, in view of the Korean incident, the number of individuals that we expect to have in combat, the number and strength of supporting units, the increased military strength in Japan, and the increased military strength in the zone of the interior, we worked with the Director of Medical Services in the Office of the Secretary of Defense trying to arrive at the best possible estimate. There is a difference of opinion as to the size of the potential patient load. Our estimates, which appear sound to us, are considerably at variance with those arrived at by the Director of Medical Services—theirs are considerably lower. Future events will determine which set of figures is correct. If his figures prove correct, we are in a satisfactory position; if ours prove correct, we are in a very poor position.
Mr. Mahon. What additional funds would be required to provide the funds which you estimated might be necessary?
General ARMSTRONG. Our estimate differed from the figures which you see before you by $15,700,000.
Mr. MAHON. In other words, instead of requesting $11,000,000, you suggested possibly $27,000,000 would be required?
General ARMSTRONG. That is correct.
General ARMSTRONG. To show you how far apart we were in this hospital-bed figure alone, we estimated that the increase in the average number of occupied hospital beds would be slightly in excess of 6,000. To be exact, 6,280. The supplemental estimate is based upon the premise that the increase in average occupied beds will be 2,39Î, which is a difference of of 3,889 occupied beds.
Mr. MAHON. Did this difference of opinion grow out of a difference of opinion as to the Korean situation, or the over-all picture?
General ARMSTRONG. The difference came about as a result of two different approaches to the problem. Briefly, we approached the problem by applying last year's hospitalization rate of 1.65 percent in the zone of the interior to the increased man-year military strength planned for the zone of the interior. We did the same thing for Japan except we used 1.9 percent which was last year's experience factor for peacetime.
In Korea we took the average number of troops that were actually going to be in combat and applied an adjusted experience figure of World War II for combat divisions. The rate of battle losses for World War II was 10 percent per month. However, because of differences in the plan of action and in the utilization of combat troops, we cut the rate in half and used 5 instead of 10 percent, which we feel is perhaps too conservative. We added five-tenths of 1 percent for noncombat casualties and diseases, due to battle conditions, for the average number of troops in Japan, to provide hospitalization required above peacetime rates in Japan, and arrived at a total increase of 6,280 in the average number of occupied beds required. I am not too sure how they arrived at their figure.
Mr. FOGELBERG. The method used was to apply 2 percent to the combined man-year Army strength of the original and supplemental fiscal year 1951 estimates to determine the number of average occupied beds required for Army patients. It was believed, by applying a 2-percent rate to the combined man-year Army strength, that sufficient cushion would be provided to care for the battle casualties in Korea. To obtain the increment, they subtracted from the total the number of occupied beds for Army patients contained in the original estimates for fiscal year 1951 and derived a figure of 2,391. That is essentially what was done.
PLAN FOR SECURING SERVICES OF DOCTORS AND DENTISTS
Mr. SIKES. I would like to ask, General Armstrong, how you plan to secure the services of sufficient doctors and dentists to cope with increased mobilization.
General ARMSTRONG. Thus far, Mr. Sikes, we have been able to meet our commitments by taking personnel out of the professional-training program. We have had some 400 young physicians in professional training in our own hospitals, and approximately 200 in training in civilian hospitals. We have reduced the number of doctors in our military hospitals to the level required for normal operations. We have also pulled every physician out of civilian courses. We always have a few men out taking courses in public health and hospital administration, and so forth.
Next we have requested our Reserves to volunteer. As you might expect, the response to date has not been too encouraging, and I will tell you why: It is the general feeling of physicians of this country that the Reserve has given and given and given.
For instance, in Oklahoma, one-third of the physicians served in either World War I or II an average of 40 months, of which 30 months
There is a group of young men in this country, not only physicians but other professional men, who received a part or most of their professional education at Government expense, who have never done a day's duty, and until that group has been asked to fulfill
their loyal obligation, then very few physicians are going to wave the flag and come forward.
Mr. SIKES. I have encountered exactly that same feeling. How can you secure the services of that group--and I am speaking of those who have had their education paid for partially or in full?
General ARMSTRONG. I have heard so many conflicting opinions, Mr. Sikes, that I would not want to attempt to answer the question. This question came up 2 years ago when we thought the Army was going to approximate the figure we have now, plus 100,000 18-yearolds that were going to volunteer. We were in sore straits. They said at that time there is just no legal way to do it; that the contract was completely broken and legislation would be required. Many said legislation would be unconstitutional.
At present there is a group of lawyers studying this problem to see whether or not the draft can be extended to include them. You see, the current age limit affects them. Although they had an accelerated educational program and graduated earlier than most of us did when we graduated, nevertheless, they are all now at least 31 or 32 years old. Therefore, the age limit would have to be extended before the draft could breathe on their necks.
