Similarly, the family planning programs of OEO were initially somewhat protected from appropriations cuts by authorizing legislation that set a specific priority on family planning. The priority designation by the OEO authorizing committees in 1967 made it possible for family planning programs to grow, even when the overall OEO appropriation was not increasing. Further earmarking was accomplished later in the fiscal 1969 appropriation bill, thus precluding internal cuts or shifting of moneys even when the total amount was reduced.

The programs of HEW in both family planning services and population research have, on the other hand, suffered from what is usually considered the greatest asset in administration-a permanent program authorization. In other words, possessing broad, permanent authority in health and welfare under the Public Health Service Act and Social Security Act, HEW did not want categorical authorizations for a limited time period. The lack of annual authorizations, and therefore the near-complete dependence on appropriations subcommittees, appears to have prevented great shifts in priority or increases in funding for family planning services and research, as well as limited HEW imagination and programming. Not that the appropriations committees have been conspicuously unfriendly to population; on the contrary, the appropriations process as a whole as never substantially cut executive branch requests for family planning services or population research. The House appropriations subcommittee admittedly has not

shown great enthusiasm for the program, has on occasion tried to reduce it, and has never increased the amounts requested by the Administration (see Table 3). But, the Senate committee has, characteristically, restored the cuts of the House and occasionally made small additions. In the absence of substantive committee and policy reviews each year, however, and in the face of inflationary trends, new programs in the population field have not been initiated through the appropriations process (see Table 4), even where, as in the case of OEO, the appropriations subcommittee has been basically sympathetic.

The HEW family planning services program was boosted in 1967 by the legislative earmarking of six percent of maternal and child health funds for family planning in the Social Security Amendments Act for a three-year period beginning in 1969. That was the first specific reference to family planning in HEW authorizations and occurred the same year as the foreign aid earmarking. That priority would have been ignored by the House appropriations subcommittee in 1969, but the Senate committee restored the funds.

Paradoxically, the program widely regarded now as the least satisfactory-NIH research15-is the only program that still enjoys a permanent and open-ended legislative authorization. Maximum Congressional influence on that program is concentrated in a single 10-man House appropriations subcommittee, which in turn focuses the attention of the agency on budget and

administrative rather than policy goals. A balance among existing programs rather than the achievement of priority objectives is stressed.16 The deliberate Congressional action in providing an extra three-year authorization for population research in the Family Planning and Population Research Act of 1970-which establishes a higher level of priority but at the same time requires Congressional review or renewal after 1973-was not welcomed by officials within the agency. As one HEW official told Science magazine,

NIH has functioned well for two decades
without authorization ceilings... and all this
further racket is just a further pain in the
neck.17

In other words, as Huntington has observed in his study of military policy-making, a bureaucrat, "if forced to choose, normally prefers fewer resources and greater freedom to allocate them as he sees fit than more

resources less subject to his control.”18 In population research as in cancer research, many NIH officials were not eager for Congress to provide additional funding if these funds entailed additional legislation oversight, but Congress authorized the funds none the less.

Beyond appropriations, beyond amendments to existing laws, beyond the three explicit population bills so far passed, Congress has further powerful methods to influence policy. Even apart from its strictly legislative role, the educational role of individual members and committees of Congress may equal or exceed that of the President. The introduction of population bills beginning in 1963 has provided a forum for publicly testing new ideas and approaches. Through such measures, the recommendations of outside advisory groups like President Johnson's Committee on Population and Family Planning were often transformed by legislators into new bills long before the executive agencies at which the proposals were directed had digested or endorsed them. Even bills that have not yet passed, or may never pass, or have not even been reintroduced in subsequent Congresses-such as Senator Gruening's proposal for an Assistant Secretary for Population in the State Department and HEW (S. 1676, 88th and 89th Congresses)-stimulated some appointments, although at a lower level. Similarly, Congressman Morris Udall's plea for reorganized agencies (H.R. 105154, 91st Congress); Tydings' suggestion for a single family planning center in HEW (S. 2108, 91st Congress); the Zero Population Growth Resolution (S.J. Res. 214, 91st Congress); and Senator Robert Packwood's bills to reduce tax exemptions after two children (S. 3502 and S. 3632, 91st Congress), and to legalize abortion in the District of Columbia (S. 3501, 91st Congress) and nationwide (S.

