unions representing groups like mine workers, railroad employees, etc. Those having Blue Cross-Blue Shield protection while active are given the opportunity to convert to individual policies upon retirement. These retired employees pay premiums directly to Blue Cross-Blue Shield and, therefore, there is no record of the number who have continued hospital and surgical insurance after retirement. Such pensioners have recently been informed that if they so wish deductions will be made from the pension check for Blue Cross and Blue Shield hospital and surgical premiums and those retired employees who had previously declined coverage are being given another opportunity to enroll. See reply to question 5 in regard to management employees. (3) The method by which protection is provided, that is, by voluntary participation by the retirees in a company program, by protection furnished by the company, by private action, etc. Reply Protection is available to retired nonmanagement employees at their sole option. (4) To what extent would the present health care protection coverage of the retired employees be duplicated by medical care under social security as presently proposed. Reply H.R. 4222 provides inpatient hospital services, skilled nursing home services, home health services, and outpatient hospital diagnostic services. The health care protection now available to our retired nonmanagement employees would be duplicated in the area of inpatient hospital services and to some extent by the outpatient hospital diagnostic services. In addition, these retired employees presently have available certain health care not provided in H.R. 4292. (5) The trend of increasing coverage of retired employees, that is, the progress that has been made in your company in offering health care benefits to retirees. Reply The trend in United States Steel Corp. has been to increase the hospital and surgical insurance coverage available to retired employees. As shown in reply to question 2, coverage is now available to virtually all nonmanage ment employees. The following is a summary of the progress that has been made regarding hospital and surgical coverage for our retired employees: Prior to March 1, 1950, no coverage was made available to retired employees. Beginning in 1950, hospital coverage and somewhat later surgical coverage was made available by various local Blue Cross-Blue Shield plans to all then retired employees, including management and nonmanagement and to each nonmanagement employee who retired after that time from groups covered while active. Except in a few isolated instances, the premiums for such Blue Cross and Blue Shield coverage are predicated on community experience rather than the experience of only the aged group, thus giving these retired employees cov erage at a favorable rate. Currently these same retired employees now on the pension rolls are being granted another opportunity to be covered by the Blue plans even though they may have chosen not to be covered at the time of their retirement. Heretofore retired employees who elcted to continue hospital and surgical coverage paid premiums each quarter directly to the Blue plans. Currently, however, if future retirees or those now on the pension rolls so wish, the Blue Cross and Blue Shield premiums for hospital and surgical coverage will be deducted from their pension checks. As indicated above, management employees who had retired prior to March 1. 1950, currently have hospital and surgical benefits available through the Blue plans. With certain exceptions, management employees who retired subsequent to March 1, 1950, currently are not covered. (NAME OF COMPANY WITHHELD ON REQUEST) (1) A total of 2.482 former employees are receiving benefits from the corporate pension plan or predecessor plans. Of this number, 191 are receiving disability allowances and all of this group is under 65 years of age. An additional 90 employees are receiving early retirement benefits and, therefore, are under 65 years of age. In other words, 2,201 of the retired employees are 65 years of age or more. (2) Exact figures are not available as to the number of retired employees who left the company prior to January 1, 1960, who have medical care protection. It is estimated, however, that 90 percent of our retirees prior to that date were able to continue medical care protection after retirement, as a result of provisions for conversion of the active employee program to a retiree program. Since Jan uary 1, 1960, all retirees have been able to continue medical care protection after their retirement date. (3) Medical care protection provided to current retirees is of two types: (a) Conversion of the basic hospital-surgical-medical plan available to active employees on an employee-pay basis. This plan may be Blue CrossBlue Shield or any one of several insured programs. In all cases, the protection is continued without break in benefit and, in many cases, at a considerably lower cost than it would be available to retirees who had not been employees. (b) The second type is a comprehensive major medical program available to all retirees which provides the retired employee and his spouse with $3,000 lifetime coverage each. This provides outpatient