Board of National Missions miners hospitals discussions, April 1963, tape 2.

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[Eugene Rosenfeld] You saw you saw it a moment ago in terms of numbers, but in terms of specialty
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services, with very few exceptions, of the sixty
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two doctors who are not on the staff of the hospital, about eight are specialists. All the
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other specialists in the area, certified specialists, are on the staffs
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of the Miners Memorial Hospital. So that in terms of services, specialty
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services, these people would have to be kept in the community or
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replacements recruited. Now under the conditions that exist nationally
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in terms of the availability of physicians, recruitment today is going to be
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extraordinarily difficult unless you could use the same techniques that
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the, that the Miners Memorial Hospitals use, and that is security, high
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levels of income, group practice. I think the
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church might have another possibility, that would not be available to
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other groups. And, that is that you might be able to recruit doctors with missionary interest,
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in addition to those that might come in for other reasons. But the doctors who are presently there
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are of two groups generally, one or the group of doctors
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who are devoted to a group practice concept of medical practice and the
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other groups of ex-Federal physicians who were either in the
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armed forces or some other branch of the federal services and are used to a
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kind of group practice and security of employment in the practice of medicine
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and are retired from federal employment. These are generally the kinds of doctors that are
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there as specialists in the Miners program. Unless they're kept under
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some arrangement that will it will interest them, I think that you're going to be
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faced with an almost insuperable problem of staffing. They can be
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under encouragement for group practice. They can't be otherwise, in my estimation.
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That doesn't mean that I am either in favor or against a method of
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practice of medicine. I think one has to be realistic about the situation as it presently exists.
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Now this problem has been
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evaluated for the five hospitals. I have not personally had the opportunity to evaluate it
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for the other five, although I've been told that there is a considerable amount of
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interest among the doctors in the other five hospitals in a similar approach.
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Most of the doctors in Harlan--that's the hospital that has twenty six
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specialists--are prepared to stay under some practice of that type.
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We have worked up a budget for
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the medical group, an income and expense budget for the medical group. If they
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wanted to reorganize themselves on that basis, and based upon
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the cost of operation at the levels of income that they enjoy at the present time,
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and the same salaries paid to para medical personnel as are paid in the hospital,
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and a reduced staffing pattern because they are a little bit too lavish. They can
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operate with a deficit in the region of perhaps sixty seventy
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thousand dollars a year for the first year. And after that, they should be able to operate with no deficits at
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all. So that there may be a need to supplement
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their earnings only for a period of a year, or at least give them some assurance that if they
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do run a deficit it can be met. After the first year, we think there is no possibility at all that
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they'll have to worry about deficit for the operation of their group. They should be able
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competitively to generate enough income from all sources to operate as a group
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practice arrangement. We projected this in
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detail in the report. And, you will see it when you get your final copies.
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We were
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concerned as to how the hospitals might operate from the point of
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view of administration and management and trusteeship. And I would ask
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Mr Dinwiddie, if you don't mind, sir, to pass around to you
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a proposed organization chart for the
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the hospitals. It became apparent that there
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was little or no possibility that the hospitals could be operated
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on the same level or even an approximate level of quality of service if an effort
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were made to operate them independently or by the local communities. We think that the
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only possibility of such an operation lies in a regional plan.
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[Rosenfeld] You notice that the picture on the board, the map on the board, shows
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them as a regional group of hospitals. They were designed this way. Each hospital is
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not a complete entity. And nor can any of them operate
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alone without dependence upon the others. All ten get their
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maintenance and central services from Williamson, which I
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think is in West Virginia. And all of them get a certain amount of
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central administration presently from Doctor Newdorp [Newdorp, John] and his staff in
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Washington. None of the hospitals have facilities
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to encompass all the specialties within their own walls. So that they are
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an integrated group of hospitals. In many ways to continue them as an integrated group would
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be a great achievement because one of the prime problems nationally is
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to find ways of regionalizing hospital services. And, here is a regional
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plan already set up. And, it would be in a way a retrogression if
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this regionalization were not to be maintained. Also in terms of
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board trusteeship and leadership, we came to the conclusion that although there are
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people in each of the counties and in the towns where
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these hospitals are located who could well serve on a regional board,
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there are not sufficient experienced numbers of people in each individual town to
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constitute an adequate board at this time, so that eventually this may be
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possible. There isn't time between now and the closing of the four hospitals to organize such
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boards. It ought to be the long range objective of the church, if you take these
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hospitals all over, to develop local trusteeship, but originally,
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initially, you should, in our estimation, approach this as a regionalization
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program. And, for this reason we have made certain recommendations. And,
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I'm going to resort to reading only in this one instance.