Congressional-Executive Relations in the

3746, 91st Congress) have led to new arguments, new support, and even new opposition.

Hearings have also played a major part in bringing new aspects of population policy to the fore. In an educational sense, very few measures will exert the public influence or explore the issue as thoroughly as Senator Gruening's three years of hearings did. Those hearings, which started in 1965, brought the whole birth. control question, as Gruening put it, out from under the table and into the open.19 In 1966, a hearing before Senator Clark's subcommittee of the Senate Committee on Labor and Public Welfare publicized growing Catholic dissent against the Vatican position on birth control through Father Dexter Hanley's statement of conscience.20 Likewise, during the week of hearings before Congressman Reuss' Subcommittee on Conservation and Natural Resources in the fall of 1969, the President was criticized for not saying more in his July message and for not urging all Americans to have only two children. This may be considered the official Washington introduction. to the goal of zero population growth.21

The legislative setting, in short, provides many opportunities for individual Senators and Congressmen to select their own areas of concentration and to focus staff and national attention upon them. The legislator who sees his role as an innovator22 can proceed as rapidly as he is able to persuade his colleagues, and eventually his constituents, to support him. Through the medium of floor speeches, bills, amendments, and (for members of the majority party) especially through hearings, he can significantly influence the shape and priority of issues and the innovation of programs. In the population field, these legislative initiatives have played a major role in highlighting the problems and defining policy alternatives.

POPULATION POLICY-MAKING IN THE
EXECUTIVE BRANCH

It would be inaccurate, however, to see the development of population policy and programs entirely as a mandate forced by individual members of Congress upon a reluctant executive branch. Essentially, the executive branch of government was divided upon the issue in much the same way as Congress. Those who had a position with broad perspective and purely policy responsibility tended to favor rapid establishment of effective voluntary family planning activities wherever appropriate; those who were concerned with the immediate problems of administering and funding other programs during a period of budgetary stringency were inclined to resist expensive new undertakings, even after the particular sensitivities of birth control as an issue had been somewhat reduced.

Thus, within the executive branch of government, the outside advisory groups, White House staff, committees, commissions, and the "in-and-outers" (as Neustadt has termed those who do not look on Federal employment as a permanent career)23 played the most aggressive role. They raised questions and proposed new activities that the operating Federal agencies were reluctant to consider. Those agencies shrank visibly from the population issue: At first, they feared the political difficulties in Congress that might result from strong Catholic opposition; later, they feared the administrative and financial difficulties that did result when family planning services and population research threatened existing professional or jurisdictional boundaries and budgets.

During the 1960's, the Presidents themselves were forced to balance a publicly and Congressionally defined policy need against these political, administrative, and fiscal constraints. As will be seen, two PresidentsEisenhower and Kennedy-first tried to still the controversies that arose. Two later Presidents-Johnson and Nixon-deliberately raised the issue for serious national consideration, but found that their outside advisors and many in Congress wanted to proceed so much faster than those within the implementing and budgetary offices that new causes of dissension arose. At every stage, however, the comments and decisions of Presidents stimulated rather than stifled debate and were widely cited and used by other advocates, in Congress and elsewhere, to advance a variety of proposals.

In specific terms, after a decade of what one observer has described as “a conspiracy of silence," "24 the problems of rapid population growth were first publicly and officially raised at the top level of government by an outside advisory group. President Eisenhower's Committee to Study the Military Assistance Program, chaired by William H. Draper, Jr., recommended in 1959 that the United States

assist those countries with which it is coopera-
ting in economic aid programs, on request, in
the formulation of their plans designed to deal
with the problem of rapid population
growth.25

The question was raised, Draper observes, at President Eisenhower's own request, but when the proposal was denounced by the Catholic Bishops of the United States, President Eisenhower would not consider it. The issue was "religious" and "not the government's business," the President asserted.26

But Eisenhower's refusal to discuss the implications of birth control only provoked a continuing policy debate that neither he nor his successor, John F.

