It was expressly stated that this legislation permitted treatment only to the extent and under conditions which chiropractors may practice in each State. It gives no authority for chiropractic to invade other areas of the healing art and I might add, here, that members of the chiropractic profession have no desire to do so. But, what the report stresses and I would like to further emphasize this point-is that State jurisdiction in this matter is recognized as it has been traditionally recognized in other related areas.

The report stresses another very pertinent point by showing that the present interpretation of the law acts in a discriminatory fashion toward Federal employees and licensed chiropractic practitioners. In other words, the administration of the present law places the Federal Government in a position wherein it actually discriminates against its own employees by denying them the cherished right to choose the type of health care which they prefer-a right enjoyed by hundreds of thousands of employees outside the Federal service. Senator METCALF. Just a moment, I wonder if you would mind if I interrupted you?

Mr. BADGER. Not at all.

Senator METCALF. The Department of Labor's report, which is adverse to this bill, suggests that because chiropractors under State laws have such varying privileges and duties and are not permitted to practice medicine and surgery that perhaps this bill should not be passed.

I will read this specific section:

In general, chiropractors who are licensed to practice under State law are prohibited from the practice of surgery and the administration or prescription of drugs and medicines. In addition to such statutory limitations, they usually have no hospital privileges.

In view of these restrictions, it is doubtful whether Federal employees who sustain personal injuries in the course of their employment would be able to get adequate medical treatment under this particular theory of healing.

Mr. BADGER. Senator, I think this portion of this report is very misleading and it places the position of chiropractic practitioners in an unfortunate light. I am sure that this is not the position which practitioners of chiropractic take.

They make no pretense of practicing in those areas which is traditionally occupied by doctors of medicine. I notice that a similar statement was made 2 years ago in the report of the Department of Labor. In those States where chiropractic is licensed, as I understand it, standards are clearly spelled out by State legislation and statute and the areas in which doctors of chiropractic are licensed to practice is clearly defined.

So that chiropractors do not pretend to invade those areas in which doctors of medicine traditionally administer.

Senator METCALF. The reason I stopped you was because you made the statement a moment ago that the members of the chiropractic profession have no desire to invade other areas of the healing

art.

You do not want to practice surgery. You do not want to prescribe drugs, or do these other things that

Mr. BADGER. That is very true.

Senator METCALF. And, so you feel that you are competent to do what the bill provides to take care of sprains and strains?

Mr. Badger. Exactly.

Senator METCALF. What about this provision that you have no hospital privileges?

Mr. BADGER. I think Mr. Bunker

Senator METCALF. I will direct questions to them.

Mr. BADGER (continuing). And Dr. Anderson who will follow me can expand upon this point. I am sure they are much more familiar with this area than I am.

Senator BURDICK. Mr. Chairman.

Senator METCALF. Senator Burdick?

Senator BURDICK. In the States where chiropractors are licensed, in every case they are permitted to handle sprains and strains; are they not?

Mr. BADGER. That is true.

Senator BURDICK. There is no limitation there.

Mr. BADGER. That is true.

Senator METCALF. While I have interrupted you, taking you away from your fine thought you were developing in your testimony, I would like to read you a paragraph from the Health and Welfare report on the Burdick bill of last year and ask for your comment.

That there is much confusion as to the nature and alleged violation of the practice of chiropractic is seen in the several States in which State codes, statutes, and boards of licensure vary markedly in their definition of chiropractic in the extent and scope of their practice which they will make.

Do you feel that that would be a justification, the fact there is a variance in the codes of the States, justification for failure to pass this bill which is limited to strains and sprains?

Mr. BADGER. I do not think that is a valid objection at all, Senator. I think the tendency over the years certainly has been toward a uniform standard of licensure and regulations, and we are moving toward that goal just as all professions are, in addition to increasing the standards of qualification and education, which has shown a marked advance in recent years, and I just do not think this is a valid objection to legislation of this nature.