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And that is that if it is your decision
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to take on the obligations of keeping these hospitals open,
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then I think you ought to follow. It ought to accept the following
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proposals. And, therefore I make these proposals to you on a step by step basis.
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That you acquire these hospitals on terms and conditions which are to be
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outlined separately. And that you create an
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Appalachian Regional Hospital board of the Presbyterian Church. Now, I use that
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term. You can use any term you want. But I've used it here only to designate that the
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hospital would be hospitals will be operated by a regional board. I think
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that this board would have to be nominated by the Board of National Missions to get it started.
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And, it would have to be incorporated under such legislation as exists
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in Kentucky and possibly in West Virginia and Virginia to operate these
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hospitals. And, that you should choose for the board
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leading members of the Presbyterian Synod in these states. Lay leaders, businessmen,
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educators, labor leaders and local community representatives.
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I think that this regional board to effectively operate should probably have no more than
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thirty members with an executive of about seven. And I think that like most
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boards in order to make it function well, it ought to have tenure, limited
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tenure, so that new leadership can come forward. And, we've made recommendations specifically on that
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score. This board would then create and set up
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a regional hospital executive and administrative structure
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to operate the hospitals that you acquire. The
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regional executive structure would have to have an executive director. And he would
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then develop a hospital administrative center. And we think the
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center should be in eastern Kentucky. It should be located with direct access to the
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hospitals and not outside of the region. It's. This executive in
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the center would then employ staff or central purchasing, central records, central
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statistics, budgeting policy, accounts payables, payrolls, maintenance, public
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relations and program development. We think that in order to make these hospitals
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community oriented. And to provide a community type of service since up to
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now their service has been largely restricted for the fund
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beneficiaries that you should develop a series of community advisory councils. And,
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you'll notice the councils on this graph that's been given to you.
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These councils should be appointed from among leaders in the individual communities by the
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Appalachian Regional Hospital board. And that. These
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councils then have membership to a regional advisory council to the board.
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We think also that in order to reflect the best
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possible quality of medical care and standards of medical care and to keep these
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standards ethical and within the concepts of
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the leading thinkers in medical education and medical organization that there ought to be a
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medical and hospital regional advisory council available to the regional board.
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And, that this council should be composed of representatives, that is
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professional representatives, of medical schools, Blue Cross
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commissions, the basic science and clinical educators, and of course
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the medical association in the states in which the hospitals are located. It should be
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advisory in a professional sense both to the Appalachian Regional Hospital board of the
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church and to the medical staff organization of the hospitals as this medical staff organization
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develops.
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Now, as we've said, the doctors who are in the Miners Program today
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would presumably reorganize themself into a private practice group. Somebody
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has already dubbed this group the Daniel Boone medical group and you'll find that terminology in your
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copy of the report. And, I will simply use it to designate
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this group of doctors. But they, together with
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the other doctors practicing in the region, would constitute the hospital staffs.
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These staff would then be coordinated, programs
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developed with emphasis upon regional specialty services,
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the development of preventive services, rehabilitation services, and community health services
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through the staffs of these hospitals.
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I think an affiliation can be worked out with the University of Kentucky School of Medicine.
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There has been some indication that they are interested in such an affiliation. And, this would help both
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administratively in terms of staffing and keeping quality of medical care at a high
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level. I think that it's possible under this arrangement to develop a coordinated
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program involving uniform employment policies, staffing patterns, budgeting procedures,
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and the emphasis upon a high degree of local autonomy for the hospital medical staffs.
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It will be necessary simultaneously with these recommendations
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that the doctors in the area, both those in this Daniel Boone medical
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group and those outside of the group who give service to fund beneficiaries,
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work out some arrangement with the United Mine Workers Welfare and Retirement Fund for
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reimbursement. And I'm assured that that can be done and that the
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fund directors are interested in working out a reasonable arrangement with the doctors
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Now among certain policy recommendations, which we think are important if this program is to
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succeed, would be the following. That all licensed physicians in
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the service area of the several hospitals be accorded staff or courtesy privileges based upon
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reasonable professional qualifications and willingness to abide by the rules and regulations of the
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hospitals. That the hospital staff be organized. Rules
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regulations by laws adopting adopted meeting the requirements of the Commission on Accreditation of the
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American Medical Association, American Hospital Association, American College of Surgeons.
