Special Message to the Congress: "Education and Health in America.

To the Congress of the United States:

In Edmonds, Washington, three new evening classes today are helping 150 high school dropouts finish school and gain new job skills.

In Detroit, a month ago, 52,000 children were immunized against measles, during a campaign assisted by Federal funds.

In 25 states, Federal funds are helping improve medical care for 6.4 million citizens who get public assistance.

Over 8 million poor children are now getting a better education because of funds provided under Title I of the Elementary and Secondary Education Act. Nineteen million older citizens enjoy the protection of Medicare.

Three years ago, not one of these programs existed.

Today, they are flourishing--because a concerned people and the creative 89th Congress acted. They are the result of twenty-four new health laws and eighteen new education laws.

But even the best new programs are not enough.

Today, we face major challenges of organization and evaluation. If our new projects are to be effective, we must have the people to run them, and the facilities to support them. We must encourage states and localities to plan more effectively and comprehensively for their growing needs and to measure their progress towards meeting those needs.

Above all, each community, each state, must generate a spirit of creative change: a willingness to experiment.

In this, my fourth message to Congress on Health and Education, I do not recommend more of the same--but more that is better: to solve old problems, to create new institutions, to fulfill the potential of each individual in our land.

Nothing is more fundamental to all we seek than our programs in health and education:

Education--because it not only overcomes ignorance, but arms the citizen against the other evils which afflict him.

Health--because disease is the cruelest enemy of individual promise and because medical progress makes less and less tolerable that illness still should blight so many lives.

I. EDUCATION

I believe that future historians, when they point to the extraordinary changes which have marked the 1960's, will identify a major movement forward in American education.

This movement, spurred by the laws of the last three years, seeks to provide equality of educational opportunity to all Americans-to give every child education of the highest quality, no matter how poor his family, how great his handicap, what color his skin, or where he lives.

We cannot yet fully measure the results of this great movement in American education. Our progress can be traced partially by listing some of the extraordinary bills I have signed into law:

--The Higher Education Act of 1965.

--The Elementary and Secondary Education Act of 1965.

--The Higher Education Facilities Act of 1963.

--The Vocational Education Act of 1963.

The scale of our efforts can be partially measured by the fact that today appropriations for the Office of Education are nearly seven times greater than four years ago. Today we can point to at least one million college students who might not be in college except for government loans, grants and work-study programs, and to more than 17,500 school districts helping disadvantaged children under the Elementary and Secondary Education Act.

This breakthrough is not the work of Washington alone. The ideas for these programs come from educational leaders all over the country. Many different communities must supply the energy to make these programs work. Yet they are national programs, shaped by national needs. Congress has played a vital role in reviewing these needs and setting these priorities.

The new Federal role in education is, in reality, a new alliance with America's states and local communities. In this alliance, the Federal Government continues to be a junior partner:

--Local school districts will submit, and state governments will approve, the plans for spending more than one billion dollars this year to improve the education of poor children.

--Federal funds for vocational education are administered through state plans controlled by state, not Federal, officials.

--The recommendations of the states have been sought and followed in more than 95 percent of the projects for centers and services which are funded by the U.S. Office of Education.

The education programs I recommend this year have three major aims:

--To strengthen the foundations we have laid in recent years, by revising, improving, and consolidating existing programs.

--To provide special help to those groups in our society with special needs: the poor, the handicapped, victims of discrimination or neglect.

--To build for the future by exploiting the new opportunities presented by science, technology and the world beyond our borders.

The budget proposals I am making for 1968 will carry forward our efforts at a new level. The total Federal dollar expenditures for educational purposes, including health training, which I have proposed for fiscal 1968 will amount to $11 billion--an increase of $1 billion, or 10 percent, over 1967 and $7 billion, or 175 percent, over 1963.

STRENGTHENING EDUCATION PROGRAMS

State and community education leaders have shouldered heavy new burdens as a result of recent increases in Federal programs. If these officials are to develop wise and long-range plans for education, they must have more help.

