Other objections to this bill are:

(1) The social security amendment would establish a vast program of compulsory health insurance for those over 65 regardless of real need or personal desires.

(2) By amending the Social Security Act in such a manner, you are opening the door to more far-reaching legislation as regards control of health and medical facilities. For just as surely as this Health Benefit Act rides on the coattails of social security, other measures will come along to ride on the precedent set by this act.

(3) The social security approach is inequitable since the burden of payment for the program falls on the low-income workers, and rais ing the taxable maximum to $5,000 will not substantially help that.

(4) New and more extensive Federal machinery would be required to operate the program. Contractual agreements will have to be entered into, reviewed, terminated, negotiated, renewed, and reviewed again with thousands of drugstores and medical facilities.

(5) This approach would further erode the American free enterprise system by eliminating millions of insurance customers automatically, plus thousands of others who will be tempted to remain without insurance through the normally healthy younger years, depending upon subsequent broadening of coverage by the Federal Government for help as they approach retirement.

(6) Persons of responsibility would tend to build less of a backlog of savings for retirement years and thus would become more dependent than ever on the Federal Government.

(7) By tying the Health Insurance Benefits Act of 1961 to the Social Security Act, you are depriving States, municipalities, and voluntary agencies of their traditional welfare role.

In summary, I personally, and the U.S. Junior Chamber of Commerce, which I represent, oppose this bill on the grounds heretofore stated.

Therefore, gentlemen, in facing the most important legislative decision confronting this session of Congress, I urge you to make a firm stand for the present free enterprise system of medical care, unencumbered by excessive Federal control. I have full confidence that you will justify the trust placed in you by the freedom-loving people of this Nation.

Thank you very much for you attention and consideration. (Resolution of Junior Chamber of Commerce follows.)

RESOLUTION ON OPPOSITION TO SOCIALIZED MEDICINE, ADOPTED JUNE 1961

Whereas the U.S. Junior Chamber of Commerce is ever mindful of Federal legislative enactment which affects the economic and social lives of the people of this great Nation; and

Whereas there is currently pending in the Congress of the United States House bill 4222 initiating compulsory medical health care benefits under the social security system which is not in the best interest of the American people; and

Whereas enactment of this or similar legislation would be detrimental to the high standards of medical care, would deprive the citizens of the United States of the opportunity to provide their own medical care, would discourage our citizens of today from preparing for their old age and, at the same time, tend to remove the responsibility of men and women of America from caring for their own families; and

Whereas such legislation would be another step toward socialism and would jeopardize our free enterprise system which has made steady progress in extending and improving voluntary hospital insurance coverage of the aged under commercial programs; and

Whereas one of the present proposals has in it the elements of Government determination of the price for hospital, nursing home, and medical service fees and would restrict the beneficiaries in their choice of hospitals and physicians; and

Whereas this bill, if enacted, would increase the cost of social security and would possibly be extended progressively to include comprehensive care for larger and larger segments of our population, thereby decreasing the take-home pay of the American citizen; and

Whereas the U.S. Junior Chamber of Commerce believes this country has become great through the individual initiative of its citizens and that legislation of this type to suppress this initiative: Now, therefore, be it

Resolved, That the U.S. Junior Chamber of Commerce, in convention assembled this 21st day of June 1961 in Atlanta, Ga., hereby opposes the House bill 4222 now pending before the Congress of the United States or any similar legislation that may be introduced; and be it further

Resolved, That the newly elected president of the U.S. Junior Chamber of Commerce be directed to request time to present personal testimony before the House Ways and Means Committee in July 1961; and be it further

Resolved, That we believe that said proposed legislation would destroy our voluntary health program in the United States and further that it violates constitutional freedoms and the creed of the U.S. Junior Chamber of Commerce; and be it further

Resolved, That copies of this resolution be presented to the President and the Vice President of the United States of America, Secretary of Health, Education, and Welfare, and each Member of the Congress of the United States of America.

Mr. KING. Mr. Conger, the committee appreciates your bringing to us the views of your organization.

Are there any questions?

If not; thank you, Mr. Conger.

Mr. CONGER. Thank you.

Mr. KING. Mr. Galyon. Is Mr. Galyon here?