Senator METCALF. Thank you very much. Go ahead with your statement.

Mr. BADGER. I think with reference to the discrimination which is evidenced by the manner in which present legislation is administered, we might point out the fact that you have a very anomalous situation where the employees of a defense contractor, working on a Government contract in those States having workmen's compensation laws providing payment for chiropractic treatment, would be covered and in such States would be entitled to select chiropractic care in suitable cases.

On the other hand, a Government employee working on the same contract would be denied that privilege.

Here is an example of how the Government discriminates against its own employees.

During the hearings on the bills, introduced in the 77th and 79th Congresses, several employee groups testified that chiropractic care was desired by certain employees whose duties are likely to incur injuries which respond to chiropractic care.

The report refers to this testimony, and the members of the committee declared that they were impressed by the large number of people who stated they felt chiropractic treatment resulted in quicker relief and remedy and hastened their return to work.

I think that figures will show that during the last 18 years since the previous bill was considered or passed by the Senate that the number of employees who are covered by legislation and regulation permitting chiropractic care has increased very substantially.

It is now 18 years since that report was written. The statements made in it are still true-and many of them, of course, have been emphasized time and time again by the developments since that time. The committee said that it was impressed by the fact that so large a number of people sought chiropractic care. Yet, I dare say that the number of people being served by chiropractic care today is more than double the number that it was when this report was written. The committee may be interested in knowing that during the past 5 years, hundreds of labor unions have negotiated contracts which included health benefits providing for chiropractic care of factory workers.

Many large industries have expanded their health insurance plans to include chiropractic care, when it was pointed out to them that this service was being denied their employees. In short, chiropractic is becoming more and more accepted by the American public as an essential healing art, and as the previous witness so clearly pointed

out.

We believe that it is time to modernize the law to end discrimination which exists. We should provide Government employees with the full range of care and treatment to which they are entitled when they sustain any disability while on duty.

The employees themselves want such discrimination to end and they have indicated they want to have chiropractic treatment available when they have any type of injury which responds more readily to chiropractic treatment.

I noticed in the Washington Post for June 23, 1964, an item concerning a preliminary report issued by the American Medical Association concerning the cost of medical care.

The report points out that the prices for medical services and goods have increased 136 percent since 1935. Whereas the prices for all goods and services have gone up only 123 percent.

The article said that the average hospital stay fell from 11 days to 8 days between 1946 and 1961 but that the average daily charge rose from $7.41 to $30.94 a day.

Mr. Chairman, I think that the cost of medical care is certainly one of the issues of the day with which the American public is most concerned.

I think it would be very interesting to find out what effect this legislation would have upon the cost of medical care. We believe that it would substantially reduce such care-not only in direct costs but also in terms of returning injured employees to their jobs much

sooner.

I have saved in my file a little item with which I was very much impressed upon the role of chiropractic in industry and I would like to just comment on one or two paragraphs from it. It is a little brochure

prepared by the late Andrew J. Sardoni, a prominent builder, banker, industrialist, and philanthropist of Pennsylvania. He also happened to be, at the time his statement was made, the president of a medical hospital in Wilkes-Barre, Pa., and he makes a very impressive statement concerning the value of chiropractic care and services within his many enterprises.

He states:

Our payroll reaches as much as $50,000 per day and from $10 to $20 million per year. You can readily appreciate that with so many employees we have our share of industrial accidents and sickness.

Because of the number and diversity of our employees we feel well qualified to form a fair appraisal of the value of chiropractic in industry.

The cost of chiropractic treatments in our Sardoni enterprises has been paid for time and again simply through increased employee efficiency, mental and physical. We had achieved a form of preventive maintenance, absenteeism due to illness was considerably lowered, and efficiency was greatly increased. The employees who formerly were easily cold victims found that the common cold could be pretty well prevented by availing themselves of regular chiropractic treatments. With business competition as keen as it is, man-hours lost in unproductive sickness are a most important factor in our equation of business production.