The Elementary and Secondary Education Act has provided funds to strengthen state departments of education. But additional funds are needed--money to improve community, state, and regional educational planning. Nothing can do more to ensure the effective use of Federal dollars.

I recommend legislation authorizing $15 million to help state and local governments evaluate their education programs and plan for the future.

A Better Education Timetable

One condition which severely hampers educational planning is the Congressional schedule for authorizations and appropriations. When Congress enacts and funds programs near the end of a session, the Nation's schools and colleges must plan their programs without knowing what Federal resources will be available to them to meet their needs. As so many Governors have said, the Federal legislative calendar often proves incompatible with the academic calendar.

I urge that the Congress enact education appropriations early enough to allow the Nation's schools and colleges to plan effectively. I have directed the Secretary of Health, Education, and Welfare to work with the Congress toward this end.

Another way to ease this problem is to seek the earliest practical renewal of authorization for major education measures.

I recommend that Congress this year extend three major education measures now scheduled to expire in June 1968:

--The National Defense Education Act of 1958.

--The Higher Education Act of 1965.

--The National Vocational Student Loan Insurance Act of 1965.

Improving Program Evaluation

Most of our education programs have been operating too short a time to provide conclusive judgments about their effectiveness. But we should be heartened by the evaluations so far.

Recently, the National Advisory Council on the Education of Disadvantaged Children reported:

"The morale of teachers and administrators in schools with many poor children-their will to succeed and their belief in the possibility of succeeding--is perceptibly on the rise in many of the schools visited. More teachers than ever are involved in an active search for paths to success. The paths are not all clearly visible as yet, but decidedly the search has taken on a new vigor."

The council did identify problems and weaknesses in the school districts. Our efforts to identify shortcomings and to assess our progress can never be fully effective until we provide sufficient resources for program evaluation.

I have requested $2.5 million to assure careful analysis of new programs so that we can provide a full accounting to the Congress and the American people of our successes and shortcomings.

The Education Professions Act of 1967

Our work to enrich education finds its focus in a single person: the classroom teacher, who inspires each student to achieve his best.

Next year, more than 170,000 new teachers will be needed to replace uncertified teachers, to fill vacancies and to meet rising student enrollments. Moreover:

--There are severe shortages of English, Mathematics, Science and elementary school teachers.

--More teachers are needed for our colleges and junior colleges.

--Well trained administrators at all levels are critically needed.

--New kinds of school personnel--such as teachers aides--are needed to help in the schools.

--By 1975, the nation's schools will need nearly two million more new teachers. To help meet this growing demand, the Federal government has sponsored a number of programs to train and improve teachers.

These programs, though they have been effective, have been too fragmented to achieve their full potential and too limited to reach many essential sectors of the teaching profession. Teacher aides and school administrators have not been eligible to participate.

We must develop a broader approach to training for the education professions. At the state and local level, education authorities must have greater flexibility to .plan for their educational manpower needs.

I recommend the Education Professions Act of 1967 to:

--Combine and expand many of the scattered statutory authorities for teacher training assistance.

--Provide new authority for the training of school administrators, teacher aides, and other education workers for schools and colleges.

Improving Student Loan Programs

In the Higher Education Act of 1965, Congress authorized a program to support state guarantees for student loans made by banks and other lending institutions. For students of modest means, the Federal Government also subsidizes the interest cost.

The program has become an example of creative cooperation between the Federal Government, the states, private financial institutions and the academic community.

Though it began in a time of tight credit, the program is off to a promising start. This year, it is expected that loans totalling $400 million will be made to nearly 480,000 students. By 1972, outstanding loans are expected to total $6.5 billion.

I have asked all of the government officials concerned with the program--the Secretary of Health, Education, and Welfare, the Secretary of the Treasury, the Director of the Budget, and the Chairman of the Council of Economic Advisers--to review its operations in consultation with state and private organizations concerned.

