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This has been of real benefit, particularly to beneficiaries living in smaller communities or rural areas where, in order to obtain services of opthalmologists or physicians skilled in diseases of the eye, the beneficiary must travel a distance of anywhere from 100 to 200 or 300 miles, while an optometrist might be his next-door neighbor.

To assure the beneficiary of this right, we respectfully recommend that there be added to H.R. 12580, title VI, section 601, "SEC. 1602(a) (6)" the following language:

*** and shall accord the individual freedom of choice of any practitioner duly licensed to render the service to which the individual is entitled.

This follows the same pattern as the 1950 amendment to the aid to the blind program except that it includes all duly licensed health disciplines.

The Senate on Friday of last week, by unanimous action passed H.R. 7966, the sole purpose of which was 'o accord a similar privilege to veterans entitled to outpatient vision care.

The same reasons which prompted both the House and the Senate to pass this bill without a dissenting vote, are equally applicable to the proposed amendment to the pending legislation.

The American Medical Association is a great advocate of freedom of choice among physicians. At the same time they advocate limiting the choice of the patient to members of the medical profession, even though other professions in the health field are regulated and licensed by the States, and their services utilized extensively by those who are free to choose.

When Henry Ford, Sr., was first approached about offering the public a choice of colors in Ford cars, he is reputed to have said: "The purchaser is free to select any color he desires so long as it is black." That is the way the medical profession regards the entire field of health care the individual should be free to select the practitioner of his choice so long as he is an M.D.

It is contrary to the public interest and American tradition for Congress to pass legislation providing health care for any group of our citizens, and leave it in the power of the executive departments of the Government to require the beneficiaries to select only members of the medical profession to render a service which can be provided by another profession in the health field which is duly licensed and regulated by State law.

If our aged citizens are to have the same freedom of choice of practitioner under Government-sponsored health care programs that they do prior to the time they reach the qualifying age, the amendments attached hereto as exhibits, or comparable amendments, are indispensable.

I have referred to our experience under the aid to the blind program and vision care for the veterans. In conclusion I would like to mention briefly the experience of our profession in connection with our national defense.

The Army during World War II refused to commission optometrists and permit them to practice their profession. In the interest of the visual welfare of the Army (the Navy was commissioning optometrists and utilizing their professional services) Congress passed the Optometry Corps bill in May of 1945, over the strenuous opposition of the War Department and the American Medical Association.

While this bill was vetoed because World War II was drawing to a close, the administration because of this congressional action agreed to and did sponsor the Medical Service Corps law of 1947. This resulted in the commissioning of optometrists in the Regular Army, Navy, and Air Force.

There are now some 350 optometry officers on active duty in our Armed Forces, with ranks ranging from second lieutenant to colonel or the equivalent ranks in the Navy.

Even the Army Medical Corps now recognizes the invaluable services which optometrists are performing in caring for the vision of the man and woman in uniform and their dependents.

When some of the States have what are referred to as antidiscrimination laws, our National Government should not attempt to discriminate between professions that are duly licensed and regulated by State laws. The individual is entitled not only to assistance when needed but to freedom of choice as to who shall provide the health care services.

The detailed amendments are attached hereto as exhibits. (The amendments referred to follow :)

PROPOSED AMENDMENTS TO H.R. 12580 To ACCOMPANY THE STATEMENT OF DR. V. EUGENE MCCRARY, REPRESENTING THE AMERICAN OPTOMETRIC ASSOCIATION, JUNE 30, 1960

(Note: The page and line references are to the bill as introduced in the House on June 9, 1960)

Page 154, line 1, strike out the word "MEDICAL" and insert in lieu thereof the word "HEALTH"; line 5, strike out the word "MEDICAL" and insert "HEALTH"; line 9, strike out the word "medical" and insert "health"; line 15, same amendment; line 17, same amendment.

Page 155, line 3, same amendment; line 5, same amendment; line 8, same amendment; line 13, same amendment; line 16, same amendment; line 17, strike out the semicolon and insert the following: "* ** and shall accord the individual freedom of choice of any practitioner duly licensed to render the service to which the individual is entitled ;".

Page 156, line 6, strike out the word "medical" and insert "health"; line 21, same amendment.

Page 157, line 7, same amendment: line 10, same amendment.
Page 158, line 13, same amendment; line 18, same amendment.

Page 159, line 4, same amendment; line 12, same amendment.
Page 160, line 5, same amendment; line 10, same amendment.
Page 162, line 4, same amendment.

Page 163, line 14, same amendment; line 15, same amendment; line 18, same amendment

Page 163, line 19, strike out the word "physician" and insert in lieu thereof the words "a duly licensed practitioner"; strike out the word "medically."

Page 164, line 6, strike out the word "medical" and insert "health"; line 8, same amendment; line 12, same amendment.

