History of Medicine
Commentary by Dr. Martin M. Cummings on his testimony before the U.S. Senate Appropriations Subcommittee concerning the National Library of Medicine, for fiscal year 1976
From interviews with Dr. Cheryl Dee, 2010
Excerpts of U.S. Senate subcommittee testimony concerning the National Library of Medicine, followed by an interview with Dr. Martin M. Cummings, Director Emeritus, National Library of Medicine, reflecting upon the testimony
DEPARTMENTS OF LABOR AND HEALTH, EDUCATION, AND WELFARE AND RELATED AGENCIES APPROPRIATIONS FOR FISCAL YEAR 1976
TUESDAY, JULY 20, 1975
U.S. SENATE . . . Subcommittee of the Committee on Appropriations
STATEMENT OF Dr. Cummings, DIRECTOR
Senator Magnuson. . . . National Library of Medicine, . . . For the record, you had $28,448,000 last year; you have $28,815,000, that's plus $367,000, is that correct?
Dr. Cummings. That's correct, Mr. Chairman.
Senator Magnuson. You don't have much to talk about, then, do you? [Laughter.]
Dr. Cummings. I do want to start by thanking you for the acknowledgement in your new book "How Much for Health," that gives credit to our library for providing some resource material.
LISTER HILL NATIONAL CENTER FOR BIOMEDICAL COMMUNICATIONS
Senator Magnuson. What are your plans for a new building? Incidentally, Doctor, I sent that reply down to Lister today.
Dr. Cummings. Mr. Chairman, this committee has for several years pressed me for the answer to the question of when the architectural and engineering plans would be completed, and I can report to you that the final drawings have been completed.
Senator Magnuson. That's the new Center; I sent that down to Lister.
Dr. Cummings. The [letter you sent] was an appropriate note. We will have these final drawings delivered to us next week, and they will be reviewed by my colleagues at NIH during the month of May. So, we are very pleased that task is completed.
Senator Magnuson. Last year you informed us about the status of the copyright suit against the Government. Could you give us an update on that situation and your views on the current Senate copyright legislation as it relates to NLM?
Dr. Cummings. In February 1975 the U.S. Supreme Court reviewed on appeal the copyright infringement suit brought against the NLM and the NIH by a publisher of medical and scientific journals. Since the Court was divided equally and failed to write opinions either pro or contra, the effect was to let stand the ruling delivered by the U.S. Court of Claims in 1973. That court held that NLM and NIH were not in violation of copyright by photocopying journal articles and disseminating them to interested health professionals. At the same time, the court, suggested that a meaningful resolution of the broad issues involved in this case would be best accomplished from a comprehensive revision of the Copyright Act of 1909 to take into account the modern development of photocopying technology. In January 1975 identical bills were introduced in both houses of Congress (S. 22 and HR. 2223) which although allowing very limited photocopying would prohibit the systematic reproduction of biomedical literature which is the foundation of the national medical library network. As it now stands, section 108(g) (2) of both bills would seem effectively to interdict the making of interlibrary loans through the use of photocopies. We think that such a result would do incalculable harm to the national effort to advance the arts and sciences and particularly would inhibit efforts to bring clinical and basic research findings rapidly and economically into the mainstream of health care.
Senator Magnuson. You plan to increase user costs for your online services? How high will they be, and will these charges put a hardship on the small-scale user?
Dr. Cummings. In response to the desire of Congress, the National Library of Medicine initiated in 1973 user charges for its' online services. The user charge is a nominal fee which is based on the concept of equal access and cost sharing. The user pays the communications costs to access our systems while appropriated funds are used to develop and maintain the data-bases. It provides an appropriate degree of management control over the growth of the system, thereby enabling the library to sustain the quality and performance of the system. At the same time, it makes it possible for the continued growth by outside users to be largely independent of the library budget. Effective July 1, 1975, it is planned to implement a new fee schedule with variable rates of $15 per connect hour during prime time hours, and $8 per connect hour during nonprime hours. This rate schedule should help distribute more evenly the workload and insure continued acceptable performance. This new fee schedule reflects full recovery of those costs outside the walls of the library chargeable to the National Library of Medicine providing online services. If there are any future increases in fees, they would be based solely on this principle. The library is sensitive to the needs of the small-scale user and we are pleased to report that we have evidence that the fees have not put a hardship on small-scale users.