If administrative changes in the program are necessary, we will make them. If any amendments to the legislation are in order, we will submit appropriate recommendations to the Congress.

SPECIAL PROGRAMS FOR SPECIAL NEEDS

Educating Poor Children

Over the past two years, we have invested more than $2.6 billion in improving educational opportunities for more than ten million poor children. This has been an ambitious venture, for no textbook offers precise methods for dealing with the disadvantaged. It has also been rewarding: we have generated new energy, gained new workers and developed new skills in our effort to help the least fortunate.

Dollars alone cannot do the job--but the job cannot be done without dollars.

So let us continue the programs we have begun under Head Start and the Elementary and Secondary Education Act.

Let us begin new efforts-like the Head Start Follow Through program which can carry forward into the early grades the gains made under Head Start.

The Teacher Corps

Young as it is, the Teacher Corps has become a symbol of new hope for America's poor children and their parents--and for hard pressed school administrators.

More than 1200 interns and veteran teachers have volunteered for demanding assignments in city and rural slums. Teacher Corps volunteers are at work in 275 schools throughout the country: helping children in 20 of our 25 largest cities, in Appalachia, in the Ozarks, in Spanish-speaking communities.

The impact of these specialists goes far beyond their number. For they represent an important idea: that the schools in our Nation's slums deserve a fair share of our Nation's best teachers.

Mayors and school officials across the country cite the competence, the energy, and the devotion which Teacher Corps members are bringing to these tasks.

Perhaps the best measure of the vitality of the Teacher Corps is the demand by school districts for volunteers and the number of young Americans who want to join. Requests from local schools exceed by far the number of volunteers we can now train. Ten times as many young Americans as we can presently accept--among them, some of our brightest college graduates--have applied for Teacher Corps service.

The Teacher Corps, which I recommended and which the 89th Congress established, deserves the strong support of the 90th Congress.

I recommend that the Teacher Corps be expanded to a total of 5,500 volunteers by the school year beginning in September 1968.

I propose amendments to enhance the role of the states in training and assigning Teacher Corps members.

Finally, to finance next summer's training program, I strongly recommend early action on a supplemental appropriation request of $2.5 million for the Teacher Corps in fiscal year 1967. Educating the Handicapped

One child in ten in our country is afflicted with a handicap which, if left untreated, severely cripples his chance to become a productive adult.

In my Message on Children and Youth, I proposed measures to bring better health care to these children--the mentally retarded, the crippled, the chronically ill.

We must also give attention to their special educational needs. We must more precisely identify the techniques that will be effective in helping handicapped children to learn.

We need many more teachers who have the training essential to help these children. There are now only 70,000 specially trained teachers of the handicapped--a small fraction of the number the Nation requires. In the next decade, five times that number must be trained and put to work.

I recommend legislation to:

--Establish regional resource centers to identify the educational needs of handicapped children and help their parents and teachers meet those needs.

--Recruit more men and women for careers in educating the handicapped.

--Extend the service providing captioned films and other instructional materials for the deaf to all handicapped people.

Ending Discrimination

Giving every American an equal chance for education requires that we put an end once and for all to racial segregation in our schools.

In the Civil Rights Act of 1964, this Nation committed itself to eliminating segregation. Yet patterns of discrimination are still entrenched in many communities, North and South, East and West.

If equal opportunity is to be more than a slogan in our society, every state and community must be encouraged to face up to this legal and moral responsibility.

I have requested $30 million--nearly a four-fold increase over this year's appropriation-to provide the needed resources under Title IV of the Civil Rights Act to help states and communities face the problems of school desegregation.

Education for the World of Work

Three out of ten students in America drop out before completing high school. Only two out of ten of our Nation's young men and women receive college degrees.

Too few of these young people get the training and guidance they need to find good jobs.

I recommend legislation to aid secondary schools and colleges to develop new programs in vocational education, to make work part of the learning experience and to provide career-counseling for their students.