benefits including reimbursement for pharmaceutical bills, doctor and nurse visits in the home, etc., in addition to inpatient protection, and the employee contributes toward the cost of this benefit. This is an insured program. (4) The proposed medical care under social security would appear to duplicate many of the basic benefits already available to our retired employees. (5) Although some type of health care benefits have always been available to retirees, the type of benefits in effect today are superior to anything that has been offered in the past. This program in its present form has been installed in the last 2 or 3 years. I want to express my thanks to the companies which have cooperated in this project by answering the questions which I posed. I believe that they have done a real service in making clearer the extent to which industry has made provision for financing health care for retired workers. Mr. CURTIS. One other request. Unsolicited, I received seven telegrams from doctors in Palo Alto, Calif., expressing their views on the legislation before us, and in particular because they felt that possibly Dr. Philip Lee in his testimony would not be reflecting accurately their viewpoint and I wanted to have these in the record. The CHAIRMAN. Without objection, the telegrams will be included in the record. (Telegrams referred to follow :) Hon. THOMAS B. CURTIS, Washington, D.C.: PALO ALTO, CALIF., August 2, 1961. I oppose H.R. 4222 and agree with position of California Medical Association on this bill. I believe Dr. Philip Lee represents minority view among the 91 doctors in the Palo Alto Medical Clinic. EDWARD LISTON, M.D., Executive Head Palo Alto Medical Clinic. PALO ALTO, CALIF., August 3, 1961. Hon. THOMAS B. CURTIS, Washington, D.C.: Aware that Dr. Philip Lee, our associate in Palo Alto Medical Clinic testified in favor of H.R. 4222. We believe committee should know his opinion that medical care for aged can be best provided under social security act not shared by majority of his partners or other physicians in community. Until Kerr-Mills bill thoroughly tested we sincerely believe further legislation premature. WILLIAM H. CLARK, M.D., Palo Alto Medical Clinic. PALO ALTO, CALIF., August 3, 1961. Hon. THOMAS B. CURTIS, Member of Congress, Washington, D.C.: Opinions in Dr. Philip Lee's testimony on H.R. 4222 not sared by associates or majority of physicians in California. Believe that present Kerr-Mills bill can be implemented to solve problem on medical care for the aged. B. J. SPENCE, Jr., M.D., PALO ALTO, CALIF., August 3, 1961. Hon. THOMAS B. CURTIS, Be assured large majority Santa Clara County's 800 physicians favor trial of Kerr-Mills legislation. Includes Palo Alto. Most informed physicians here oppose H.R. 4222. C. L. BOICE, M.D., Hon. THOMAS B. CURTIS, PALO ALTO, CALIF., August 3, 1961. The practicing physicians of the Palo Alto area do not support the KingAnderson bill or agree with the philosophy expressed by Dr. Philip Lee in testimony before the House Ways and Means Committee. Have been unable to find on extensive polling a physician in the actual practice of medicine other than the Lees who does not feel that the Kerr-Mills action should be implemented and allowed to prove its validity before other legislation is enacted. We believe a means test is mandatory. The Government should limit its charities to those demonstrating need. Insurance implies that the recipient of benefits contributes to the reserve from which the benefits are paid. The social security arrangements are not insurance in the context. Respectfully, RICHARD P. JOBE, M.D. PALO ALTO, CALIF., August 3, 1961. Hon. THOMAS B. CURTIS, Washington, D.C.: Wish to express opposition to H.R. 4222. This bill provides coverage for many who do not need the protection but fails to provide for a segment of the elderly population who cannot qualify under the provisions of the measure. I favor the provisions incorporated in the Kerr-Mills bill because this provides protection for those who need it. CARL L. BIORN, M.D. Palo Alto Medical Clinic. PALO ALTO, CALIF., August 2, 1961. Hon. THOMAS B. CURTIS, Washington, D.C. SIR: I support medical care for the aged via existing legislation as outlined by Dr. Warren Bostick, president of the California Medical Associates. I emphatically oppose the social security approach of H.R. 4222 as advocated by Dr. P. Lee and a fraction group from this area. Respectfully. BURL DAVIS, M.D. The CHAIRMAN. Mrs. Hymes, will you identify yourself for the record by giving us your name, address, and capacity in which you appear? STATEMENT OF MRS. CHARLES HYMES, NATIONAL PRESIDENT, NATIONAL COUNCIL OF JEWISH WOMEN, REPRESENTING ALSO MRS. KAL EISENBUD, VICE PRESIDENT, NATIONAL COUNCIL OF JEWISH WOMEN (BROOKLYN SECTION) Mrs. HYMES. I am Mrs. Charles Hymes. My home is in Minneapolis, Minn. I represent the National Council of Jewish Women of which I am the national president. The CHAIRMAN. All right, Mrs. Hymes, you are recognized. If you can complete your statement in the time that we have allotted to you, we would appreciate it. Mrs. HYMES. I will try to. I am combining my statement with that of Mrs. Kal Eisenbud, one of our vice presidents of one of our sections, so