Mr. BAKER. Mr. Chairman, it gives me a great deal of pleasure to welcome to the committee and present to the committee Aubrey E. Galyon of Knoxville, Tenn., whom I have known for many years. He is a man of great ability and an outstanding labor leader. I respect his views highly.

Mr. KING. You may proceed.

STATEMENT OF AUBREY E. GALYON, BUSINESS REPRESENTATIVE, KNOXVILLE BUILDING & CONSTRUCTION TRADES COUNCIL, AFL-CIO

Mr. GALYON. Thank you, Congressman Baker.

Mr. Chairman, you have had several witnesses here describing the conditions throughout America and throughout all parts of the world. I do not know whether this is a switch or not, but I am confining my remarks to one of the greatest communities in the richest country in the world, east Tennessee. I am here in behalf of the AFL-CIO members and the Senior Citizens Committee in the Second Congressional District of Tennessee. In their behalf, I express appreciation to this committee for giving me the opportunity to give our views in support of the President's health insurance proposal, H.R. 4222, the Health Insurance Benefits Act of 1961.

I shall begin by outlining the basic medical care requirements of persons aged 65 and over in this particular section. Our citizens who are in their declining years today have earned better treatment than they are getting. They, like most others in their age group throughout America, have lived through a very difficult period, characterized by depressions, wars, and spiraling and nonceasing inflation. Yet, during this trying period they have been forced to contribute the major portion of their earnings to our Government through direct and hidden taxes, making it almost impossible for the majority of them to provide individually for income in the years of retirement that is adequate to meet the greatly increased cost of medical care.

We have seen that final and disastrous illness, such as lingering cancer, cannot be met with the low income of the elderly people, and the average family of married children are doing well to meet their own high cost-of-living needs, making it impossible to provide medical care for parents that are affronted by these catastrophic illnesses. My home county (Knox) is in the third year of attempting to solve the problems of caring for our aged citizens, and our welfare commissioner, William P. Wilson, a dedicated officeholder and stanch supported of the Anderson-King bill, says that our program is far ahead of most counties in the State. But, gentlemen, we are falling short in properly caring for our elderly people.

We have over 24,000 people in Knox County over 65 years of age. Over 7,000 of these are over 75 years old. These are not just cold statistics but are life and blood human beings whose needs must be met if we are to continue to live in a democracy that claims a belief in the brotherhood of man.

We are providing a bare existence and a minimum of institutional care for a small portion of our aged indigents at Maloney Home (a tax-supported institution for indigents). But our budget is dis gracefully inadequate and the buildings are so obsolete they create a serious fire and health hazard.

Older persons, as we all know, have longer than average medical care needs. They spend approximately 21⁄2 times as many days per year in general hospitals as does the rest of the population. They have special need for long-term institutional care. Yet, as a group. their income is considerably lower than the rest of the population and, in most cases, is fixed or even declining.

At present in the Knoxville area 500 beds are being occupied by the aged indigents; 200 of these are in Eastern State Hospital (a State- and county-supported hospital for the mentally ill) thus withholding treatment from those who could be benefited by therapy and psychiatric treatment. These 200 beds should be made available for such patients who have the possibility of becoming well again.

In 1960 the city of Knoxville and Knox County spent in excess of $1 million for the care of aged, indigent citizens. In spite of this expenditure of the taxpayers money, we are in dire need of 1,500 nursing-home beds. That was given to me by the welfare director of the city of Knoxville and also the welfare director of the county. The average cost for bed-patient care in a privately owned nursing home in Knox County is $200 a month. Naturally, many quali fied indigents are turned away daily by the welfare organizations due to lack of bed space. Our nursing homes meet the standards re

quired by the State of Tennessee. A nursing home, of course, differs from a chronic ailment hospital in that the hospital has a laboratory and X-ray equipment. For this type of service our county has a contract with the University of Tennessee Memorial Hospital for our aged indigents.

Right here, I want to state that the term "medical care" is a blanket expression that needs to be broken down into the true and clear meaning of "professional medical care," "hospital patient care" and "nursing home care."

Our greatest problem at home, and I am certain the same situation exists throughout the Nation, is with hospitalization. Lengthy periods spent in a hospital for a chronically ill person can pauperize a family and eventually place a great burden on the taxpayers. In such cases, the stipulation in the Anderson-King bill which provides skilled nursing home services after transfer from a hospital, up to 180 days after 60 days in the hospital would be of the utmost benefit to the patient, his family, and the local government.