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We think that you should not attempt the
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acquisition, operation of the hospitals until you have assurances
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from the Fund that the Fund will continue utilization of the several hospitals for
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fund beneficiaries. And, this has been discussed with representatives of the fund. And, I
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understand that certain assurances are forthcoming in this respect.
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And finally, you cannot possibly operate the hospitals
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on anything approaching a reasonable level of service unless there are some
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assurances that the deficit of operation, representing care to the medically
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indigent, can be met. The level required I've
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already given you. I think the encouragement by either a
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regional hospital council or regional hospital board of community
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councils and advisory councils is important and will help to keep the quality of this
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program high and will give it the status that it needs nationally that the church
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will in effect be creating and conferring upon it. Because up to this time that it's been
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a subject of a good deal of controversy, as you know. I think finally that
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your programs if you adopt it should look forward to about five years or so of
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operation during which time local leadership should be rising up through the advisory
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councils and the regional board so that eventually this will become largely a
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local operation. At the present time I think that neither time nor
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leadership is possible, is available, to carry on such a program at the level
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of service that has been characteristic of the program up to this time.
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We have some assurance already that the Kentucky State
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Medical Association is recognizing the difficulties inherent in
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keeping the staffs intact and are willing to cooperate in this respect.
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I would say to you that the present situation in eastern Kentucky
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in respect to the continued operation of the hospitals presents a challenge to both the
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medical and lay leadership and to you folks to your missionary zeal,
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as well as a challenge to the several governmental units concerned
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to find a way of eliminating the resistance to the group
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practice programme of upon the part of local non Miners doctors, whose charges of
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corporate practice medicine against the Miners original program has been the basis of continued bitterness in the
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area. The program we have outlined here is designed to provide a
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method of maintaining the benefits that have been brought to the community and
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retaining especially services in the area while eliminating the corporate practice of medicine
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and seeks to develop cooperation within the hospital staffs in the communities between these
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doctors practicing in an organized group and those practicing in solo
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practice. It is essential however in developing this necessary cooperation.
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I've put them in the essential purpose however of developing this necessary cooperation is neither the demonstration
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of its feasibility, as important as this may be, but rather the fact that in the absence of
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such a coordinated program and a continuation of the group practice principle, there is little
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possibility of the several hospitals can remain open and continue to provide adequate care of a reasonable
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standard. This is the basic purpose. I could go on with a
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lot of detail but I think that.
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If you want detail you better ask me questions. I've attempted here to summarize
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our findings and our recommendations. And to give you a basis for
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considering whether this is a program that you can undertake. There is
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one other aspect that I want to mention briefly and that is that we've recommended
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a development budget. Aside from the budgets of the hospitals and the central
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budget which would be maintained the central budget by the hospital's income. The
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central budget is included in the deficit projections but in addition to that we've made we
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recommended to you a developmental budget which would be about seventy five
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thousand dollars a year not sustained through hospital operations or part of the
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hospital deficit projections. This would be a budget that you would have to meet directly yourself
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and with that. I'll be happy to attempt to answer any questions that you may have. [Neigh] Thank you, Dr. Rosenfeld.
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OK You're not leaving? No sir. And you will be here to morrow or morning? If you
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wish. I think that it probably is desirable
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to get the whole picture. I've not
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been able to deal either with the question of
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those funds involved in acquiring the hospital
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nor with the problems dealing with
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the operational deficit projected. And, I
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think that it. Probably as we get the picture before us,
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is well for us to get those in front of us in addition to the
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questions you raise concerning the technical aspects of the
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operation of the hospital, together with the statement of the deficits. And if you
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can, sir, I would hope if you would be able to stay
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and be here tomorrow morning. This is a
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United Presbyterian Church and I haven't the vaguest idea what will happen
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to the schedule or left what the
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requirements will be.
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Do you want anything to be said at this time about the capital acquisition? I think we need to do
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that later.
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Yes. And thank you very much for that portion of your
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presentation. Now, as we mentioned,
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Dr Rosenfeld indicated very pointedly, the
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real question of the operation of the hospitals centered around three points,
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the acquisition, the operational deficit and
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the ability to provide a staff. I think before
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anything, and I know how easy it is for mis-
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apprehension
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become embedded in a document upon
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which you will be discussing tomorrow
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will not be this. It will be a statement although this is an
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embodiment of the, is in the statement of the
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operation. Now, the document for
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consideration, the mimeographed sheet that has been placed in your hands.