Then there are wordings in the law about interfering with health, and most of them are married men and have two or three children. There are a lot of problems I do not know the answer to. I do know that those of us in uniform and every physician that I have talked to, including these individuals themselves, feel like they should come in. They say, “I am not going to volunteer until I know that the other guy is going to have to serve some, too.” They are perfectly willing, but they are waiting for somebody to say—“You are all going to have to do it—and they are then willing to come in. I believe that is it.
Mr. SIKES. Do you feel that the need for doctors and dentists can be met without having to call in reservists against their will while this matter is being determined ?
General ARMSTRONG. Unless this matter could be resolved quickly, we are going to have to ask the Army's permission to recall physicians against their will.
Mr. SIKES. In other words, you are going to need additional physicians quickly?
General ARMSTRONG. That is correct. (Discussion off the record.)
Mr. SIKES. Is it contemplated there will be a request of the Congress for legislation to cope with that particular situation before you call back into the service men who already have given years of their lives?
General ARMSTRONG. I am hoping that will be possible, I am assuming something now; it is my own personal opinion that if those who advise the Secretary of Defense on such matters say that it is an unsoluble proposition, then we may have to call them first, but I know they are rushing with all possible speed to try to decide whether or not this is a problem that reasonable legislation could cope with.
Mr. SIKES. In the event it is necessary to call in reservists prior to the enactment of such legislation, do you propose to use procurement boards within the various States?
General ARMSTRONG. I will tell you our plan, which has the tentative approval of our G-1 Division; that is, we would take the number of reservists in the grades in which we are interested and break them down by Army areas in relation to the number we have in that particular area. That Army area would be instructed to break them down by States in relation to the number in the States. The State and military instructor is to be instructed to call in the State medical society and the component county society and medical reserve organizations to sit down with that district commander and decide who can best be spared.
Now, if you have any suggestions as to a better way to do that, we would welcome them, because whatever we do will be most difficult. We are going to have unhappy people. We are hoping to get some responsibility on the part of the local profession to help us decide.
Mr. SIKES. Can you tell me how many people have received training and have served, and can you tell me how many people have received partial training and have not served ?
General ARMSTRONG. I would rather insert that.
(The information requested is as follows:) Medical personnel receiving training under the Army specialized training program
Dropped for academic or other reasons.
2, 000 Dropped at end of program--
4,500 The trainees dropped at the end of the program represent students in various stages of training. Data are not available as to the number of these students completing their training. Of those completing their training it is possible that a few have volunteered for service.
TRANSPORTATION SERVICE, ARMY
COL. R. C. MILTON, TRANSPORTATION COMPTROLLER
Mr. MAHON. We will now take up the Office of the Chief of Transportation.
Colonel Milton. The Transportation Service, Army, estimates presented for your consideration are for the procurement of rail and marine equipment; for increased ocean transportation support the United States Army and United States Air Force; for ocean transportation of bulk POL to Japan for issue to the United States Navy; for increased port activity in the Far East and in the United States; for the replacement of military personnel with civilians wherever feasible; and for increased United States Army transportation activities in the continental United States.
In order to provide transportation for the task-force activities and for the other increased activities of the United States Army, and for the United States Air Force and United States Navy where the Army has responsibility, it is estimated that 258.8 million dollars will be required over the amount of 289.9 million dollars as reported by the Senate Appropriations Committee. The funds required by major project are:
For “Procurement and production” an additional 68.4 million dollars is estimated, of which about 90 percent represents task-force requirements. . Of the total, 45.3 million dollars is for marine equipment (LCM's, barges, freight and passenger boats, patrol boats, tugs, floating cranes) and 23.1 million dollars is for rail equipment (locomotives, tank cars, flat cars, box cars, etc.). It is essential that procurement of most of the items required be initiated immediately.
Most of the supplemental funds required are for transportation operations. Of the total supplemental, funds estimated for operations amount to 190.2 million dollars, of which 97 percent is in support of the task force, with the balance to be used for increased activities in the United States. The estimates are based on projected workloads and may or may not be adequate depending on the rate of shipment of ammunition, supplies, equipment, and troops to the Far East. More than half of the funds included in these estimates will be made available to the Military Sea Transportation Service for the purpose of providing ocean transportation. The balance covers commercial freight transportation, increased port operations, replacement of military personnel with civilians, and other increases in transportation activities.
The $270,000 included for training activities provides for the replacement of military personnel with civilians at the transportation school.
The suppplemental request as presented represents the best transportation estimates that can be made at this time. The exceedingly ìong supply line in support of the task-force operations will place a continuing increasing burden on the transportation system. It is essential that adequate transportation funds be provided so as to permit a rapid acceleration in the flow of matériel and personnel, to the Far East and to other areas as may be necessary.
Mr. SIKES. Colonel Milton, is the Army going back into the business of operating boats?
Colonel MILTON. No; the Army is not going back into the business of operating oceangoing vessels, but I believe there will be some additional craft that will be broken out by the Navy. However, a large part of the ocean transportation requirements will be by commercial means.