Broken hips are a common accident among the aged and hospitalization until the patient has completely recovered can, and very often has, wiped out the life savings of a family.

Under the measure we are discussing, such a patient would be moved from the hospital to his home and receive the therapy provided by a home health agency, thus releasing a hospital bed and possibly saving his family from bankruptcy.

Commercial insurance: One of the major claims the medical associations have taken against providing medical care for the aged through social security is that commercial insurance will provide this service. However, the fact is that commercial insurance does not solve the problem for many reasons. First, the very people who need insurance the most will not buy insurance. Second, after the individual reaches a certain age he cannot buy insurance. Third, commercial insurance exists for the sole purpose of making money.

Many insurance companies return only 24 cents of each dollar to the policyholder.

Mr. Chairman, this will be challenged, no doubt, and if the committee wishes I can give you the names. I did not ask permission to use them, but they were two vice presidents of insurances companies there is Knoxville. They did give me permission to put this in there and if the committee wants me to I will name them the names and so forth. I will repeat that. Many insurance companies return only 24 cents of each dollar to the policyholder, and such a return cannot provide the necessary care to meet the social need. We must have Social insurance. Social security is a form of insurance.

Regardless of whether a company is mutual or has stockholders, it is in existence for profit. We are in the 26th year of social security insurance and we are confident that the dignity it has afforded our senior citizens in retirement will carry over to giving them muchneeded hospitalization and nursing-home care provided in H.R. 4222. Dual participation in prepaid hospitalization is nothing new; many agreements between employer and employee are in effect in our area. In many instances, the employer pays the whole premium and we feel that the Anderson-King bill attached to the social security program is nothing more than a prepaid hospitalization plan.

Shortcomings of H.R. 4222: H.R. 4222 falls short of an ideal solution to the problem in many respects, which I shall not take the time to define now. The most glaring aspect of one shortcoming is that it provides nursing-home care for only a certain number of days in the year. This creates no small problem for those of prolonged, terminal, catastrophic illness. Nursing-home care is provided on a calendar-year basis which is almost ridiculous since hospital care or nursing care should be based on the needs of the patients.

In a prolonged illness, the welfare organization must seek other facilities to ease and care for the suffering patient.

This bill places all persons in a chronological or calendar age. I believe we all realize that people are individuals and should be classi fied individually. In discussing this matter with trained and experi enced social workers I reached the opinion that an "Aged quotient similar to the well-known IQ test given to students would be a fair and equitable way of determining the mental alertness and physical ability of our senior citizens.

As we all know, some people in their late 70's and early 80's have more mental and physical ability than a lot of our citizens at 50 and if this test were to take place, it would thus provide the proper agency with information on their needs.

Our AFL-CIO members have voiced their opinion time and again on this matter, they are deeply interested in the passage of the bill and feel that financing H.R. 4222 as recommended will be adequate

for the present.

I will conclude my remarks with this statement: the AFL-CIO members in east Tennessee are wholeheartedly for the President's health insurance proposal (H.R. 4222) and feel that enacting it into law merely magnifies the fact that we, as a Christian Nation, are our brothers' keeper.

Mr. KING. Mr. Galyon, the committee appreciates your coming to it with the views of your council.

Are there any questions?

If there are no questions, Mr. Galyon, we thank you again.

Mr. GALYON. Thank you.

Mr. KING. The committee will now recess until 2 o'clock this after

noon.

(Whereupon, at 12:30 p.m., the committee was recessed, to reconvene at 2 p.m., the same day.)

AFTERNOON SESSION

The committee reconvened at 2 p.m., upon the expiration of the

recess.

Mr. KING (presiding). The committee will please come to order. Dr. Henderson, will you identify yourself for the record, please. STATEMENT OF DR. EDWARD HENDERSON, IN BEHALF OF THE AMERICAN GERIATRICS SOCIETY

Dr. HENDERSON. I am Dr. Edward Henderson, of Montclair, N.J. I am appearing today on behalf of the American Geriatrics Society, a group composed of more than 7,000 physicians especially concerned with the health care of the aged.