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Now, some of us as we've gotten involved in this, have
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become utterly amazed
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at the sacrifices that
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many people in very
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busy lives have been willing to make in order to do it.
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To see a way through it. And. The
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governor of Kentucky [Combs, Bert T.] is one of them.
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We felt that
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no one could represent the position of the State
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of Kentucky any more adequately than he. And
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probably without any more feeling. And, he has kindly consented to be
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here. I would like to present to you, those of you who haven't met him,
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Gordon Corbett, [Corbett, Gordon L.], who is the executive of the
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Synod of Kentucky. Now, a lot of discussion about
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grass roots, and the precincts and the administration of National Missions in
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this meeting. One of the strong administrators in the Board of National Missions,
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carrying responsibility, not only for National Missions, but the total program of the United
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Presbyterian Church, is Gordon Corbett, the Executive of the Synod of
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Kentucky, who, Heaven help us!, is a reconstructed
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Baptist.
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[Corbett] Dr. Neigh has
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indicated to you that there are a number of just plain providential
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things in connection with this whole problem. In my judgment,
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one of the very providential things was the employment of Dr Rosenfeld as a
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consultant. If you haven't been overwhelmed by this presentation, let me
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assure you that having spent many days with him, I have been
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continually amazed by the breadth of his knowledge and his skill
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and his compassion in studying this problem. And, we've been most fortunate
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to have him working for us. Dr Neigh also indicated
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that there have been many times that we have ardently wished that we could
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get such a firmly locked door in our faces that we could with a
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clear conscience turn away from this problem. But
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strangely, week after week, one door at a time
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has opened. Now Dr Neigh was very blunt on the executive
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officers in talking to me and to Dr Barrie and saying. You
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can talk about these hospitals as long as you make it plain
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that the United Presbyterian Church has no money to spend on acquisition
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and no money to subsidize operation and surely in any
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sensible world that would have been enough to lock the door and let us out of this
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thing.
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But these doors have opened.
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On Monday I spent all day with the staff of the governor's
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the governor's staff working on a proposal
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whereby the state government would undertake to
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assure us that the cost of taking care of
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indigent people would be assumed by the state government.
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Monday night we met with the governor [Combs, Bert T.]. And, it was my
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first meeting with the governor. And, I looked forward to it with a great deal of interest.
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The governor was brief. He was brusque. He told me the
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facts of life about dealing with the state legislature.
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And, he will tell you about it. I [Corbett] recognized some of what he was saying
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because I assured him that as a staff member, I had great respect for the Board of
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National Missions. And I know that no staff member ever dared to
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predict what this Board would do when it meets.
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But I was appalled. I could picture myself
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standing before you and trying to assure you that it seemed
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reasonable that the state of Kentucky would
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take care of this indigent load. And the governor in his honesty and
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his candor, left so many doors wide open that he could walk out of
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and leave us holding the bag that I was scared.
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Now Tuesday morning we met with representatives of the Union.
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And they're an interesting group. Miss Roche [Roche, Josephine A.],
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the trustee, is a
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lady of about seventy nine or eighty, with snapping black eyes,
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an Irish girl,I believe, the granddaughter of a Methodist bishop
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And she just laid the wood to us.
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She said these hospitals we made the commitment to close
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them last October and we face the fact that we've
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got to send out the severance notices to our staff
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on May first unless we know that someone is going
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to take over these hospitals.
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And I said I can't commit the United Presbyterian Church to take
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these until I know that the state government's going to assure us that we'll
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have the operating money. The governor says I can't call the state legislature to meet
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until the first of June. and the A.R.A. man said and I can't promise any money
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until I know the state will act. Miss Roche smiled. And, she said, "Yes,
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gentlemen, but we have to send out our notices on next Wednesday." And, we
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went round and round the room looking at each other. Who's going to break out of the
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circle? And then we went back. Well we got up and left. There was
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nothing more to say. We went back to the governor's suite and sat
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down and talked a little about it. And it
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became very apparent to me that we United Presbyterians are the
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one people that have got to take the first step and it's a risky one.