Page 165, line 8, same amendment; line 12, strike out the words "physicians' services" and insert in lieu thereof "health services"; line 13, strike out "a" end insert "an"; line 14, strike out "physician" and insert in lieu thereof "individual" and after the word "licensed" insert the words "to practice in the field of health care."

Page 166, line 9, strike out the words "a physician" and insert in lieu thereof the words "an individual duly licensed to practice by the State in the field of health care."

Page 167, line 18, strike out the word "Medical" and insert in lieu thereof the word "Health."

Page 168, line 2, strike out the word "medical" and insert in lieu thereof the word "health"; line 22, same amendment.

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Page 169, line 3, strike out the word "medical" and insert "health"; line 8, same amendment; line 24, same amendment.

Page 170, line 7, same amendment; line 23, same amendment.

Page 171, line 13, same amendment.

Page 178, line 5, strike out the word "Medical" and insert "Health"; line 6, same amendment; line 9, same amendment; line 10, same amendment; line 12, strike out the word "medical" and insert "health"; line 13, same amendment; line 16, strike out "medical" twice and insert "health" twice; line 19, same amendment; line 21, strike out "medical" and insert "health"; line 22, same amendment; line 24, strike out "medical" twice and insert "health" twice.

SUGGESTED AMENDMENTS TO H.R. 4700 (FORAND BILL-FEBRUARY 1959)

Page 7, line 10, strike out the period and add the following: "and except that in prescribing and furnishing corrective eye wear or lenses following eye surgery, such individual may select a duly licensed optometrist."

Page 11, line 16, after the word "dentists" insert "optometrists."
Page 12, line 8, after the word "dentist" insert "optometrist."
Page 16, line 11, after the word "homes" insert "optometrists."
Page 17, line 3, after the word "physicians" insert "optometrists."

Page 18, line 14, after the word "physician" insert "optometrist"; line 15, after the word "home" insert the words "postoperative."

PROPOSED AMENDMENTS TO S. 3503 (SOMETIMES REFERRED TO AS THE MCNAMARA BILL)

Page 1, line 3, strike out the word "Medical" and insert in lieu thereof the word "Health".

Page 2, lines 6, 13, 20, 25, strike out the word "Medical" and insert in lieu thereof the word "health".

Page 3, line 7, same amendment.

Page 4, lines 5 and 16, same amendment.

Page 5, lines 14 and 21, same amendment; line 24, strike out the word "physician" and insert in lieu thereof "duly licensed practitioner".

Page 6, line 1, strike out the word "physician" and insert in lieu thereof the word "practitioner"; line 3, strike out "medical" and insert "health”.

Page 7, line 25, strike out "medical" and insert "health".

Page 10, line 5, after the word "homes" insert "(iv) clinics" after "and" strike out "(iv)" and insert in lieu thereof "(v)"; line 8, before the word "and" insert the word "clinics"; line 19, before the word "or" insert the word "clinic"; line 24, strike out "medical" and insert "health".

Page 11, lines 6, 16 and 22, same amendment; line 13, after "hospital," insert "clinic"; line 25, after the word "hospitals" insert "or clinics".

Page 12, line 22, strike out the word "and". After the word "services" insert "and clinics".

Page 14, line 3, after the word "agency," insert "clinic," line 6, before the word "or" insert the word "clinics"; line 14, strike out "medical" and insert "health".

Page 15, line 4, and in the balance of the bill, wherever the word "medical" appears, strike out the word and insert in lieu thereof the word "health"; line 10, before the word "or" insert "clinical services".

Dr. MCCRARY. Mr. Chairman, I want to thank you for this opportunity to express the views of our profession, and to assure you I will be happy to answer any questions you or the members of your committee may wish to ask.

The CHAIRMAN. Any questions.

Senator DOUGLAS. Doctor, I take it you object to being placed in a medical leper colony.

Dr. MCCRARY. Well, let me say we feel that it is important for the health and welfare of the American people to have all disciplines who work in the health care field to be heard and to cooperate together in carrying on and caring for the health needs of the American people. Senator DOUGLAS. How long a period of study do the optometrists have to have?

Dr. MCCRARY. The present requirements are 6 years at college level in some of our schools, and 5 years in the others.

Five years is the minimum.

Senator DOUGLAS. That includes liberal arts and then medicine, too; I mean optometry, too?

Dr. MCCRARY. Yes, sir.

Senator DOUGLAS. Courses in physics and in vision and so forth? Dr. MCCRARY. Yes, sir; the subject matter in the preoptometry, premedicine, predentist is basically the same for the 2 years and then as you study in a more particular area of the field, we cover physiology and anatomy, psychology, physics, pathology, all of the various aspects.

Senator DOUGLAS. So you are not corresponding school doctors? Dr. MCCRARY. Positively no, to my knowledge.

Senator DOUGLAS. How do you account for the attitude of the American Medical Association?

