This concept of urban renewal as a program that changes existing land uses for new ones and in the process alters the character of the city has come to be recognized by some of the more sophisticated cities as a program with the kind of leverage that can be utilized to achieve basic development objectives.

Mr. Slayton noted that the computerized studies of the CRP can analyze the city's existing physical, social, economic and financial situation, examine the effects of alternate development decisions and forge a comprehensive development program. Such an approach could provide the foundations for the development of an effective demonstration cities effort.

If a city can bring together in a coordinated manner, its urban renewal program, its public improvements program, its major highway program, its public housing program, its housing code enforcement program, its fiscal program, its social welfare program, and its economic opportunity program, into one comprehensive approach it can exercise a consistent leverage over its development and redevelopment.

The combining of positive programs to achieve development goals can replace the attitude of the past that the city was without effective control over its own development. The carrying out of this concept rests upon the use of sophisicated and, at times, computerized techniques to provide better understanding of the development and redevelopment process and upon the important relationship between physical, economic, social, and financial factors that must be considered in solving our urban problems. This concept is also greatly strengthened with the recognition by local officials that they have the tools to direct and control development and redevelopment. This process is a powerful tool, it is a physical tool with strong social implications developed and properly used, it can program housing for various income groups, it can encourage in-migration and out-migration, it can use the quality of a school to attract families to a particular neighborhood. It can, in fact, result in some social restructuring of the community.

While the Congress was reluctant to require a CRP for all cities of over 50,000 population as a prerequisite to undertaking and carrying forward urban renewal and related programs, it is recommended that consideration be given to requiring that all cities who wish to take part in the demonstration cities program either have developed, or as a prerequisite, develop a well thought out CRP as a foundation for an effective demonstration cities effort.

Summary

1. The demonstration cities proposal is the most significant and far reaching proposal for the solution to America's urban problems since the Housing Act of 1949 and should be adopted.

2. Comparing the magnitude of the need with the funds proposed for the program, it is clear that the program can only provide a limited demonstration. With a 1965 Agriculture Department budget of $7.3 billion to assist the 1 million American farmers, a $380 million yearly budget for the demonstration cities program does seem to be out of proportion.

3. We must give more concern and financial support to the recruiting and training of the administrative, professional, and technical people needed today and in the future in carrying out the program embodied in the demonstration cities concept.

4. The community renewal program gives us the most logical approach to the effective utilization of the demonstration cities program and should be made a prerequisite to undertaking such a program.

STATEMENT OF THE COOPERATIVE LEAGUE OF THE USA IN SUPPORT OF S. 3215

Our support of S. 3215 introduced by Senator Sparkman and now before your committee has been repeatedly and specifically expressed by the top policymaking group, the cooperative league congress, at many of its biennial sessions over the past 15 years.

This congress which draws its delegates from all sections of the United States speaks for families, over 16 million of them, who own and patronize businesses in the fields of credit, farm marketing and supply, health care, electricity, housing, household needs, and insurance to name a partial list of them.

Here are some of the reasons such as broad diverse cross section of our citizenry agree so emphatically on the principles embodied in Senator Sparkman's bill.

Like the Group Health Association of America, the cooperative league believes in the better and more rational organization of medical care and health services in our country. We believe that there are four basic elements in that more rational and effective organization. One is group practice of medicine by balanced groups of doctors and professional medical personnel. Another is prepayment of the costs of medical care on a budgeted basis so as to bring the best of modern medical care within reach of as large a percentage of our people as possible. A third is preventive, comprehensive, regular care, aimed at maintaining family health and keeping people out of hospitals rather than episodic medical care which is necessarily limited to attempting to cure disease after it has been serious. And the fourth element is the opportunity and the responsibility of groups of our citizens to act voluntarily in the formation of group health plans in collaboration with groups of their doctors and nurses.

Such plans are to be found all across our country, in all sorts of communities, among all kinds and groups of people. Their basic philosophy is that the doctor should be provided with an assured income as a reward for keeping people well instead of having to depend on an uncertain income derived from people after they have become sick.

We support this legislation, S. 3215, because we are convinced it is necessary if voluntary constructive action by consumers of health care is to receive the encouragement it should have and to make the contribution to the better health of our people which such action can bring.