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But we've got to make the step. And I said. "Governor,
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I know you can't write a letter that would commit your legislature. It isn't
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done. Would you be willing to send some of your staff up and try to explain to the
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Board more effectively than I could?" And, with that
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brusqueness and brevity that many of us Kentuckians have come to admire
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very much in our governor, he [Combs] said, "Would it help if I came and
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talked to your Board?" Well, I said I'd have to ask
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Dr Neigh. And run it by him.
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But Governor Combs as a concerned dedicated man and I don't need
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to describe him because you'll begin to catch that flavor as he speaks to you.
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He offered to come from Kentucky to meet with you to tell
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you what he can try to do and what he hopes to do.
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And I'm [Corbett] very proud as the Synod Executive of the United Presbyterian Church in
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Kentucky and as a citizen of the Commonwealth to
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introduce the Honorable Bert Combs, the governor of Kentucky.
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T. Oh
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[Combs, Bert T. speaking]Thank
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you very much, Gordon [Corbett]. Mr Chairman, Mr. Rosenfeld,
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members of the Board, distinguished visitors. I suppose it is
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appropriate that
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a reformed Baptist sent me to you. I happen to be the first Baptist governor of Kentucky in
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one hundred years. And my Presbyterian and
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Methodist friends never let me forget it.
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Usually when I am presented, they tell this old
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story that many of you heard, of course. But being a Baptist,
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won't necessarily keep you from sinning. But sure as heck will keep you from enjoying it.
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I'm glad you have the copy of Newsweek.
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L. S. Grigsby is typical of the
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residents of this area. I think you would agree that
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he has a strong face. He has a face with character.
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And, with the proper education,
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with an opportunity, he would be a
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fine Kentuckian and a fine American.
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The "Miner's Lament"
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a scene from which you saw here is not
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exaggerated. It's not minimized, but it's typical
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of this area. I happened to
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be a product of this area. My
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home was in Clay County, close to Harlan, shown on the map here.
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And I live now in Floyd County close to McDowell, where one of the
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other hospitals is located. So
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I know, I suppose, as much about these people, about their potential,
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about their weaknesses as almost anyone.
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And, they do have a great potential. They have a great deal of
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courage and determination and all that.
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Breathitt County, close to Hazard on the map, was the only
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county in the United States in World War One
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which did not have a single person drafted from it.
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They had more than their quota of
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volunteers.
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Kentucky, for the most part, is prosperous.
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The Bluegrass Region is about one hundred miles from this area we ae talking about.
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And today
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in the bluegrass, they're running the Bluegrass
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Stakes, the preliminary to the Kentucky Derby, which will be run on the
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first Saturday in May. And, the rich
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and the influential in this country will be
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at Keeneland racetrack today. And, except that I'm
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here, I would have presented the cup,
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but this is much more important
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We have accumulated in this region not any
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specific problem I suppose which is unusual but an aggravation
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of most of the problems which beset America today.
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The unemployment rate is more than twice as much as the national average
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We have trouble getting new industry into the areas to take the place
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of the dying coal industry.
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And although we have built new parks in the area, although
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we have flood control projects, although we have reforestation projects, although we have spent
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a greater proportion of Kentucky's money in this area, especially since I've been governor
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We really have not begun to solve that problem. And
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when we thought we at least were making a start,
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just a few weeks ago, the most devastating
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flood which has ever occurred in Kentucky, hit this
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area. And before we had
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dug out from the mud and debris left
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by the flood,
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we were afflicted with a great many forest fires. And, they are raging today in this area. And, we
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close the forest by executive order a couple days
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ago. This area of course has been given
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attention
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by a great many people, a great many groups. The Appalachian Governors Conference
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has been formed, composed of about eight governors, Pennsylvania, West Virginia, Kentucky,
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Tennessee, and so on. I served as the chairman of that conference for two
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years and chairman now is Governor Barron[Barron, William Wallace] of West Virginia.
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We were in Washington recently
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in a conference with, I believe, four Cabinet members and the President of the United
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States talking about the problems
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of the Southern Appalachian region. And, the president has
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appointed a task force to get a program going. An
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overall problem for this area.
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These hospitals are a symbol of
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a better way of life.
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They were constructed five or six years ago when the coal
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industry was much more prosperous and at a time when all of us thought
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the future look brighter. And the miners
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particularly have come to visualize these
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hospitals as a symbol of a few of the
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good things of life, at least adequate medical treatment.
