IVER M. GESTELAND MAY 31, 1944.-Committed to the Committee of the Whole House and ordered to be printed Mr. SAUTHOFF, from the Committee on Claims, submitted the following REPORT [To accompany S. 754] The Committee on Claims, to whom was referred the bill (S. 754) for the relief of Iver M. Gesteland, having considered the same, report favorably thereon without amendment and recommend that the bill do pass. The purpose of the proposed legislation is to appropriate the sum of $617.70 to Iver M. Gesteland, of Sawyer, Wis., in full settlement of all claims against the United States for reimbursement of medical and hospital expenses incurred by him as the result of illness contracted in March 1942, the serious nature of such illness having prevented his removal to a United States marine hospital where he would have been entitled, as a seaman, to medical treatment and hospitalization without cost to him. The facts will be found fully set forth in Senate Report No. 746, of the Seventy-eighth Congress, second session, which is appended hereto and made a part of this report. Your committee concurs in the recommendation of the Senate. [S. Rept. No. 746, 78th Cong., 2d sess.) STATEMENT OF FACTS It appears from the attached letter signed by Capt. Ambrose Knudson, master, steamer W. D. Calverly, Jr., that Iver M. Gesteland, able seaman, who, as of the date of the letter (May 19, 1942), had been a member of his crew for 2 years, in good standing, was suddenly taken ill at Sturgeon Bay, Wis., on March 11, 1942, with acute appendicitis. The attached letter from Dr. Dorchester, of Sturgeon Bay, Wis., who performed the emergency operation, states that "when Mr. Gesteland entered the Egeland Memorial Hospital on March 11, 1942, he was suffering from a very acutely inflamed appendix. The condition of the appendix was so severe that an emergency appendectomy was necessary. The question of transportation to Green Bay was impossible." The report of the Federal Security Agency states: "Briefly, to establish eligibility for Public Health Service medical benefits under regulations of the Service, a seaman must have been on board a documented vessel of 5 tons or more in the care, preservation, or navigation of the vessel, or in the service on board of persons who are primarily so engaged, for at least 60 days of continuous service, part of which period must fall within the 60 days immediately preceding his application for treatment. It cannot be determined whether the claimant was able to meet these requirements. "It does not appear that medical care and treatment for which reimbursement is asked were obtained at Sawyer, Wis., but there is at Green Bay, Wis., some 45 miles from Sawyer, a Public Health Service relief station from which the claimant could have received the necessary treatment upon application to the medical officer in charge and establishment of his eligibility as a seaman. It does not appear either that the condition of the claimant was such as to require his immediate hospitalization or prevent his utilization of Public Health Service facilities. Nor can it be determined whether $617.70 are just and reasonable charges for the hospitalization and medical treatment required by the claimant's condition." As will be seen from Dr. Dorchester's report, Mr. Gesteland required an emergency operation and "the severity of the appendicitis attack and the severity of the pulmonary embolism syndrome did not permit him to be safely carried over the distance of 45 miles." Captain Knudson further stated: "I have known Mr. Gesteland for 25 years. business and is ready to become a ship's officer. He is a sailor and makes this his "In view of the fact that he is entitled to medical treatment at the marine hospital and the fact that this was an emergency case and he was unable to get to the marine hospital in time to save his life, I feel that he is entitled to some consideration from the United States Public Health Service * From the statement of the Egeland Memorial Hospital, which was submitted to your committee, Mr. Gesteland was hospitalized for approximately 59 days. After carefully considering the facts and circumstances of this case, your com mittee feel that it is a meritorious one and recommend favorable action thereon. Appended hereto is the report of the Federal Security Agency, together with other pertinent documents. Hon. ALLEN J. ELLENDER, FEDERAL SECURITY AGENCY, Chairman, Committee on Claims, United States Senate, Washington, D. C. MY DEAR MR. CHAIRMAN: This is in reply to your request of April 1, 1943, for a report upon S. 754, a bill for the relief of Iver M. Gesteland. S. 754 would authorize the payment of $617.70 to Iver M. Gesteland of Sawyer, Wis., to reimburse him for medical care and hospital expenses incurred as a result of illness contracted in March 1942. The bill recites that he was a member