A number of our colleges have highly successful programs of cooperative education which permit students to vary periods of study with periods of employment. This is an important educational innovation that has demonstrated its effectiveness. It should be applied more widely in our schools and universities.

I recommend an amendment of the College Work-Study Program which will for the first time permit us to support cooperative education projects.

I am also requesting the Director of the Office of Economic Opportunity and the Secretary of Labor to use Neighborhood Youth Corps funds at the high school level for this purpose.

Combating Adult Illiteracy

At least three million adults in America cannot read or write. Another 13 million have less than an eighth grade education. Many of these citizens lack the basic learning to cope with the routine business of daily life.

This is a national tragedy and an economic loss for which each one of us must pay.

The Adult Education Act, enacted last year, is our pledge to help eliminate this needless loss of human talent.

This year, I am requesting $44 million-an increase o! nearly fifty percent--for adult basic education programs.

These funds will help new projects, sponsored by both public agencies and non-profit private groups, to train volunteers for work in adult literacy programs and to establish neighborhood education programs reaching beyond the formal classroom.

BUILDING FOR TOMORROW

Public Television

In 1951, the Federal Communications Commission set aside the first 242 television channels for non-commercial broadcasting, declaring:

"The public interest will be clearly served if these stations contribute significantly to the educational process of the Nation."

The first educational television station went on the air in May 1953. Today, there are 178 non-commercial television stations on the air or under construction. Since 1963 the Federal Government has provided $32 million under the Educational Television Facilities Act to help build towers, transmitters and other facilities. These funds have helped stations with an estimated potential audience of close to 150 million citizens.

Yet we have only begun to grasp the great promise of this medium, which, in the words of one critic, has the power to "arouse our dreams, satisfy our hunger for beauty, take us on journeys, enable us to participate in events, present great drama and music, explore the sea and the sky and the winds and the hills."

Non-commercial television can bring its audience the excitement of excellence in every field. I am convinced that a vital and self-sufficient non-commercial television system will not only instruct, but inspire and uplift our people.

Practically all non-commercial stations have serious shortages of the facilities, equipment, money and staff they need to present programs of high quality. There are not enough stations. Interconnections between stations are inadequate and seldom permit the timely scheduling of current programs.

Non-commercial television today is reaching only a fraction of its potential audience-and achieving only a fraction of its potential worth.

Clearly, the time has come to build on the experience of the past fourteen years, the important studies that have been made, and the beginnings we have made.

I recommend that Congress enact the Public Television Act of 1967 to:

--Increase federal funds for television and radio facility construction to $10.5 million in fiscal 1968, more than three times this year's appropriations.

--Create a Corporation for Public Television authorized to provide support to non-commercial television and radio.

--Provide 19 million in fiscal 1968 as initial funding for the Corporation. Next year, after careful review, I will make further proposals for the Corporation's long-term financing.

Non-commercial television and radio in America, even though supported by federal funds, must be absolutely free from any federal government interference over programming. As I said in the State of the Union Message, "we should insist that the public interest be fully served through the public's airwaves".

The board of directors of the Corporation for public television should include American leaders in education, communications and the creative arts. I recommend that the board be comprised of fifteen members, appointed by the President and confirmed by the Senate.

The Corporation would provide support to establish production centers and to help local stations improve their proficiency. It would be authorized to accept funds from other sources, public and private.

The strength of public television should lie in its diversity. Every region and every community should be challenged to contribute its best.

Other opportunities for the Corporation exist to support vocational training for young people who desire careers in public television, to foster research and development, and to explore new ways to serve the viewing public.

One of the Corporation's first tasks should be to study the practicality and the economic advantages of using communication satellites to establish an educational television and radio network. To assist the Corporation, I am directing the Administrator of the National Aeronautics and Space Administration and the Secretary of Health, Education, and Welfare to conduct experiments on the requirements for such a system, and for instructional television, in cooperation with other interested agencies of the government and the private sector.

