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medical costs that go along with decent standards of medical health care. Tens of thousands of people, primarily Iowa's aged citizenry, are now going without adequate medical care because of the tremendously high cost involved coupled with a very low income. We feel that passage of H.R. 4222 is absolutely a must if Iowa's aged citizenry is to receive even the most minimum standards of medical health care.

I remain,

Sincerely yours,

JACK E. McCoy, Executive Vice President.

KANSAS STATE FEDERATION OF LABOR, AFL-CIO,
Topeka, Kans., August 15, 1961.

The Honorable WILBUR D. MILLS,

Chairman, House Ways and Means Committee,
New House Office Building,

Washington, D.C.

DEAR CONGRESSMAN MILLS: The Kansas State Federation of Labor, AFL-CIO, is extremely anxious to see H.R. 4222, the Anderson-King bill, adopted.

The State of Kansas has not adopted the necessary legislation that would enable our State to participate in the medical assistance for the aged bill adopted in 1960.

Kansas has 240,000 citizens aged 65 and over and if the Anderson-King bill is adopted, it would enable approximately 190,000 persons to receive health benefits in 1963. The average old-age benefit paid in the State of Kansas is $70 per month. This compares with an average hospital charge for bed and board of $16 a day in a semiprivate room and $14 a day if six or more adults are in one room.

A huge majority of the citizens of Kansas 65 years of age and older have no savings or very little, consequently their social security benefits are totally inadequate to permit these individuals to get the needed hospital and medical care that they so vitally need.

We urge you to enter this in the record of the committee and sincerely hope the committee will give the Anderson-King bill, H.R. 4222, favorable recommendation. Rspectfully yours,

F. E. BLACK, Executive Secretary.

STATEMENT OF SAM EZELLE, EXECUTIVE SECRETARY, KENTUCKY STATE AFL-CIO

The Kentucky State AFL-CIO is the largest organization in Kentucky, excluding political parties and religious denominations. Representing over 135,000 laboring families, this State labor council has had full opportunity to learn of the acute health problems of our older citizens.

This organization is on record favoring the President's health insurance proposal, H.R. 4222, to provide medical care for the aged through our social security program.

There are approximately 292,000 persons aged 65 years and over in the Commonwealth of Kentucky. Estimations are that the Anderson-King bill would enable 228,000 of our old folks to receive health benefits by 1963. The estimated amount of this assistance in 1963 is $16 million.

When one considers that the average old-age benefit in Kentucky is only $65 a month, and semiprivate hospital rooms are averaging $14 a day, the problem comes sharply into focus. A Louisville survey discloses that one can reserve an air-conditioned suite in any of the four leading hotels, with private bath and television, cheaper than one can reserve a private room in our hospitals! Kentucky's State report to the White House Conference on the Aging clearly indicates that thousands of older people in our State are not receiving adequate medical care. Between the years 1956 and 1960, 4,036 persons over the age 65 were admitted to State hospitals for treatment of mental disorders. In addition, the Kentucky State Department of Health, in conjunction with the department of economic security, has made a survey which shows that to date this State has approximately 80,000 persons 65 years of age, or older, who are not receiving adequate medical care.

Existing Federal and State legislation does not scratch the surface. Kentucky was one of the first States to avail our people of the new Federal benefits but look at the sad results: Payments were first made in April 1961 to only 14 recipients. There were 38 recipients in May; 37 in June; and by July, only 40. A total of only 129 Kentuckians have received a total of $5,781.81, from April 1 through July 28.

The program is inadequate * *

Hospital care is limited to only 6 days.

Physicians services are for "acute, emergency, and life-endangering conditions," limited to two visits per month per patient. This regulation is contradictory on its face, because such serious conditions of health could hardly be limited to two visits per month.

Dental services have recently been added, but are limited to $48 per recipient per annum. A complete set of dentures, plus the necessary extractions, would have to be acquired over several years, no matter how essential to life or health. Drugs are in accordance with an established list and fee schedules, but we are receiving reports already (Carter County) that druggists are not cooperating with the plan and are refusing to be bothered with the forms and regulatory

measures.