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If these hospitals close, the whole program collapses. The President's [John F. Kennedy]
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task force might as well stay in Washington.
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The program of the Appalachian Governors
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Conference will never get off the ground.
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Conditions couldn't be worse if these hospitals should fold, because
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a vestige of hope, almost the last vestige, perhaps
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while these people
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will have been destroyed.
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And I've been suggested that maybe these people all just move out of eastern Kentucky and West Virginia
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Southern Appalachian region, but they're just not going to do it.
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and so all that is not the solution. They are going to stay there.
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We've built a modern four-lane highway in eastern
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Kentucky. And, I've been criticized some for that. A fellow said to me, "Why would you build a road up
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there? You've got nothing but people and people without any money at that." And I
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told him the story about old Fess Whitaker, who lived in Letcher County, close to Hazard here.
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Old Fess was the jailor for the county. And, every time he ran for re-election he would
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harangue the people about what a great hero he'd been in the Spanish-American War, and how they should vote for
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him.
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Well, he would say, "I was one of the real genuine bona fide heroes. I rode
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in the great Teddy Roosevelt Roughriders." And say, "We rode up San
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Juan Hill on our horses stirrup to stirrup, slaying the Spaniards as we went.
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We got to the top of the hill, looked over the plains and saw the Spaniards in the distance.
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There I sat on my horse, stirrup to stirrup with Teddy Roosevelt." He said, "Teddy
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turned to me. And, he said Fess, "That we won the war. We'll be
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famous."
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I said one of us will probably President. And Fess said, "I said to
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Teddy. Teddy, you be president. All I want to be is the jailor of Letcher County,
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Kentucky."
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And so, we can't move them out. They're going to stay. We have
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tried to improve the schools. We have passed a three percent sales tax in Kentucky with
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a great deal of protest as you might imagine. And I was introduced the
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other day as
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the first Baptist governor, as I told you. Smart aleck up front. There's always one, you know. Said, "Yes,
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and you'll be the last one in one hundred years if you don't do something about this sales tax." But
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sixty seven percent of that tax revenue goes for education.
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And so given time, given an opportunity
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the younger
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Ellis Creek Spears will be educated and be
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capable of taking their place in this world.
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Now. The State Government of course cannot get in the hospital business. The medical
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association wouldn't permit it.
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And it is not a proper function of the state government.
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But given an opportunity a vehicle through which state government can
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work, the legislature of Kentucky. I'm entirely convinced
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that the legislature would not subsidize a
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program, that wouldn't be the proper word, but
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the legislature, in my judgment, will pass
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legislation enacting a program into law
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which will make it possible for these hospitals to be operated
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without a deficit. And we can do that through the so called per meal fill
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then medical assistance program to indigent people.
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And certainly nobody.
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Lon Rogers [Rogers, Lon B.] I see sitting back here lives in that area [Pikeville, KY] now.
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Nobody would deny that this would be a proper
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function of state to make it possible for the government to
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pay to indigent citizens enough of their medical bills
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that the program to be operated without a deficit
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[Bert Combs] It's been suggested that might be seven hundred fifty thousand dollars per year.
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But, we can handle that much
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money. The legislature, in my judgment, would not hesitate to make a
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sufficient appropriation
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to cover that. We cannot get the legislature into session
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with any hope of success before June first. We're
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having a primary election in Kentucky. And, if you have heard about Kentucky elections, you would know
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why we can't have a session of the legislature this month. But after
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the first of June, I repeat.
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I'm thoroughly convinced that the legislature would
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pass legislation making it possible for the state to contribute sufficient
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funds to prevent an operating deficit
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Now I cannot say that to the papers, and I hope we have no reporters here. The only
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reason in my judgment which would prevent a legislature from doing it, would be that they thought I had come up here and
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said they would.
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And so, I don't want you to say that I said that when you get back home. Because
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you got one hundred thirty-eight members of that legislature. And each of them is a prima
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donna, a big wheel in his own right. and so the
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reason they would pass it would be that we would say to them, the need is great. And we can keep the
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hospital open if you do this. They do happen to
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be in a majority with the state administration. I
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happen to be a Democrat and most of the legislature are members of the same party so
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I have some reason to think I can predict what they might do. Now, I
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understand of course that one of the conditions here is subject to a grant
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by the A.R. A. I'm not sure that anybody us here from the federal government
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today. I understand you perhaps have a letter or a message, and somebody else will report on that. But,
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I have been in Washington recently. And, I have
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discussed with some of the people of the possibility of making this grant possible
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which would permit the acquisition of the hospital and without
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attempting to anticipate him certainly I am encouraged by their
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attitude. I think that there is a very definite possibility
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that they A.R.A. grant will be forthcoming, making it possible for
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your group to purchase the hospitals, conditioned on the
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legislature of Kentucky passing the necessary legislation, which I think
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probably could be done in the first part of June.