He said again:

I have seen chiropractic treatment save suffering, needless loss, time, money, and health. Chiropractic in industry will continue to win an ever-widening recognition for it makes the lives of all those it touches happier, more productive, and more meaningful.

In conclusion, Mr. Chairman, I would like to add one further comment. When I was an employee of the U.S. Senate, at the time of the 79th Congress, similar legislation as I have indicated was unanimously approved by that body.

I was employed by Senator Eibert D. Thomas of Utah, who, as you know, was a member of this committee at that time, and its chairman for many years. If anyone had told me at that time that this same legislation would still be pending before the Congress a generation later I would not have dared to believe them. But here we are today and similar legislation unanimously approved by the Senate 18 years ago, is still waiting to be approved by the Congress of the United States.

It seems to me that this fact is almost incredible. Particularly because of the additional fact that during those intervening 18 years this committee has, as I have already indicated, considered and approved a long list of measures which have brought about many pioneering reforms in the field of social legislation-which have set new standards in many areas for local government's industry, labor, and public and private institutions to follow.

Usually, the Federal Government has been far in the forefront and has taken the lead in establishing standards governing working conditions, wages, and hours of employment, pensions, retirement compensation benefits, health care, pure food and drug laws, sanitation, water pollution regulations, fair employment practices, child labor laws, mine safety regulations and standards in many other areas, and industry, State and local governments, and private and public institutions have followed the Federal Government's leadership.

But we are considering here today in this legislation a flagrant example of how the Federal Government has lagged far behind local governments, labor, industry, and many private institutions by

failing to afford its employees the right to choose the type of medical care which they prefer.

It seems to me, therefore, that the Federal Government should rectify this situation as quickly as possible and reassume the traditional role of leadership in this area that it has traditionally held.

I trust, Mr. Chairman, that this committee will follow the suggestions and guidelines laid down by two previous congressional committees and report this legislation favorably.

I would like to ask that Senate Report No. 1317 of the 79th Congress, from the Committee on Education and Labor, a copy of which I will submit, be included in the record at this point. Thank you very much.

Senator METCALF. The report will be attached. Do you have any comments, Senator Burdick?

Senator BURDICK. No, Mr. Chairman. There is a question that comes to my mind. I think you stated that you are going to have another witness on this subject. I think the report states that the hospital will receive chiropractic patients. Is that by a policy or by law?

Mr. BADGER. Senator, I would prefer to have either Mr. Bunker or Dr. Anderson who will follow me comment on this, because they are much more familiar with these standards than I am.

Senator METCALF. We will direct that inquiry to them.

Mr. BADGER. Thank you.

Senator METCALF. Thank you very much.

The next witness is Mr. Bunker, who is appearing for the American Chiropractic Association. If you will come forward.

I have also been provided with a copy of your statement, sir; I have had an opportunity to read it. If you want to summarize it you will be permitted.

STATEMENT OF JAMES E. BUNKER, ATTORNEY, AMERICAN CHIROPRACTIC ASSOCIATION; ACCOMPANIED BY DR. BENJAMIN GOLDSTEIN, CHIROPRACTIC INSTITUTE OF NEW YORK Mr. BUNKER. First of all, I would like to suggest I have with me Dr. Benjamin Goldstein of the Chiropractic Institute of New York. He is what I would like to consider my expert, because there may be some professional matters I cannot answer because of my lack of qualifications in the chiropractic field.

Senator METCALF. We are pleased to have you both before the committee, and if you will sit down and proceed in your own manner. Mr. BUNKER. Mr. Chairman, it is again a pleasure to be here, although it is not a pleasure to have to be here again on the same subject.

With your permission, I would like very much to offer my statement as it was submitted to the committee and in the interest of time I would like to touch on some of the highlights of our position and the things that we think are particularly important as the committee considers the bills under consideration.

Senator METCALF. Thank you; that will be very helpful. (The prepared statement of Mr. Bunker follows:)