We are, by analogy, offering band-aid and aspirin to old people needing surgery and nursing home care.

The six health ailments of highest prevalence are arthritis and rheumatism, heart trouble, blood pressure, urological difficulties, problems of the digestive system, respiratory ailments, and ailments associated in some way with the skeletal structure. Many persons named health ailments associated with the heart, such as heart trouble, blood pressure, hardening of the arteries, and poor circulation. Others, about one out of six older persons, named arthritis or rheumatism as bothersome health ailments. Almost one out of four persons named health ailments associated with the heart, such as heart trouble, blood pressure, hardening of the arteries, and poor circulation.

Kentuckians are proud people. Our older people, in particular, resent any condition that brands them as beggars, and the pauper's oath provisions that now confront them are repugnant to them. They are left with simple home remedies, or none at all, while the marvels of modern medical science are daily revealed all about them.

Private health insurance is obviously not the answer. The rates are high for the aged because the risk is high. Policies are often revocable, and the first time it is used brings a cancellation. Following a cancellation, additional insurance is hard to acquire.

The practice of passing the cost of one's illness on to children is difficult in Kentucky, which has had so much unemployment. There is now a mass exodus from Kentucky to other States, and the aged are left here to shift for themselves, while their sons and daughters seek jobs elsewhere.

We believe that a plan based on social security, which has an administrative cost less than 2 percent, must be the answer for Kentucky.

To provide in our youth for the health problems of our declining years seems to be much more palatable than the taxing of an entire population for those who must add the pangs of humiliating charity to their present infirmities.

Hon. WILBUR D. MILLS,

BALTIMORE COUNCIL OF AFL-CIO UNIONS,

Baltimore, Md., August 9, 1961.

Chairman, House Ways and Means Committee,

House Office Building, Washington, D.C.

DEAR SIR: The Baltimore Council of AFL-CIO Unions is writing to your honorable committee to request their support of H.R. 4222, a bill to provide for medical aid to the aged tied to the social security system.

The legislative committee of this council has given considerable thought and study to the many approaches to this problem that have been presented, and after thorough examination have come to the conclusion that the provisions of H.R. 4222 most nearly meet the desires of the people we represent. We make this request with the full knowledge that the Medical and Chirurgical Faculty of Maryland, through its official spokesmen, have testified before your committee in opposition to this measure.

While we have not been afforded the opportunity of reading in toto the testimony of the above-named organization, we have been afforded the privilege of reading the testimony of President George Meany of the AFL-CIO, and beg to advise that this very able statement by President Meany reflects in all detail the opinion of this council.

Your consideration in the above matter will be appreciated.

Sincerely yours,

FRANCIS S. FILBEY, President.

Hon. WILBUR D. MILLS,

MASSACHUSETTS STATE LABOR COUNCIL, AFL-CIO,
Boston, Mass., July 31, 1961.

Chairman, House Ways and Means Committee,
New House Office Building, Washington, D.C.

DEAR CONGRESSMAN MILLS: On behalf of the Massachusetts State Labor Council, AFL-CIO, I wish to record that our organization and its 500,000 members are strongly in support of H.R. 4222, the King bill, establishing health insurance benefits for the aged under the social security system. We heartily concur in the views expressed by AFL-CIO President George Meany on this legislation. As you know, Massachusetts is one of the seven States that has availed itself of the medical care for the needy aged (Kerr-Mills bill) enacted by the 1960 Congress. While this medical assistance legislation has been beneficial to ap proximately 15,000 aged in Massachusetts since its adoption, it has still failed to benefit the majority of our citizens over 65 who are not on public welfare (OAA) or who, if on Federal social security, can't qualify or prefer not to undergo the community stigma of the means tests requirements.