Dr. MCCRARY. Well, sir, that is a big question. I think frankly that there is basically an economic reason for it. I think basically that is the segment of vision care rendered the American public; there are two groups which render this care and that as a result of this there is some economic rivalry existing. This is my personal opinion, and I am speaking now as an individual giving his personal opinion. This is my feelng, and this seems to be the basis.

Now to point up an illustration; In the Armed Forces, I had the privilege of holding a commission in the Medical Service Corps of the Navy.

I have served 2 years on active duty from 1951 to 1953. There is no problem with any professional cooperation when the economic factor is removed. I would say that interprofessional relationships were beautifully cooperative and I might add, too, for the benefit of the patient because when these differences take place, it is the patient ultimately who loses.

Senator DOUGLAS. You make a very serious charge, sir.

Dr. MCCRARY. Well, we are quite concerned about this. We in optometry are quite anxious to resolve these differences because we feel it is in the public interest to do so.

Senator DOUGLAS. Have you tried to adjust this by conciliation with the AMA?

Dr. MCCRARY. Yes; there has been in past years a committee known as the Interprofessional Committee on Eye Care which had representatives from medicine, optometry and opticianry, this committee operated, I believe, lived about 6 years and was disbanded about 5 years ago; it was disbanded in 1955, as a result of the action of the house of delegates of the AMA.

We would like to see this problem resolved and we would like to make every effort to do so.

Senator DOUGLAS. So you resort to legislation only as a last resort. Dr. MCCRARY. Yes; we feel that the optometrist is well trained to render the unique services which he offers to the public and he should not be disenfranchised from rendering this service.

Senator DOUGLAS. Thank you.

The CHAIRMAN. Any further questions?
Thank you, Doctor.

Senator HARTKE. Mr. Chairman, before the next witness is called I would like permission of the committee to insert in the hearings at this time a resolution approved by the Governors' Conference on June 29, 1960, advocating the medical care under the framework of the old age survivors and disability system and recording the vote of 30 for and 13 against with 11 not voting and also, not a part of the resolution but the statement that all the Governors present indicated they were for the principle of national health insurance plan for the aged although they voted, some voting against disapproved of OASDI financing.

The CHAIRMAN. Without objection, the insertion will be made a part of the record.

(The document referred to follows:)

TEXT OF RESOLUTION APPROVED BY GOVERNORS' CONFERENCE, JUNE 29, 1960

PROBLEMS OF THE AGING

Whereas the Governors' Conference for many years has been acutely aware of the growing number and complexity of problems faced by our increasing population of senior citizens, including health and medical care, employment and income maintenance, provision of suitable housing, and enrichment of leisu e time activities; and

"Whereas the most pressing of these problems is the financing of adequate health and medical care: now, therefore, be it

Resolved by the 52d annual meeting of the Governors' Conference, That Congress be urged to enact legislation providing for a health insurance plan for persons 65 years of age and over to be financed principally through the contributory plan and framework of the old age survivors and disability insurance system; and be it further

Resolved, That the States support and participate actively in the forthcoming White House Conference on Aging to the end that public and private agencies be stimulated and encouraged to develop approaches to all the problems of the aging.

Vote: 30 for; 13 against; 11 absent or not voting.

Vote for (30): Alabama; Egan, Alaska; Arizona; Faubus, Arkansas; Brown, California; McNichols, Colorado; Ribicoff, Connecticut; Collins, Florida; Docking, Kansas; Combs, Kentucky; Maine; Furcolo, Massachusetts; Williams, Michigan; Freeman, Minnesota; Blair, Missouri; Montana; Nebraska; Sawyer, Nevada; Meyner, New Jersey; New Mexico; Rockefeller, New York; DiSalle, Ohio; Oklahoma; Rhode Island; Herseth, South Dakota; Tennessee; Texas; Vermont; Rossellini, Washington; Nelson, Wisconsin.

Vote against (13): Delaware; Georgia; Idaho; Illinois; Indiana; New Hampshire; North Carolina; South Carolina; Utah; Virginia; West Virginia ; American Samoa; Virgin Islands.

Absent or not voting (11): Hawaii; Loveless, Iowa; Louisiana; Maryland; Mississippi; North Dakota; Oregon; Pennsylvania; Wyoming; Guam; Puerto Rico.

The CHAIRMAN. The next witness is Dr. Hugh E. Chance, International Chiropractors Association.

Dr. Chance, take a seat, sir.

STATEMENT OF DR. HUGH E. CHANCE, INTERNATIONAL CHIROPRACTORS ASSOCIATION; ACCOMPANIED BY DR. S. K. KEISER, LANCASTER, PA.

Dr. CHANCE. Mr. Chairman and members of the committee, I have with me Dr. S K. Keiser of Lancaster, Pa., chairman of our committee on legislation; previously in the room but he had to leave was Dr. John Thaxton, our vice president, from Raton, N. Mex.

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