Formulation of long-range policies concerning the future of satellite communications requires the most detailed and comprehensive study by the Executive Branch and the Congress. I anticipate that the appropriate committees of Congress will hold hearings to consider these complex issues of public policy. The Executive Branch will carefully study these hearings as we shape our recommendations.

Instructional Television

I recommend legislation to authorize the Secretary of Health, Education, and Welfare to launch a major study of the value and the promise of instructional television which is being used more and more widely in our classrooms, but whose potential has not been fully developed.

Computers in Education

In my 1968 Budget, I propose that the National Science Foundation be given new resources to advance man's knowledge and serve the Nation. Its endeavors will help our scholars better to understand the atmosphere, exploit the ocean's riches, probe the behavior and the nature of man.

The Foundation will also step up its pioneer work to develop new teaching materials for our schools and colleges. The "new math" and the "new science" are only the first fruits of this innovative work.

One educational resource holds exciting promise for America's classrooms: the electronic computer. Computers are already at work in educational institutions, primarily to assist the most advanced research. The computer can serve other educational purposes-if we find ways to employ it effectively and economically and if we develop practical courses to teach students how to use it.

I have directed the National Science Foundation working with the U.S. Office of Education to establish an experimental program /or developing the potential of computers in education.

Enriching the Arts and the Humanities

Our progress will not be limited to scientific advances. The National Foundation on the Arts and the Humanities, established in 1965, has already begun to bring new cultural and scholarly spirit to our schools and communities. State arts councils, museums, theaters, and orchestras have received not only new funds but new energy and enthusiasm through the National Endowment for the Arts.

The National Endowment for the Humanities has made grants to support new historical studies of our Nation's heritage, to encourage creative teaching in our colleges, to offer outstanding young scholars opportunities for advancement.

I recommend that Congress appropriate for the National Foundation on the Arts and Humanities $16 million--an increase of nearly one-third.

Higher Education for International Understanding

For many years, America's colleges and universities have prepared men and women for careers involving travel, trade and service abroad. Today, when our world responsibilities are greater than ever before, our domestic institutions of higher learning need more support for their programs of international studies.

The 89th Congress, in its closing days, passed the International Education Act--an historic measure recognizing this Nation's enduring belief that learning must transcend geographic boundaries. Through a program of grants under the Act, America's schools, colleges, and universities can add a world dimension to their students' learning experience.

I urge the Congress to approve promptly my forthcoming request for a supplemental appropriation of $350,000 for the International Education Act, to permit necessary planning for next year's program, as well as an appropriation of $20 million for fiscal 1968.

II. HEALTH

No great age of discovery in history can match our own time. Today, our wealth, our knowledge, our scientific genius give us the power to prolong man's life--and to prevent the erosion of life by illness.

In 1900, an American could expect to live only 49 years. Today, his life expectancy has been increased to 70 years.

These advances are the result of spectacular progress in research, in public health, in the medical arts. We have developed:

--Sufficient knowledge to end nearly all of the hazards of childbirth and pregnancy.

--Modern nutrition to wipe out such ailments as rickets, goiter, and pellagra.

--Vaccines, antibiotics and modern drugs to control many of the killers and cripplers of yesterday: polio, diphtheria, pneumonia.

--New medical and surgical techniques to combat cancer and cardiovascular disease.

--Life-saving devices: plastic heart valves, and artificial artery transplants.

In 1967, to pursue this vital work, the Federal Government is investing more than $440 million in the construction of health facilities, $620 million for health manpower education and training, $1.3 billion in biomedical research, $7.8 billion to provide medical care.

But each gain, each victory, should focus our attention more sharply on the unfinished business facing this Nation in the field of health:

--Infant mortality is far higher than it need be.

--Handicaps afflicting many children are discovered too late or left untreated.

--Grave deficiencies remain in health care for the poor, the handicapped and the chronically ill.

--American men between the ages of 45 and 54--which should be the most productive years of their lives--have a death rate twice that of men of the same age in a number of advanced countries.