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The need is great. It's
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very great. There is no other way in my judgment, by
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which these hospitals can remain open.
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I'm not going to attempt to minimize the problems. There are
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problems. But a great many Kentuckians,
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great many loyal Americans
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will be praying today that you will
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undertake this task.
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Anybody have any questions?
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Thank you very much.
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[Kenneth Neigh] Governor, I know that your time is at a premium.
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I hope that you will stay as long as you can, but please feel free to leave
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at any time that it is
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urgent for you to leave.
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Bob. I'm really naked without Bob, [Barrie, Bob]
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today. Dr. Neigh,
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[Bob Barrie speaking] I think maybe it might be time to give you such word as we have from the Area Redevelopment
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Administration about the acquisition costs. I really don't mean to be
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as dramatic as this is, but literally I didn't have the letter until after the governor started to speak.
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I knew what was going to be in it because it had been read to me last night on the telephone and I would now like to
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read it to you. It is on the letterhead of the United States
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Department of Commerce Area Redevelop Administration. It is signed by the acting
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administrator for the Administration, Mr H. W. Williams. Dear Mr Barrie.
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The Area Redevelopment administration is prepared to receive
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and give immediate attention to a request from the Presbyterian Board of
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National Missions or an appropriate community or area trust entity for a
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grant under Section eight of the Area Redevelopment Act to finance the acquisition of
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all or a group of the ten hospitals now owned and operated by the Miners Memorial
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Welfare Association in the states of Kentucky, West Virginia and Virginia.
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Among the factors which would influence our decision are the following: one a
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negotiation of a minimum purchase price for the hospitals; two, the assurance
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that adequate provisions have been made for the continued long term operation of the hospitals;
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and three, a finding of compliance with our statutes and regulations.
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Now, against the background of many conferences with the staff of the A. R. A. and a
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great number of telephone calls over the past few days,
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in my personal judgment,
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this letter constitutes a virtual commitment to make it
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possible for us to acquire the hospitals without any expenditure of Board of
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National Missions funds.
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[Kenneth Neigh] Mr. Chairman, may I add, Mr. President, two other
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germane. At least it seems to me germane,
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observations. The first has to do with
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the matter of group practice. It has said,
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and said I think a little too easily, that and
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probably inaccurately that what we are doing here is
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de-socializing medicine. But, what we have attempted to do
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is to create a program by which the best in group
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practice and best in the practice of
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medicine that has been a part, a very great part,
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of the success of these hospitals. With reference to that
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on last Sunday afternoon, Mr Barrie
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met with the. Was it the trustees, Bob, of the
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Kentucky Medical Association? And
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we don't have, I think, the original of this action
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but here are the actions as they
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came to us from the Executive Secretary of the Kentucky Medical
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Association. "Resolve: That the Kentucky State
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Medical Association wishes to commend the Presbyterian Church for the
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humanitarian effort to keep these hospitals in operation.
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Resolved: Further, that we feel that the members
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of the Kentucky Medical Association who provide medical
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care to the patients in those hospitals."
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And, then there are three provisions. Most of
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the three are. Have been
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outlined or have been discussed
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by Dr Rosenfeld [Rosenfeld, Eugene D.] in his,
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in his, statement and which,
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I think, open the door almost
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completely or for the complete cooperation and understanding of
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the State Medical Association, subject to certain
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negotiations about principle. Following, and then further.
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"The Board of Trustees of the Kentucky Medical Society
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[Kenneth Neigh] Jim [Gailey, James R.], this is like the Board of Christian Education. I could never understand what the initials mean.
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K. S. M. A., which is the medical association, stands
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ready to cooperate in the future with the concerned parties in
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implementing this program in keeping with these policies."
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This would seem to say that the Kentucky
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Medical Association. Well, it does say. We are congratulated
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on the humanitarian effort to keep the thing in operation.
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Dr. Neigh, that has been confirmed, we just haven't been able to keep in communication fast
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enough, but I do have a
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sign.