STATEMENT OF

  DR, LORIN Ea KERR

UNITED MINE WORKERS OF AMERICA

BEFORE THE

COMMITTEE ON ENERGY AND COMMERCE

SUBCOMMITTEE ON HEALTH AND THE ENVIRONMENT

APRIL 3, 1981


     MR, CHAIRMAN, MEMBERS OF THE SUBCOMMITTEE, I AM
DR, LORIN El KERR, DIRECTOR OF OCCUPATIONAL HEALTH FOR THE
UNITED MINE WORKERS OF AMERICA,  1 APPRECIATE THIS OPPORTUNITY
TO PRESENT OUR VIEWS ON THE NOMINATION OF DR, C, EVERETT KOOP
TO THE POSITION OF SURGEON GENERAL OF THE UNITED STATES PUBLIC
HEALTH SERVICE.

MR , CHAIRMAN, THE UMWA HAS GONE ON RECORD IN OPPOSITION

TO THE NOMINATION OF DR, KOOP TO THIS VITAL PUBLIC HEALTH POSITION,
WE BASE OUR OPPOSITION ON THE STRONG BELIEF THAT THE SURGEON
GENERAL SHOULD HAVE AN EXTENSIVE BACKGROUND IN COMMUNITY HEALTH

AND PREVENTIVE MEDICINE,  IN FACT, SINCE 1935 EACH OF OUR
SURGEONS GENERAL HAS HAD A STRONG PUBLIC HEALTH BACKGROUND, To
OUR KNOWLEDGE, DR, KOOP HAS NO EXPERIENCE OR TRAINING IN PREVENTIVE

MEDICINE OR PUBLIC HEALTH,

     WE BELIEVE THAT THE MOST IMPORTANT PUBLIC FUNCTION OF
THE SURGEON GENERAL IS TO ADVISE AND EDUCATE THE NATION ON SUCH

IMPORTANT PUBLIC HEALTH MATTERS AS ENVIRONMENTAL HEALTH HAZARDS,

DIET AND NUTRITION AND SMOKING'S EFFECT ON HEALTH, ANOTHER VITAL

FUNCTION IS TO ENCOURAGE AND ADVOCATE THE PREVENTIVE SIDE OF

MEDICINE THROUGH IMMUNIZATION, SANITATION AND OTHER DISEASE
PREVENTION MEASURES, ALTHOUGH DR, KOOP IS AN ACCOMPLISHED

SURGEON AND PHYSICIAN, WE DO NOT BELIEVE THAT HIS TRAINING AND

EXPERIENCE IN CLINICAL MEDICINE PREPARE HIM FOR THIS CRITICALLY

IMPORTANT PUBLIC HEALTH ROLE,


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     CLINICAL MEDICINE CONSISTS BASICALLY OF THE TREAT-
MENT OF PATIENTS AFTER THEY HAVE CONTRACTED A DISEASE, THE

RELATIONSHIP IS TYPICALLY ONE-ON-ONE, WITH THE EMPHASIS oN

TREATMENT,  PUBLIC HEALTH PROFESSIONALS, ON THE OTHER HAND,
DEAL WITH COMMUNITIES AND ENTIRE POPULATIONS, THE PRIMARY

EMPHASIS IS THE PREVENTION OF DISEASE RATHER THAN TREATMENT,

CONSEQUENTLY, PUBLIC HEALTH PROFESSIONALS AND CLINICAL

PRACTITIONERS HAVE DIFFERENT APPROACHES TO MEDICINE AND OFTEN

FOLLOW WIDELY DIVERGENT METHODS,
      THE PUBLIC HEALTH PROFESSION ENCOMPASSES THE SKILLS
OF PHYSICIANS, CHEMISTS, BIo'LoGIsTs, VIROLOGISTS, BACTERIOLOGISTS,
ENVI,RONMENTAL SCIENTISTS, NURSES, INDUSTRIAL HYGIENISTS,