of the crew of the steamer, W. D. Calverley, Jr., and that the serious nature of his illness prevented his removal to a United States marine hospital where he would have been entitled to medical treatment and hospitalization as a seaman without cost to himself. Medical benefits furnished by the Public Health Service to seamen are not intended to replace the responsibility of the vessel for medical care of seamen who become sick or are injured in the service of the ship. The Public Health Service has not undertaken to furnish relief at all places where seamen may happen to become disabled. It furnishes medical relief only through relief facilities and stations regularly maintained and established by the Public Health Service to seamen wnc demonstrate their eligibility for such benefits in accordance with the regulations of the Service. The Comptroller of the Treasury has ruled that appropriations for the Public Health Service are not available to pay for treatment rendered by private hospitals or physicians to a seaman at the request of an officer of the vessel on which he was employed and not by authority or with the knowledge of any officer of the Public Health Service, even though the seaman would have received treatment at the expense of the United States if an officer of the Public Health Service had been on duty at that place at the time of the injury. It does not appear from the facts recited in the bill that it was not feasible to procure treatment at a relief station operated by the Public Health Service, that the claimant was eligible for such treatment, or even that the charges for which he seeks to be reimbursed were just and reasonable. The applicant for legislative relief is described in the bill as "Iver M. Gesteland, of Sawyer, Wis., a member of the crew of the steamer, W. D. Calverly, Jr." Briefly, to establish eligibility for Public Health Service medical benefits under regulations of the Service, a seaman must have been on board a documented vessel of 5 tons or more in the care, preservation, or navigation of the vessel, or in the service on board of persons who are primarily so engaged, for at least 60 days of continuous service, part of which period must fall within the 60 days immediately preceding his application for treatment. It cannot be determined whether the claimant was able to meet these requirements. It does not appear that medical care and treatment for which reimbursement is asked were obtained at Sawyer, Wis., but there is at Green Bay, Wis., some 45 miles from Sawyer, a Public Health Service relief station from which the claimant could have received the necessary treatment upon application to the medical officer in charge and establishment of his eligibility as a seaman. It does not appear either that the condition of the claimant was such as to require his immediate hospitalization or prevent his utilization of Public Health Service facilities. Nor can it be determined whether $617.70 are just and reasonable charges for the hospitalization and medical treatment required by the claimant's condition. Even though Gesteland might have been able to establish his eligibility for treatment as a beneficiary of the Public Health Service if he had made application, I feel that the payment of this claim would set an undesirable precedent in that it would encourage seamen, shipping companies, and ship owners to disregard the established facilities for the treatment of seamen and to expect reimbursement from the Federal Government for expenses incurred in the procuring of other treatment. For these reasons I am unable to recommend the enactment of this legislation. The Bureau of the Budget advises that there is no objection to the submission of this report to your committee. Sincerely yours, WATSON B. MILLER, Acting Administrator. FEDERAL SECURITY AGENCY, Washington, February 2, 1944. Hon. ALLEN J. ELLENDER, Chairman, Committee on Claims, United States Senate, Washington, D. C. MY DEAR MR. CHAIRMAN: There is forwarded herewith for your information and such action as you may desire to take, letter dated January 21, 1944, from Dr. D. C. Dorchester, Sturgeon Bay, Wis., concerning Ivar Milton Gesteland, a seaman for whom Senate bill 754, for the relief of Ivar Milton Gesteland, was introduced to reimburse him for medical care and hospital expenses incurred as a result of illness contracted in March 1942. You will recall that in response to your request of April 1, 1943, this office submitted a report on May 7, 1943, which did not favor enactment of the abovementioned legislation. The enclosed letter of Dr. Dorchester appears to have been written in reply to a question raised as to the reason Mr. Gesteland was treated in a private institution by a private physician when Public Health Service facilities located at Green Bay, Wis., some 45 miles away, could have been