--We still search in vain for ways to prevent and treat many forms of cancer.

--Many types of mental illness, retardation, arthritis and heart disease are still largely beyond our control.

Our national resources for health have grown, but our national aspirations have grown faster. Today we expect what yesterday we could not have envisioned--adequate medical care for every citizen.

My health proposals to the 90th Congress have four basic aims:

--To expand our knowledge of disease and our research and development of better ways to deliver health care to every American;

--To build our health resources, by stepped up training of health workers and by improved planning of health facilities;

--To remove barriers to good medical care for those who most need care;

--To strengthen our Partnership for Health by encouraging regional, state, and local efforts--public and private--to develop comprehensive programs serving all our citizens.

HEALTH RESEARCH AND DEVELOPMENT: THE FOUNDATION OF OUR EFFORTS

Supporting Biomedical Research

Our progress in health grows out of a research effort unparalleled anywhere in the world. The scientists of the National Institutes of Health have shaped an alliance throughout the nation to find the causes and the cures of disease.

We must build on the strong base of past research achievements, exchange ideas with scholars and students from all parts of the world, and apply our knowledge more swiftly and effectively.

We must take advantage of our progress in targeted research as we have done in our vaccine development program, in the heart drug study, in artificial kidney and kidney transplant research, and in the treatment of specific types of cancer.

In the 1968 budget, I am recommending an increase of $65 million--to an annual toted of almost $1.5 billion--to support biomedical research.

I am seeking funds to establish an International Center for Advanced Study in the Health Sciences and to provide scholarships and fellowships in the Center.

I am directing the Secretary of Health, Education, and Welfare to appoint immediately a lung cancer task force, to supplement the continuing work of existing task forces on leukemia, cancer chemotherapy, uterine cancer, solid tumor and breast cancer.

Health Services Research and Development

America's annual spending for health and medical care is more than $43 billion. But despite this investment, our system of providing health services is not operating as efficiently and effectively as it should.

--In some U.S. counties infant mortality rates, one yardstick of health-care, are 300 percent higher than the National average.

--Seventy percent of automobile accident deaths occur in communities of less than 2500 people, where medical facilities are often poorest.

--Even though we have good techniques for detecting and curing cervical cancer, eight thousand women die each year for lack of proper care.

--Emergency rooms in U.S. hospitals are seriously overcrowded, not with actual emergency cases, but with people who cannot find normal outpatient care anywhere else.

Research and development could help eliminate these conditions by 'pointing the way to better delivery of health care. Yet the government-wide total investment in health service research amounts to less than one-tenth of one percent of our total annual investment in health care.

We have done very little to mobilize American universities, industry, private practitioners, and research institutions to seek new ways of providing medical services.

There have been few experiments in applying advanced methods--systems analysis and automation, for example--to problems of health care.

Our superior research techniques have brought us new knowledge in health and medicine. These same techniques must now be put to work in the effort to bring low cost, quality health care to our citizens.

We must marshal the nation's best minds to:

--Design hospitals, nursing homes and group practice facilities which provide effective care with the most efficient use of funds and manpower;

--Develop new ways of assisting doctors to reach more people with good health services;

--Devise new patterns of health services. To begin this effort, I have directed the Secretary of Health, Education, and Welfare to establish a National Center for Health Services Research and Development.

I recommend legislation to expand health services research and make possible the fullest use of Federal hospitals as research centers to improve health care.

I also recommend an appropriation of $20 million to the Department of Health, Education, and Welfare in 1968, for research and development in health services--nearly twice as much as in 1967.

DEVELOPING MANPOWER AND FACILITIES FOR HEALTH

Health Manpower

The United States is facing a serious shortage of health manpower. Within the next decade this nation will need one million more health workers. If we are to meet this need, we must develop new skills and new types of health workers. We need short-term training programs for medical aides and other health workers; we need programs to develop physicians' assistants, and speed the training of health professions. We also need to make effective use of the thousands of medical corpsmen trained in the Armed Forces who return to civilian life each year.

