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:)

PREPARED STATEMENT OF JAMES E. BUNKER, GENERAL COUNSEL, AMERICAN CHIROPRACTIC ASSOCIATION, WEBSTER CITY, IOWA

Mr. Chairman and gentlemen of the subcommittee, my name is James E. Bunker, Webster City, Iowa. I am general counsel of the American Chiropractic Association, a nonprofit corporation composed of voluntary membership, representative of the chiropractic profession nationally. Significantly, our organization is a new one formed in recent months by a merger of several hundred independent doctors of chiropractic and the National Chiropractic Association. Thus, for the first time in the history of the chiropractic profession, it is represented by an organization, for which I speak today, composed of a majority of practicing doctors of chiropractic throughout the Nation.

You have been given the legislative history of the amendment to the Federal Employee's Compensation Act proposed by S. 1710 and S. 2078. I will try to point out the concern of the chiropractic profession with regard to the amendment and offer some background information with respect to the profession itself.

Chiropractic is one of the four major healing arts professions and is so classified officially by the Federal Government along with medicine, osteopathy, and dentistry. It differs from those three professions in that it is concerned primarily with the relationship between structure and function in the human body and the role of that relationship in the maintenance and restoration of health. It is concerned especially with the relationship between the spinal column and the nervous system, and its practices are conducted without the use of drugs and surgery. Thus, it is peculiarly appropriate and has been found most helpful in dealing with cases of trauma such as strains, sprains, and the like.

Doctors of chiropractic are licensed to practice in 48 States including the District of Columbia, and the educational requirements are high. A full 4-year course of professional training is required which includes so-called basic sciencesanatomy, physiology, pathology, bacteriology, and chemistry-together with the clinical subjects of the chiropractic school. About one-half the States or more require 1 or 2 years of college training in addition to the professional training. Educational standards are constantly being elevated.

The effectiveness of chiropractic therapy is best evidenced by the substantial portion of the population which seeks the services of doctors of chiropractic in ever-increasing numbers. We all know that if these services were ineffective, persons who are sick or injured would not seek them out time and again. The profession is accepted and recognized under the workmen's compensation laws of all but a handful of States. More than 75 percent of the 800 commercial health insurance companies provide coverage for chiropractic care in one or more of their policies. The recently enacted program of medical assistance for the aged (Kerr-Mills) has been adopted in several States, many of which provide benefits for doctors' services. Of these several include the services of doctors of chiropractic.

Under the Federal Employees Health Benefits Plan of 1959, of the employee organizations offering plans, most include the services of doctors of chiropractic. This in itself is persuasive evidence of a demand for such care by Federal employees. The statements filed and testimony presented by representatives of Federal employee organizations are further evidence of this demand. It becomes quickly apparent that an employee of a private employer suffering an injury compensable under State law has an advantage over a Federal employee suffering a similar injury under Federal law, since the former could select chiropractic care if he chose to do so, whereas the Federal employee would do so at his own expense. This brings us to the real harm and inequity which the proposed amendment would correct. As we understand the program and its practical administration, a Federal employee injured on the job is ordinarily entitled to select a qualified physician to render the necessary care. If the injury is a strain, sprain, or similar type of injury, the employee may-indeed often does-select a doctor of chiropractic to attend the injury. Since such doctors are licensed and qualified to treat injuries of that nature, it seems unjust to deny the employee the benefits which would have been available to him had he selected a doctor of medicine or osteopathy. As frequently happens, the injured employee received the chiropractic care to his total satisfaction from a doctor of his choosing and was then burdened personally with the resulting expense. Usually an employee has enjoyed such success with similar care in the past that he chooses chiropractic care with full knowledge that he does so at his own expense.

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Upon submitting this claim to the Bureau of Employees Compensation, he is advised by form letter that he must pay the bill himself since the Federal law makes no provision for chiropractic care. This letter has a dual effect: It is unfair not only to the employee, but also to the doctor. For this doctor, licensed and qualified to render the care involved, finds himself maligned-although unintentionally, we are sure-by an agency of the Federal Government. When our department is called upon by one of our members to explain this inequitable treatment, we must always advise that under present policy of the Bureau the only solution is amendment to the Federal law. That, gentlemen, is our purpose in supporting the amendments to the present law and in making ourselves available to you for questions you may have regarding any pertinent aspects of the chiropractic profession.

In summary, it is our position that Federal employees should enjoy the same rights and privileges in compensation matters as are enjoyed by persons in private employment. The rights of the individual regarding his personal health are comparable to other personal rights of a fundamental nature. Certainly Congress did not intend to discriminate against the right of any individual in the health care he receives or the doctor of chiropractic in providing it. Accordingly, if the present law permits incidental discrimination in its administration, congressional attention is in order.

We believe that the licensing powers of the several States provide adequate assurance that those rendering care to these injured persons are possessed of the necessary qualifications. The inequity under present Federal law creates an economic barrier to the proper exercise of that traditional State prerogative. Mr. Chairman, we are grateful to you and the members of your subcommittee for this opportunity to present the views of the chiropractic profession regarding these proposals. Thank you.

Mr. BUNKER. First of all, as to the organization I represent, it is a new organization, the American Chiropractic Association, which consists of a merger between the National Chiropractic Association and a number of independent doctors of chiropractic which took place in the fall of last year; significantly for the first times in the profession's history it is represented in this organization by a majority of practicing doctors of chiropractic throughout the country.

We are very pleased with that; we think it will provide us with an opportunity to conduct the affairs of the profession in a more responsible and authoritative way.

Senator METCALF. Can you tell me about how many members you have?

Mr. BUNKER. I am informed that our membership to date is approximately 8,000, of which some 6,500 are full-time active practitioners.

We are informed that the last census touching on the fields of endeavor of the public showed a chiropractic population of something in excess of 13,000 full-time practitioners.

Quite frankly, although personally I am what I will say mildly opposed to the limitations contained in Senator Burdick's bill, S. 1710; nonetheless, I recognize the impracticability, perhaps, of persuading upon your committee and the Congress the less limited provisions of Senator Magnuson's bill, S. 2078.

I have weighed this myself and have concluded it probably would be in the profession's best interest if either of those bills were passed at this time, even though there might be limitations which do not conform to our overall objectives.

There are some general considerations with respect to the nature of the bills under consideration-the things that would be accomplished, and what the bills seek to do is to provide a means of relief for injured workers, not for persons suffering from illness or pathology,