j: ii ( !i i i ! ! CLOSING THE GAP: THE REGIONAL MEDICAL PROGRAMS 1966-1974 Treatment for a 20-30 minute videotape ?Fhe rising tide of biomedical research has already doubled and redoubled our store of knowledge... Many of our scientific triumphs have been hollow victories for most of the people who could benefit from them....How are we going to close the gap?" Commission on Heart Disease, Cancer b Stroke, 1964 The videotape will sketch out the reasons for the creation of the Regional Medical Programs, how it was created, how it was operated, what it accomplished and how and why it was terminated. Style It will be told in the words of the men who were there; those who started this Great Society effort, as well as those who were there to bury it eight years later. Their comments, cross cut from one participant to another, along with voice-over narration will spell out one of the country's boldest experiments in the advancement of medical knowledge and health care for its citizens. It will be a fast paced overview of the years of the Regional Medical Programs. Elements/Segments 1) The United States in the early Sixties: after Korea, a just- escalating Viet Nam, unrest in the cities, zeroing in on the health of the people and the need to make medical care available to all facets of American society. 2) Lyndon Johnson creates the Commission on Heart Disease, Cancer & Stroke. 3) The Commission's report and its recommendations. . 4) Passage of PL 89-239. 5) How RMP began, the form it took, not necessarily along state lines, joining of disparate agencies, institutions, etc. 6) Accomplishments. (Dr. Lindberg to suggest additional possible examples.) One example, that could be taped on site (if still operating today) is what happened in southwestern Kentucky. This achievement was described by Dr. Faxon Payne when he testified before the House Subcommittee on Public Health and Environment Oversight hearings in May, 1973: * An eight hospital co-operative consortium to reduce costs for laundry, linen supply and supply purchasing. * Establishment of two full scale coronary care units, two holding coronary care units and a school for training cardiac nurse specialist. * A continuing educational program for nurses, technologists, nurses aides, surgical technicians, dietitians and hospital administrators. * An open toll-free phone line between a number of hospitals and Vanderbilt University Hospital for EKG transmission, telephone consultation with specialists, etc. 7) Changes and compromises. Legislation adding Community Health Planning (PL 89-749), kidney disease, the Experimental Health Services Delivery System program, PRSOs, HMOs, EMS, to the mix. 8) Termination of the RMP; moves by the Nixon administration to kill RMP, "forced carryover of funds, deletion of RMP funding from the FY74 budget, oversight testimony before the House Subcommittee on Public Health & Environment, the court battle to free impounded funds, etc. 9) The "evolution" of the National Health Planning and Resources Development Act of 1974: picking up the pieces of RMP, CHP and Hill-Burton and putting something together. CLOSING THE GAP PRODUCTION TECHNIQUE Interviews Most of the content of the videotape will be built around interviews with selected individuals who were participants in the RMP. These interviews will be taped wherever the individuals live or work today. Emphasis will be on concise, brief answers to questions. Questions will be asked off camera with the participant answering in statement form. After the interviews are shot, transcripts will be made of the participants comments. Using these transcripts, l'sound bites" will be selected and a structure for the videotape will be created. The script will then be written. The names have been selected from the list of invitees who have accepted the invitation to come here on 12/6 or have indicated they would consent to being interviewed on tape. They are: * Michael DeBakey, MD - Chairman, Commission on Heart Disease, Cancer & Stroke * Robert Q. Marston, MD - Director, RMP * Merlin K. DuVal, MD - Asst Secy, DHEW; Head, Ariz. RMP * Karl D. Yordy - Asst Director, Pgm Policy, RMP * Vernon E. Wilson, MD * Roger 0. Egeberg * Ed Friedlander - Asst Director, Communication & Public Information Div, RMP The following invitees have not responded but should be interviewed: * Paul D. Rogers - Chaired House Oversight Subcte, 1973 * Paul D. Ward - Exec Director, California RMP, wrote excellent article in West Jour Med, "The Curious Odyssey of Regional Medical Programs" And, comments from two others might be interesting: * John S. Zapp, MD - Deputy Asst Secretary for (if still living) Legislation (Health), DHEW * Harold Margulies, MD - Director, RMP Service, DHEW . Stock Film/Stills In that the activities of the RMP were not covered extensively by the media during the period of 1965-1974, much of the visual element will have to be covered by still photos, newspaper headlines, etc. Generic footage of the country in the '60s will be obtained from sources such as NBC Archives, CBS Archives, and the Lyndon Johnson Library, etc. Graphics/Animation Wherever applicable Bosch animation will be used for maps, graphics, etc. CLOSING THE: GAP ESTIMATED BUDGET Location interviews, incl travel costs, crews, per diem, mist expenses Writer Researcher Stock film/photos Transcripts Talent (Voice-over) Audio recording studio Mix/efx/music rights Total $20,000 4,500 2,000 1,500 1,500 500 100 1,500 $31,600 CILISING THE GAP ESTIMATED BUDGET 20-30 MINUTE VIDEOTAPE Location interviews, incl travel costs, crews, per diem, mist expenses Writer Researcher Stock film/photos Transcripts Talent (Voice-over) Audio recording studio Mix/efx/music rights Total $31,600 ARCHIVAL INTERVIEWS (2 camera shoot) Commercial Rental: 2 Betacam Cameras & Crew $2,400 per day (half day rate, negotiable) APDB Staff: Rental, 2 Betacam cameras $1,000 per day $20,000 4,500 2,000 1,500 1,500 500 100 1,500 ". /.. ,, - .n* .i.. - ..- ._. ._ . *_ " ,. . . i II . .I- . . . ..., 2 i 1,. ._ I .`.._ .~... 1 , "..___ I _ ' --L