that will represent a statement from both of us. I appreciate the opportunity to state before the committee the views of this organization of 123,000 women belonging to 329 affiliated units throughout the country. A major concern in our program in the past decade has been the problem of America's growing numbers of senior citizens. We have studied these problems intensively in our communities and have taken action in support of legislation needed to help bring security and dignity to our aging fellow citizens. Most significantly, we have been serving the elderly across the Nation through sponsorship of some 200 service projects, including recreation centers, sheltered workshops, friendly visiting, meals on wheels, employment solicitation, and occupational and recreational service to elderly persons in institutions. Discussion of the problems of family relations with the elderly in recent study institutes held by council sections in communities across the country pointed up as a key problem the prevalent fear of illness among older people and especially their anxiety about meeting large medical bills in case of serious illness. Following through on these reports, the National Council of Jewish Women did a survey, which has just been concluded, of medical costs among the members of council golden age recreation centers and participants in other council-sponsored programs for the aging in 200 communities. A questionnaire (copy attached) was distributed among these groups of elderly men and women, which sought the following information: In the past 2 years approximately how much did these elderly people spend for medical or surgical doctor bills, for hospitalization, for drugs, for nurses, or for other costs such as appliances? What was the sources of the funds used for these medical needs: insurance, current income, savings, contributions, or loans? Were they in debt because of medical expenses? We also asked the members of our senior citizen clubs whether they are in favor of medical care insurance under social security, and, if not, what plan do they favor. We received something over 1,500 responses from 53 communities. (List of responding communities attached.) Who are these 1,500 people? Since council senior citizens recreation centers serve elderly people of all races and religions, they do not represent a homogeneous group in this respect. Most of the communities represented are fairsized cities or suburban areas. Approximately two-thirds of the group are women. We can presume that the group covered in this survey is a relatively active and healthy segment of the older population able to participate in recreation center and other community activities. In age, the group ranges from 60 to 92, with the greatest number in their late sixties and early seventies. We can also assume that this group is not in the lowest income bracket, since very few indicate welfare payments as a source of funds for medical care costs. We shall not attempt to tabulate or correlate the findings in this particular report, but rather to give some general observations based on an examination of the questionnaires returned. The first finding of this study is that all but a handful of replies favor medical care insurance under social security. A few state that they are not covered by social security and ask for a plan which would include them. We believe that the most significant finding of the survey relates to the source of funds used to pay for the costs of medical care. There is no correlation, incidentally, between the amount of money spent on medical care and the source of funds. Aside from those who are completely dependent on their children, most did not draw funds from a single source. (One woman who claimed to be 92 complained that she was completely dependent on her daughter, because her husband had died too long ago to have been covered by social security; nor did she get any benefits of her daughter's coverage although her daughter worked and paid for social security.) Savings, help from family, and current income (mostly social security benefits) were drawn upon to pay for medical bills. In no case was there sufficient insurance to cover the total medical care costs. Major medical care costs reported-doctors' bills and hospitalization-ran the gamut from no cost to $4,000-$5000. Incidentally, we found that possibly there is somewhat of an error in our survey. This was reported to me just yesterday. The questionnaire that was sent to an individual here in Washington and she reported that she had had no doctor bills for the past 5 years. When she was asked why she had no doctor bills she said it was because her son was a doctor and she had all this service free. A statistical average, based on a range of this kind would be meaningless. It appears, however, that the largest number would fall into the range between $400-$700 over a 2-year period. The most consistent item in the questionnaire replies is the cost of drugs. The great majority of those responding to the questionnaire had drug costs ranging between $150-$250 for the 2-year period. One 69-year-old widow from Jacksonville, Fla., responded to the question on drug costs with "too much" and a 74-year-old widow from |