Last May, I appointed a National Advisory Commission on Health Manpower to recommend how we can:

--Speed the education of doctors and other health personnel without sacrificing the quality of training;

--Improve the use of health manpower both in and outside the government.

Meanwhile, I directed members of my Cabinet to intensify their efforts to relieve health manpower shortages through Federal programs. This week they reported to me that federally-supported programs in 1967 will train 224,000 health workers--an increase of nearly 100,000 over 1966. Thirty thousand previously-inactive nurses and technicians will be given refresher training this year.

Through the teamwork of Federal and state agencies, professional organizations and educational institutions, we have launched a major effort to provide facilities and teachers for this immense training mission.

To maintain this stepped-up training already started in fiscal year 1967, I am recommending expenditures of $763 million-a 22 percent increase/or fiscal year 1968--to expand our health manpower resources.

Planning for Future Health Facilities

Over the past two decades, the Hill-Burton program has assisted more than 3,400 communities to build hospitals, nursing homes and other health care centers. Hill-Burton funds have helped to provide 350,000 hospital and nursing home beds, and to bring modern medical services to millions of Americans. The authorization for this program expires on June 30, 1969. The contribution of the Federal Government in financing construction of health facilities has changed, especially with the beginning of Medicare, Medicaid, and other new programs. It is timely, therefore, that we take a fresh look at this area.

I am appointing a National Advisory Commission on Health Facilities to study our needs /or the total system of health facilities--hospitals, extended care facilities, nursing homes, long-term care institutions, and clinics. In addition to considering the future of the Hill-Burton Program, the Commission will make recommendations for financing the construction and modernization of health facilities.

ELIMINATING BARRIERS TO HEALTH CARE

In previous messages to Congress this year, I have made recommendations to:

--Extend Medicare to 1.5 million seriously disabled Americans under age 65.

--Establish new health services through broader maternal and child health programs; a strengthened Crippled Children's program, and new projects in child health and dental care.

--Improve medical services for the needy under Medicaid.

--Combat mental retardation by supporting construction of university and community centers for the mentally retarded, and for the first time, helping to staff the community centers.

--Guarantee the safety of medical devices and laboratory tests by requiring Food and Drug Administration pre-clearance of devices, and by requiring licensing of clinical laboratories in interstate commerce.

We must act in other ways to overcome barriers to health care.

The Office of Economic Opportunity has developed a program of Neighborhood Health Centers which not only bring modern medical care to the poor but also train citizens for jobs in the health field.

Last year, Congress endorsed this new approach and authorized funds for 24 such centers. More are needed.

I am requesting the Director of the Office of Economic Opportunity to encourage communities to establish additional centers. Our goal will be to double the number of centers in fiscal 1968.

In the past four years, we have launched a new program to attack mental illness through community mental health centers. This program is now well underway. More centers are needed, and we must strengthen and expand existing services.

I recommend legislation to extend and improve the Community Mental Health Centers Act.

Among the most tragically neglected of our citizens are those who are both deaf and blind. More than 3,000 Americans today face life unable to see and hear.

To help reach the deaf-blind with the best programs our experts can devise, I recommend legislation to establish a National Center/or the Deaf and Blind.

Ending Hospital Discrimination

With the launching of the Medicare program last July, the Nation took a major step toward ending racial segregation in hospitals.

More than 95 percent of the Nation's hospitals have already complied with the antidiscrimination requirements of the Medicare legislation. They are guaranteeing that there will be no "second-class patients" in our health-care institutions; that all citizens can enter the same door, enjoy the same facilities and the same quality of treatment.

We will continue to work for progress in this field--until equality of treatment is the rule not in some, but in all of our hospitals and other health facilities.

Rising Medical Costs

In 1950, the average cost per patient per day in a hospital was $14.40. In 1965, this cost more than tripled to over $45. Other health costs have also risen sharply in recent years.