Kennedy, the first Catholic President, could quiet. Kennedy pledged to consider the issue in the light of national, not religious, interest, but he too did not welcome the religious or political implications. In 1960, 1961, and 1962, he tried without success to persuade the insistent press and interested observers that United States assistance in providing birth control overseas would be "a mean paternalism"-that each nation should decide for itself without United States advice what to do

about population growth and birth control policies.27

Kennedy first acquiesced in a more active position when population, linked with economic development, came up on the United Nations General Assembly agenda in December 1962. Richard Gardner, an international lawyer and Deputy Assistant Secretary of State, prepared a speech that was cleared in the White House affirming United States concern and support for a "population policy" that included more discussion, more research, and an open acknowledgement of the problem.28 At a press conference several months later, President Kennedy was questioned about a widely publicized report on world population by the National Academy of Sciences and about a Catholic physician's appeal for research to make the rhythm method more reliable.29 Rephrasing the question and avoiding the real issue of a major new research commitment, Kennedy replied:

If your question is, can we do more, should we
know more about the whole reproduction
cycle, and should this information be made
more available to the world so that every one
can make their own judgment, I would think it
would be a matter which we could certainly
support...30

With those words, Kennedy did at last open the door for a Federal population research policy.

President Lyndon Johnson wanted to encourage the discussion when he declared in his 1965 State of the Union Message:

I will seek new ways to use our knowledge to
help deal with the explosion in world popula-
tion and the growing scarcity in world re-
sources, 31

Much quoted and much applauded, President Johnson's reference made the population problem respectable for policy consideration in the executive agencies concerned. At the same time, his public statement provided a cue for other actions in Congress and from outside groups looking towards a higher priority and greater resources than the executive agencies were as yet willing to provide. For example, advisory panels at two White

House conferences in late 1965-the White House Conference on Health and the White House Conference on International Cooperation Year-recommended support for birth control at home and abroad, with an immediate target of $100 million for foreign assistance.32 Yet before the Title X earmarking for 1968, the AID population program amounted to less than $5 million a year.33 After 1965, with the famine in India and the War on Poverty in America, the pressure for action as well as words steadily increased. From Congress and other groups (such as the Commission on Rural Poverty, the Commission on Violence, the various agency advisory boards, White House task forces, President Johnson's own Committee on Population and Family Planning, and his White House staff) came suggestions to back up rhetoric with resources-more resources than the budget for the war in Vietnam readily allowed. By late 1968, President Johnson himself had made more than 40 different references to population, family planning, and birth control, but every Congressional proposal for specific funds or higher level personnel was frowned upon by the agencies concerned.

President Richard Nixon, like his predecessor, was prepared to take a serious public stand on population issues. Encouraged by his domestic affairs advisor, Daniel P. Moynihan, and by John D. Rockefeller, 3rd, who had also encouraged his predecessor, President Nixon went beyond incidental references to dispatch the first explicit Presidential Message on Population to Congress. Following the United States landing on the moon, the President called for more advance planning on earth and declared that "we should establish as a national goal the provision of adequate family planning services within the next five years to all those who want them but cannot afford them." He pledged that "this Administration does accept a clear responsibility to provide essential leadership."34 Additional resources were to be allotted following reviews in each agency, and Congress was asked to authorize a Commission on Population Growth and the American Future.

But the population issue seemed to retain a momentum of its own, always moving beyond what any President would say and presenting new policy alternatives that were even more controversial than the last. No sooner had President Nixon promised to use Federal funds to make birth control services available for all Americans, than the National Academy of Sciences. pointed to a new and threatening gap between population and energy resources and a new menace in pollution.35 Before the end of 1969, “zero population growth" and "two will do" were new slogans competing with the, by that time, well-accepted concept of "planned parenthood" for support and respectability.