In Massachusetts, there are approximately 575,000 persons aged 65 or over, 85 percent of whom would qualify for benefits under the King bill. Our State has long been one of the most progressive and liberal States as far as old-age assistance and other welfare benefits are concerned. However, Massachusetts, faced with serious fiscal problems, shortly will be unable to continue to finance these welfare benefits from existing tax revenues. Like most of the New England States, Massachusetts has a higher average per capita age than prevails throughout the Nation. Accordingly, the medical care needs of this higherthan-average age population can't continue to be financed from general taxation. In our opinion, financing medical care for the aged under the contributory social security system is more economical, efficient, and acceptable than the existing program or any other that has been proposed. Based upon my observation of the experience of Massachusetts under the 1960 Federal legislation, this stopgap measure has created more problems than it has solved. Medical care for the aged, integrated with the social security system, will enable a worker, on a pay-as-you-earn basis, to provide for his medical care problems and payments when he reaches age 65. He will be able to do so during his lifetime of work with a feeling of security, while retaining his self-respect and freedom of choice of doctors, etc., upon his retirement.

I strongly urge that your honorable committee approve H.R. 4222 and thereby bring about a logical and economical extension of the social security system. Respectfully submitted.

KENNETH J. KELLEY,
Secretary-Treasurer.

DETROIT, MICH., August 17, 1961.

WAYS AND MEANS COMMITTEE,
House of Representatives,

Congress of the United States,

Washington, D.C.:

As officers of the Michigan AFL-CIO, representing 600,000 members of labor in Michigan, we wish to record with your committee our interest in passage of the Anderson-King bill.

Our organization favors the social security system, but we feel it should also protect recipients against medical catastrophe because medical costs destroy hard-earned economic security of retired persons and impose tremendous burdens upon their children. We agree with the majority opinion of delegates who served on Section on Income Maintenance at last White House Conference on Aging that the social security mechanism should be the basic means of financing health care for the aged.

We object to any health program for the aged based solely on old-age assistance which constitutes a means test, thereby inflicting humiliation and unwarranted imposition upon the aged and relatives.

The 14 million senior citizens of our United States are proud of their independence, but aware of limitations against economic forces of their time, and on their behalf, we urge favorable consideration of H.R. 4222.

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Today many thousands of elderly Mississippians are not receiving proper medical care due to the high cost involved. In a few short years many more thousands will find themselves in the same predicament. There can be no question that many have failed to live out a full lifespan because of the lack of finances. Others have placed an unbearable burden upon their relatives and friends.

It should be plain for all to see that our society can ill afford a continuation of this deplorable situation. There is only one feasible approach to this problem and that is a prepaid medical plan financed through social security. Such a plan is now being advocated by the present administration and is embodied in H.R. 4222. It is my understanding that your committee is presently holding public hearings on this bill and will act upon it soon. Regardless of the position taken by the Mississippi Chamber of Commerce, the American Medical Association, and other special interest groups, I am firmly convinced that a great majority of Mississippians are in favor of the ingredients contained in this piece of legislation.

In their behalf and in the behalf of the 50,000 AFL-CIO members of Mississippi your committee is sincerely requested to report this bill favorably. Sincerely,

CLAUDE E. RAMSAY,

President, Mississippi Labor Council, AFL-CIO.

SUPPLEMENTARY WRITTEN STATEMENT OF JOHN I. ROLLINGS, PRESIDENT, MISSOURI STATE LABOR COUNCIL, AFL-CIO

The Missouri State Labor Council AFL-CIO, through its president, wishes to accept your kind offer of July 20, 1961, to file a supplemental statement in support of H.R. 4222.

The Missouri State Labor Council AFL-CIO has within its affiliation approximately 1,000 union organizations with about 300,000 members. When related to the populatiton in Missouri on the basis of 3% persons in a trade union member's family, about 1 million of Missouri's citizens would be closely associated with our trade union membership.

Our

Missouri's population is 4,319,813; 503,000 of our citizens are over 65 years of age. Approximately 25 percent of these (120,000) are OAA recipients. State is among the highest in percentage of population above 65 years of age, and also among the highest in percentage of residents over age 65 who are OAA recipients. The average OAA monthly payment is about $70. When you compare this monthly payment with a normal per day cost of $15 for hospitalization charges for bed and board, it is easily understood the predicament these elder citizens are in. Many of them are on the OAA rolls because of exhausting their meager resources by trying to pay for medical needs.