Last August, I asked the Secretary of Health, Education, and Welfare to initiate a study of medical costs. This study, now completed, indicates that medical costs will almost certainly continue to rise. It emphasizes the absolute necessity of using medical resources more efficiently if we are to moderate this increase in the cost of health care.

This is a job for everyone who plays a part in providing or financing medical care--the medical profession, the hospital industry, insurance carriers, state and local governments and many other private and public groups. Federal programs must also play a role in promoting cost consciousness in medical care.

The new National Center for Health Services Research and Development will develop ways to make our medical systems more efficient. The Center's first assignment will be to develop new ways to improve the use of professional and auxiliary health workers--a key factor in reducing hospital costs. We can take other steps.

I am directing Secretary John Gardner to convene at the Department of Health, Education, and Welfare a National Conference on Medical Costs.

This conference will bring together leaders of the medical community and members of the public to discuss how we can lower the costs of medical services without impairing the quality.

In the weeks and months ahead, the Secretary of Health, Education, and Welfare will consult with representatives of the medical profession, universities, business and labor to:

--find practical incentives for the effective operation of hospitals and other health facilities.

--reduce the costs of construction and speed the modernization of hospitals, nursing homes and extended care facilities.

--support those innovations in medical education which will lead to better training programs and promote the efficient practice of medicine.

OUR PARTNERSHIP FOR HEALTH

The Partnership for Health legislation, enacted by the 89th Congress, is designed to strengthen state and local programs and to encourage broad gauge planning in health. It gives the states new flexibility to use Federal funds by freeing them from tightly compartmentalized grant programs. It also allows the states to attack special health problems which have special regional or local impact.

I recommend that Congress extend the Partnership for Health legislation for four years; provide supplemental appropriations for planning in fiscal 1967 and total appropriations of 161 million--an increase of $41 million--in fiscal 1968.

Our Regional Medical Programs for heart disease, cancer, and stroke depend on a second partnership, involving doctors, medical schools, hospitals, and State and local health departments. These programs will bring to every citizen the fruits of our Nation's research into the killer diseases. They will also promote the continuing education of the Nation's doctors, nurses and other health workers.

To sustain these nationwide programs, l recommend an appropriation of $64 million for fiscal 1968--an increase of $19 million over 1967.

Occupational Health and Safety

Occupational health and safety is another area in which we need to strengthen our partnership with labor, industry, medicine and government.

In 1965, more than 14,000 job-connected deaths and 2 million disabling work injuries caused untold misery and privation to workers, 239 million lost man-days of production, and billions of dollars in lost income.

We must learn more about the nature of job-connected injuries, so we can set effective safety standards and develop better protective measures.

I am recommending in the 1968 budget an appropriation for the Department of Health, Education, and Welfare of $8.1 million--a 25% increase over this year--to expand research and training programs in occupational health, and to strengthen state and local public health programs in this field.

I am directing the Secretary of Labor to improve and strengthen health protection and safety standards for workers through cooperative Federal-State programs.

III. TO FULFILL THE INDIVIDUAL

As a people, we have wanted many things, achieved many things. We have become the richest, the mightiest, the most productive nation in the world.

Yet a nation may accumulate dollars, grow in power, pile stone on stone--and still fall short of greatness. The measure of a people is not how much they achieve--but what they achieve.

Which of our pursuits is most worthy of our devotion? If we were required to choose, I believe we would place one item at the top of the list: fulfillment of the individual.

If that is what we seek, mere wealth and power cannot help us. We must also act-in definable and practical ways--to liberate each individual from conditions which stunt his growth, assault his dignity, diminish his spirit. Those enemies we know: ignorance, illness, want, squalor, tyranny, injustice.

To fulfill the individual--this is the purpose of my proposals. They present an opportunity-and an obligation--to the Ninetieth Congress.

I hope and believe this Congress will live up to the high expectations of a progressive and humanitarian America.

LYNDON B. JOHNSON

The White House

February 28, 1967