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Thus, even as the President sent to Congress the first executive branch population bill-to create a Commission on Population Growth and the American Futurehe was criticized before Congressman Reuss' subcommittee by population control advocates for stressing voluntary family planning instead of insisting on a two-child family.36

The first arguments for Federally supported birth control had emphasized the need to permit "freedom of information" and "freedom of choice"-as Senator Gruening had insisted37-so that the poor, dependent on public facilities, could exercise the same options in controlling their fertility as the rest of society. But, by 1969, some adherents to the population movement were suggesting exactly the opposite-that freedom of choice or voluntary family planning should not be permitted to rich or poor alike-because large families and too rapid population growth would jeopardize the quality of life for all. Ironically, too, while the first Federal support for family planning was prompted by an economic definition of the problem (in the anti-poverty program) and a determination to accelerate development by limiting reproduction, by the early 1970's economic growth itself was no longer an unquestioned objective. In fact, every aspect of growth was being restudied. Protecting the environment was a new, and to some outside of government, even more compelling need than economic wealth. Also, abortion, even more distasteful to the Catholic Church in 1971 than birth control had been in 1959, was reawakening the religious controversy that had been subdued during the mid and late 1960's. The population problem clearly extended beyond the policy

consensus.

Since 1959, four Presidents have found that issues of population growth could not easily be ignored. Outside pressures for Federal involvement have steadily increased, even though the kinds of new involvement proposed have remained highly controversial. But the task of the President in trying to deal with the issues has been in many ways more difficult because of the reluctance of the established Federal departments and agencies to initiate new programs or to propose explicit population policies. The first Cabinet members to speak out on United States population problems were the Secretaries of Labor (Willard Wirtz), Interior (Stewart Udall), and Agriculture (Orville Freeman) whose agencies felt the impact of rapidly rising population but whose programs dealt only indirectly with the possible solutions. Wirtz, Udall, and Freeman began in 1964 and 1965 to point openly to the employment, environmental, and food crises they thought were threatening the United States or the developing nations. Not until 1966 did the Department of Health, Education, and

Welfare, under the newly appointed Secretary John Gardner, publicly support family planning in a policy statement and not until 1969 did HEW programs of service or research have a firm foundation. Similarly, on the foreign side, the State Department (which has a policy-making orientation) recognized the problem and began to define policy nearly five years before the Agency for International Development (which has operational responsibilities) began to consider possible solutions.

Within the executive branch of government to date, five agencies have adopted major policies or programs designed to slow down population growth or reduce unwanted births.38 (See Table 5.) In the order of their adopting such roles, the agencies were the Office of Economic Opportunity, located in the Executive Office of the President; the Agency for International Development in the State Department; the Children's Bureau in HEW; the Public Health Service in HEW; and the National Institutes of Health, within PHS and HEW. There is a very rough negative correlation between, on the one hand, the age of the agency, the number of employees, and the degree of organizational complexity, and, on the other hand, the timing of policy statements and the extent of financial resources devoted to the population problem.

As Table 5 suggests, the younger the agency, the smaller the number of employees and the less complex the structure of authority, the faster the agency was willing to consider the issue and the larger the sums allotted to population or birth control. Although such comparisons are necessarily inexact, these data agree

with the comments of others in and out of government. OEO and AID made a fast start compared with the agencies in HEW. The population and/or family planning programs of OEO, for instance, won praise from Senator Gruening in 1968 and other members of Congress who had been very critical of the lack of leadership in HEW.39 President Nixon in his Message on Population, and the chairman of the House Foreign Affairs Committee, praised the AID program. HEW programs, on the other hand, were criticized in two outside studies-one by Oscar Harkavy of the Ford Foundation in 1967, and another by President Johnson's Committee on Population and Family Planning in 1968-for lack of clear priority and forward planning.40 Four HEW secretaries have acknowledged the need to improve and upgrade HEW programs."

41

A common factor in both the AID and OEO programs was the strongly economic definition of the problem. Where family planning or population control was seen as a means to individual economic opportunity or national economic development as in OEO and AID, governmental programs developed faster and with less controversy than anticipated. Where family planning was related only to health objectives, however, and integrated with medically or scientifically defined goals, as in the Public Health Service or NIH, the priority tended to decline. The more traditional fields of health care and basic research tended, especially at a time of sharply rising costs, to crowd out a new and not entirely professional field.

Finally, both OEO and AID, as relatively new agencies with weak political constituencies, were much