Recently an elderly St. Louis couple, 65 and 63 years of age, were found dead in bed. They left a note telling of their despair in meeting financial problems arising out of their medical needs. Mr. Palmisano had never recovered from a

heart attack suffered 2 years before. They had tried to get in a home, but the cost was $4,800 per year. Their equity in their home would have provided only about 1 year of care. One of the last sentences in a note left by Mrs. Palmisano read, "Please, for God's sake, try to help the sick and aged".

The financial condition of the Palmisanos is typical to thousands of Missouri's elderly couples-their resources exhausted by the high cost of medical care, they become a burden of the State or the local community.

Missouri Legislature just concluded, refused to enact a law authorizing medical assistance for the aged under Public Law 86-778.

In the opinion of the Missouri State Labor Council AFL-CIO, there is only one solution to this problem and that is through social security-with no means test. The provision for hospital services, home nursing services, outpatient diagnostic and X-ray services, etc., can and must be supplied through a sound system of financing, and provided as a matter of right to our elder citizens.

STATEMENT OF HAROLD C. HANOVER, PRESIDENT, NEW YORK STATE AFL-CIO

We express our appreciation to the chairman and members of the House Committee on Ways and Means for this opportunity to express the views of the New York State AFL-CIO on the merits of the Anderson-King bill, H.R. 4222, which is now pending before the Congress. It is the judgment of this labor organization and its 2 million members that the passage of this bill would be in the best public interest.

Health protection and care for our older citizens is one of the most pressing social problems confronting the people of our State. In 1950 there were 1,270,000 New York State residents 65 years of age and over; today the number is approximately 1,680,000 and is expected to increase to 2,550,000 in 1975 or 12 percent of the State's population.

Our population aged 65 and over spends approximately 50 percent more per capita for medical care. The relatively greater need of older persons for health services has been demonstrated in a number of studies on this subject, and the findings of the 1957 New York State Insurance Department's actuarial study show that the average number of days per year of hospital confinement is more than four times higher for a man aged 65 than for one aged 35, while the average annual surgery cost at age 65 is more than double that of age 35. Moreover, a report of the New York State Committee of One Hundred for the 1961 White House Conference on Aging shows that for the 65-and-over group, 78 percent have one or more chronic conditions, of which 27 percent have one, 20 percent have two and 31 percent have three or more chronic conditions.

Despite the greater medical care costs for persons 65 years and older, these people have far less income and ability to pay for such care. The primary Federal social security benefit on which most of the aging must rely in our State averages $79 per month. According to the 1958 studies of the New York State Interdepartmental Committee on Low Incomes, 80 percent of the aged population have incomes of less than $2,000 a year, while 60 percent of those over 65 receive less than $1,000 a year including social security.

We of organized labor do not believe that medical care can be provided by private voluntary Blue Cross plans or the insurance industry.

The 1958 study of the New York State Insurance Department on Voluntary Health Insurance and the Senior Citizen shows that:

According to underwriting practices for individual policies 80 percent of the individual contracts were not issued after age 65; that 52 percent of the contracts were scheduled to expire at or before age 65; that, thus for more than half of the individual insurance contracts, older persons are disqualified by virtue of age limitations (p. 31).

Only 35 percent of New York State's citizens 65 years of age and over have hospital insurance. "Presumably, an even smaller proportion are protected by other forms of medical care insurance. As a consequence, a large proportion of older persons without adequate financial resources must rely upon care provided by public agencies, charities, or relatives, with an attendant loss of dignity. Many fail to seek care because of the costs involved and others go into debt" (p. 115).

Furthermore, these policies are evidently not geared enough to the chronic illness problem of the aged when, for instance, insurance vendors in New York State paid only $11,400,000 or 13.7 percent of the more than $83 million hospital bill for the aged in 1955.

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