Only where the costs of preventive care are already paid and where doctors' income is thus already assured through the voluntary action of his patients— only under these circumstances is there incentive on the part of doctor and patient alike to keep people out of hospitals and thus to check the alarming increase in costs of medical care and the alarming and soon to be aggravated pressure upon both hospital space and hospital costs.

We can submit carefully compiled evidence to show that subscribers to group health plans do have hospital utilization rates which are from 50 to 80 percent of those of other insured groups in the population. (See supplementary data at the end of this statement.)

But for easily understood reasons group health plans face a difficult problem of receiving financing for the physical facilities they need. This has always been true and no one can accurately estimate how much benefit such plans might have brought to our country through voluntary action of its citizens if the financial problem could have been solved.

Such consumer-sponsored plans are nonprofit, of course, to begin with. They therefore cannot offer expectation of substantial earnings as security. Second, the doctors' facilities, clinic buildings, and the like, which are essential if such plans are to operate at all, are single-use buildings and therefore not in the nature of prime objects of investment by financial institutions. Third, in many, many cases the need is greatest in smaller communities where even if the local bank desires to make such loans, it simply lacks the resources with which to do so unless a guarantee is provided such as S. 3215 could give. Fourth, while the members and subscribers to such plans or the potential members and subscribers to such plans could and indeed have put up enough contribution to finance the operations of a plan, there are times when they are quite unable to subscribe the amounts of money necessary to finance expensive modern health facilities.

Let me cite a couple of examples.

First, take the case of a small community threatened with loss of its only hospital and of all its doctors and where families subscribed $100 each to provide their town with desperately needed modern clinic facilities. Some $45,000 was needed to complete construction of these facilities over and beyond what could be raised by the people's efforts. In the absence of legislation like S. 3215, it took 15 years before these earnest people were able to borrow the funds necessary to supplement their own and to provide the facilities their town needed. Another case is one where an already established group health plan in a rural area is ready and willing to construct a branch clinic in a neighboring community. The nearest hospital to this community is 30 miles away. And no facilities exist where efficient medical service could be provided or where, in

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1 departments and agencies in meeting temporary needs for

2 facilities and equipment in the carrying out of such programs.

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"(d) The Secretary shall not provide assistance under 4 this section to any city, or other political subdivision of a 5 State, unless he has obtained adequate assurances (1) that 6 the locality will maintain a level of aggregate expenditures 7 for preventing the spread or recurrence of slums and blighted

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areas (including code enforcement activities) at not less 9 than its normal expenditures for such purposes prior to 10 receiving such assistance, and (2) that the locality has a 11 satisfactory program for the provision of all necessary public

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improvements in the areas to be benefited by such assistance. Assistance provided under this section shall to the

greatest extent practicable be coordinated with other related 15 Federal programs of assistance.

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"(e) The provisions of sections 101 (c), 106, 114, and

115 shall be applicable to activities and undertakings assisted 18 under this section to the same extent as if such activities and

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undertakings were being carried out in an urban renewal

area as part of an urban renewal project."

89TH CONGRESS 2D SESSION

S. 3314

IN THE SENATE OF THE UNITED STATES

MAY 5, 1966

Mr. JAVITS introduced the following bill; which was read twice and referred to the Committee on Banking and Currency

A BILL

To increase the capital-grant authorization under title I of the Housing Act of 1949.

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 3 That the first sentence of section 103 (b) of the Housing 4 Act of 1949 is amended by striking out all that follows 5 "1965," and inserting in lieu thereof the following: "and

6 by $1,000,000,000 on July 1 in each of the years 1966, 7 1967, and 1968."

II

89TH CONGRESS 2D SESSION

S. 3315

IN THE SENATE OF THE UNITED STATES

MAY 5, 1966

Mr. JAVITS introduced the following bill; which was read twice and referred to the Committee on Banking and Currency

A BILL

To amend the Housing and Urban Development Act of 1965 to include in the rent supplement program housing financed under certain State or local programs.

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 3 That section 101 (b) of the Housing and Urban Develop4 ment Act of 1965 is amended by inserting after the first 5 sentence the following: "Such term also includes a private 6 nonprofit corporation or other private nonprofit legal entity, 7 a limited dividend corporation or other limited dividend legal 8 entity, or a cooperative housing corporation, which con9 structs, owns, and operates rental or cooperative housing 10 financed under a State or local program providing assistance 11 through loans, loan insurance, or tax abatements, and which 12 is approved for receiving the benefits of this section."