Interview with Martin Cummings, MD Director Emeritus, National Library of Medicine, 1964-84; interviewed by Cheryl Dee, PhD, 2010.
Lister Hill National Center
Dr. Dee. Dr. Cummings, Senator Magnuson appears to be asking you very leading questions to describe the current needs of the Lister Hill Center. Senator Magnuson's questions sound very supportive.
Dr. Cummings. Senator Magnuson was a strong supporter of the National Library of Medicine. His questions allowed me to state for the record the needs of the National Library of Medicine for the Lister Hill Center. Funds for the Lister Hill Center were moved down the priority list for several years. Senator Magnuson allowed me to again restate the National Library of Medicine's case for the building construction. Senator Magnuson was asking very National Library of Medicine-friendly questions.
Dr. Dee. Dr. Cummings, would you tell us about the WAMI project?
Dr. Cummings. A health education experiment involved a consortium of the four WAMI states (Washington, Alaska, Montana and Idaho) and involved faculty at the University of Washington (which had the only medical school in the WAMI area) in Seattle with students and faculty at the University of Alaska in Fairbanks. There was two-way voice and video interaction for classes plus conferencing, and computer-aided instruction. We found that the program via satellite was successful not only for patients in Alaska but as a long-term potential for the delivery of medical education at distant and remote settings.
Dr. Dee. Dr. Cummings, in 1975 the U.S. Supreme Court reviewed on appeal the copyright infringement suit brought against the NLM and the NIH. The court held that NLM and NIH were not in violation of copyright by photocopying journal articles. Do you have additional comments about this continued struggle?
Dr. Cummings. The publisher continued to pursue their cause to the Congress. NLM, however, believed that both bills prohibited interlibrary loans through the use of photocopies. As we stated to the U.S. Supreme Court, such an action would do tremendous harm particularly to our goals to bring clinical and basic search findings rapidly and economically to the primary users of health care. The publishers were still fighting and taking the case to Congress. They were not giving up on the case.
MEDLINE User Fees
Dr. Dee. Dr. Cummings, we talked about user fees earlier. Do you have additional comments about the user fees?
Dr. Cummings. The user fees were in response to the desire of Congress in 1973 that the National Library of Medicine begin user charges for its online services. The fee was based on equal access and cost sharing. The user paid the communications costs to access our systems. While we did not favor the user fee, it is important to note that appropriated funds were used to develop and maintain the NLM databases. NLM has always been very sensitive to the small-scale users and did not want to see a hardship placed on the small user. In 1975, NLM implemented a new fee schedule with variable rates. According to the Senate Testimony, the rates were $15 per connect hour during prime time hours, and $8 per connect hour during non-prime hours. The new fee schedule provided full recovery of costs beyond NLM that were chargeable to NLM for providing online services.
- Magnuson, Warren G. (1905-1989). Biographical Directory of the United States Congress. https://bioguide.congress.gov/scripts/biodisplay.pl?index=M000053
Institutions and Programs
- Lister Hill National Center for Biomedical Communications building. NIH Office of Research Facilities, Development and Operations. https://orf.od.nih.gov/AboutORF/BFM/Pages/38ABeth.aspx.
- Lister Hill National Center for Biomedical Communications building plans. Carroll, Grisdale & Van Alen Collection, Architectural Archives, University of Pennsylvania. Local ID #: aaup.087.23. Image derived from Philadelphia Architects and Buildings: https://philadelphiabuildings.org (registration required).
- Lister Hill National Center for Biomedical Communications fact sheet. https://www.nlm.nih.gov/pubs/factsheets/lister_hill.html.
Articles and Oral Histories
- Cummings, MM. Copyright and reproduction. Bull Med Libr Assoc. 1973 Jul; 61(3):344-345. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC198693/.