utilized. Although the circumstances recited in the letter may have necessitated immediate hospitalization of Mr. Gesteland at Sturgeon Bay, Wis., the position taken by this office in the report of May 7, 1943, is not affected. Sincerely yours, WATSON B. MILLER, Acting Administrator. DORCHESTER & BECK STURGEON BAY, WIS. JANUARY 21, 1944. Re: Ivar Milton Gesteland, Sawyer, Wis. PUBLIC HEALTH SERVICE, United States Public Health, Washington, D. C. DEAR SIRS: The question has arisen in regard to the bill of the above-mentioned patient. "Why was Mr. Gesteland treated in a private institution by a private physician when a public health hospital could have been used, there being one in Green Bay, Wis., only 45 miles away?" When Mr. Gesteland entered the Egeland Memorial Hospital on March 11, 1942, he was suffering from a very acutely inflamed appendix. The condition of the appendix was so severe that an emergency appendectomy was necessary. The question of transportation to Green Bay was impossible. His recovery from the appendectomy was perfectly normal while in the hospital; 6 days after his discharge he suffered a pulmonary embolism that very nearly cost his life. On March 20, 1942, he was readmitted to the hospital where he remained until May 9. During his stay in the hospital he suffered a second embolism on April 9 and a third on April 13. For the first 30 days of his stav in the hospital his condition was extremely critical. There was no time during his stay in the hospital due to the embolism when transportation could be considered. Such ordinary procedures as X-rays of the chest were carried out with extreme care for fear of loosening larger and more serious emboli. I am always willing to cooperate with the United States Public Health. Many of my patinets are members of the United States Coast Guard, United States Lighthouse Service, United States Navy and the United States Merchant Marine. I have always endeavored to provide transportation for these patients to the United States Public Health hospitals in Green Bay, Milwaukee, and Chicago if it is possible to do so. In the case of Mr. Gesteland, however, the severity of the appendicitis attack and the severity of the pulmonary embolism syndrome did not permit him to be safely carried over the distance of 45 miles. I hope this explanation will satisfy any doubt as to the legality of Mr. Gesteland's claim for Government aid in his illness. Sincerely yours, UNITED STATES PUBLIC HEALTH SERVICE, Treasury Department, Washington, D. C. GENTLEMEN: Iver M. Gesteland, able seaman, who has been a member of my crew for the past 2 years in good standing, was suddenly taken ill at Sturgeon Bay, Wis., on March 11, 1942, with acute appendicitis, emergency operation, could not delay. March 27, 1942, severe attack of blood clot in lung. April 9, 1942, second attack of blood clot, moderate. April 13, 1942, third attack of blood clot, very severe. He is a sailor, and makes this his I have known Mr. Gesteland for 25 years. business and is ready to become a ship's officer. In view of the fact that he is entitled to medical treatment at the marine hospital and the fact that this was an emergency case and he was unable to get to the marine hospital in time to save his life, I feel that he is entitled to some consideration from the United States Public Health Service, and will appreciate anything you can do. Yours respectfully, CAPT. AMBROSE KNUDSON, Master, Steamer "W. D. Calverly, Jr." MASTER'S CERTIFICATE OF SERVICE OF SICK OR INJURED SEAMEN MEDICAL OFFICER IN CHARGE, United States Public Health Service. I certify, on honor, that Iver M. Gesteland, whose signature and description appear below, has been employed on board in the care, preservation, or navigation, or in the service on board of those so employed, of the steamer W. D. Calverly of Wilmington, Del., official regisrry No. 96635, a vessel whose personnel is entitled to medical treatment by the United States Public Health Service. His period of service on the above-named vessel was from the 31st day of March, 1941, to the 3d day of December, 1941. I further certify that the person named herein has, in my presence, signed his name in the blank space provided below for that purpose.1 A. KNUDSON, Signature of the person named above Iver M. Gesteland. Nativity American, age 30 years, height 5 feet 10 inches, color of eyes blue, color of hair blond. Total service on United States vessels 5 years. 1 The medical officer, or attending physician, should compare the seaman's signature with that given in the certificate, as a means of identification. NOTICE. This certificate is merely for information of Public Health Service officers at Marine Hospitals and other relief stations of the Public Health Service. It does not authorize relief by any private agency. О H. 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