DI,ETITIANS AND PLANNERS,  WHILE EACH OF THESE MAKES A VITAL

CONTRIBUTION TO THE FIELD, ONLY THE PUBLIC HEALTH PROFESSIONAL

HAS THE TRAINING AND EXPERIENCE THAT COVERS THE ENTIRE SPECTRUM

OF COMMUNITY HEALTH,  CLINICAL MEDICINE PLAYS AN IMPORTANT AND

LIFE-GIVING ROLE BUT IS IS ONLY ONE PART OF PUBLIC HEALTH, IN

THE LONG RUN, PREVENTIVE MEDICINE MUST BE OUR PRIMARYCONCERN,

      PREVENTIVE MEDICINE HAS LED TO IMPROVEMENTS IN THE
HEALTH STATUS OF AMERICAN CITIZENS IN RECENT YEARS,. HOWEVER,

OUR WORLD IS CHANGING RAPIDLY, &ARE JUST BEGINNING TO

RECOGNIZE THE PANDEMIC PROPORTIONS OF THE OCCUPATIONAL CANCERS

AND LUNG DISEASES THAT ARE OCCURRING IN OUR MAJOR INDUSTRIES,
WE ARE ALSO RECOGNIZING THE ENORMOUS COSTS OF OUR PAST PRACTICE

OF IGNORING THE PUBLIC HEALTH DANGERS RESULTING FROM THE


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CONTAMINATION OF OUR ENVIRONMENT,  IF WE ARE TO SECURE FUTURE

IMPROVEMENTS IN THE QUALITY OF LIFE AND HEALTH OF THE WORKING
AMERICAN, WE MUST LOOK TO THE PUBLIC HEALTH POLICIES OF

DISEASE PREVENTION, HEALTH PROMOTION AND IMPROVED CONTROL OF

ENVIRONMENTAL AND OCCUPATIONAL CONTAMINANTS,

    MR, CHAIRMAN, I HAVE SPENT OVER FORTY YEARS OF MY

PROFESSIONAL LIFE IN THE FIELD OF PUBLIC HEALTH,  1 HAVE BEEN
THE DIRECTOR OF COUNTY HEALTH DEPARTMENTS IN SEVERAL STATES
AND HAVE SERVED THE U,S, PUBLIC HEALTH SERVICE IN A NUMBER OF
POSITIONS INCLUDING THE INDUSTRIAL HYGIENE DIVISION, THE
MIGRANT LABOR PROGRAM, THE WAR FOOD ADMINISTRATION AND REGIONAL
MEDICAL OFFICER OF THE FARM SECURITY ADMINISTRATION, IN

ADDITION, I SPENT TWENTY-ONE YEARS AS A MEDICAL OFFICER WITH
THE UMWA HEALTH AND RETIREMENT FUND,

     MY EXPERIENCE IN PUBLIC HEALTH HAS TAUGHT ME MANY
THINGS, BUT THE MOST IMPORTANT LESSON 1 HAVE LEARNED IS THAT

PREVENTIVE MEDICINE IS RELATIVELY INEXPENSIVE AND LIMITLESS

IN ITS APPLICATION,  CURATIVE MEDICINE, HOWEVER, IS TREMENDOUSLY

EXPENSIVE AND QUITE LIMITED,  IN ORDER TO REVERSE THE FRIGHTEN-

ING TREND OF OCCUPATIONAL DISEASES WE MUST HAVE A STRONG NATIONAL

COMMITMENT TO PREVENTION,  WE MUST HAVE A SURGEON GENERAL WHO IS

NOT ONLY COMMITTED TO PUBLIC HEALTH AND PREVENTIVE MEDICINE, BUT
WHO HAS EXTENSIVE TRAINING AND EXPERIENCE IN THE PUBLIC HEALTH

DISCIPLINES,  IF WE DO NOT MAKE THIS COMMITMENT THEN WE MUST


ACCEPT THE INEVITABILITY OF CONTINUED DEATH AND DISABILITY
AMONG OUR WORKERS AND OUR FELLOW CITIZENS, MR, CHAIRMAN,
WE URGE THE ADMINISTRATION AND THE CONGRESS TO MAKE THAT

COMMITMENT NOW SO THAT OUR CHILDREN AND GRANDCHILDREN MAY

LIVE OUT THEIR LIVES AS FULL AND USEFUL CITIZENS,