the country economically and for the individual psychologically if he received adequate medical care because he had insured himself for it and no longer needed public assistance to make ends meet.

Approximately 175,000 blind people-or nearly half of our blind populationare over 65. Many are blind from cataracts and other conditions which frequently accompany aging. An adequate health care program under the social security system would make many operations for sight restoration possible— operations which just aren't being performed because the people concerned cannot afford them.

The American Foundation for the Blind respectfully urges the Committee on Ways and Means to take favorable action on the proposed legislation.

ALABAMA LEAGUE OF AGING CITIZENS, INC.,

Montgomery, Ala., July 18, 1961.

Re House bill 4222 (Health Insurance Act of 1961).

Chairman WILBUR D. MILLS,
Committee on Ways and Means,

House of Representatives,

Washington, D.C.

DEAR SIR: I am Rubin Morris Hanan, of Montgomery, Ala., where I am engaged in business. I am the president of the Alabama League of Aging Citizens, vice president of the National Association of Senior Citizens of America, member of the Governor's advisory board on aging, ex-vice chairman of the Committee on Aging of the State of Alabama, general executive director of the joint legislative committee of Alabama's pensions and senior citizens organizations, in which capacity I am appealing on behalf of the affiliated membership of 175,000 senior citizens of the State of Alabama and 3 million aged citizens of the National Association of Senior Citizens of America.

I urge your favorable consideration of House bill 4222 (Health Insurance Act of 1961). This bill would provide for payment of hospital services, skilled nursing home services, and home health services furnished to aged beneficiaries under the old-age and survivors insurance program, and for other purposes.

The economic philosophy of today is based on an economy of abundance due in great measure to the fact that the industrialized nations of the world reached new peaks of production because of foreign aid granted by the Government of the United States of America. Yet, in Alabama, so far as our aging citizens are concerned, in lieu of abundance there is widespread poverty. Many of the aged are poorly housed, undernourished, scantily clad, and lack much-needed medical and nursing care. Since they are no longer wage earners, they have profited little from the industrial boom. To the contrary, they are waging a losing battle as their fixed incomes have been diminished by rising costs.

The average income of most of the people in Alabama who are over 65 years of age is so low that they cannot maintain what this Nation generally assumes to be a decent standard of living and good health. After many of Alabama's old folks pay for their housing and utilities and purchase the minimum amount of food required to sustain life, there is little, if any, money left for medical fees and high priced drugs. I can assure the committee that many of our old folks are forced by poverty to do without much needed medical services.

A survey made prior to the White House Conference on Aging showed a screaming need for medical care and drugs for Alabama's aged citizens. This survey indicated the average monthly cost of providing the health care actually needed, including dental care, hearing aids, eyeglasses, and drugs, would be approximately $26 per month.

This survey also revealed that many elderly persons needed hospitalization or nursing home service, the cost of which is far beyond their meager monthly income of $33, $55 or, at the most, $66. Much of this need could be filled if all persons over 65 carried hospital and nursing home insurance. If the amount of a monthly premium for a policy of basic hospital care insurance is added to the above estimate of the cost of medical care it will bring the total to $30 per month.

Statistics show that chronic disease or disorders usually develop with age and that about 78 percent of all Americans past 65 are currently suffering from some chronic disorder. Few of these were seriously disabled by the mentioned chronic disease, but most need drugs and medical attention to alleviate pain and free

them from the fear of the unknown. In order to determine the average cost of medicinal products needed by Alabama's oldsters, several reputable druggists were asked to examine their records and report to this committee. They reported that during a calendar year the average monthly cost was a minimum of $10 and a maximum of $55.

Few of Alabama's aged people can afford prescription drugs. Hence, they resort to patent medicine and home remedies which only partially relieve their suffering. It is a vicious cycle for them--a cycle which ends only with the peace of the grave.

A well-known Montgomery physician stated that his average patient past 65 paid him about $8 a month for professional services alone, not including medicines.

Three well-known Alabama dentists agreed that it would take a minimum of $125 a year to maintain proper oral hygiene.

Yet the pensioner struggles enough to put food in his stomach and a roof over his head and cannot afford the "luxury" of medical care.

Such miseries could well be exploited by our foreign enemies.

The welfare of the public at large is no better than the welfare of the least and most feeble of its citizens.

For the sake of humanity and the sake of the Nation, I beseech you to consider favorably House bill 4222.

We see our aged every day clustered together and alone. We hear them pray for the release of their suffering and agony of the night that comes with death, clinging to a hope for somebody's affection that does not come to pass. We see our millions of American aged citizens deprived and forgotten, masters yesterday, outcasts today.

Yes, millions of our aged citizens of America are having to exist on substandard nutritional levels, and many are undernourished and underfed simply because their incomes are not sufficient to provide them with adequate diets for good health.

The distress of the unfortunate American senior citizens who are unable to make ends meet and who are on short rations could be substantially alleviated by a more effective utilization of our national resources and skills.

What America owes to the old is not only reverence, but all they ask for is consideration, attention, and justice; not to be discarded and forgotten; to be treated as human beings. What they deserve is preference to the health problems confronting our aged citizens of America. Yet we do not even grant our aged citizens equality and the freedom from want.

H.R. 4222 will take a leading part in reducing our yearly mortality rate of about 1 million among age 65 and over. Every approach should be explored which might offer a remedy for the present situation, where large numbers of senile patients are sent to the hospitals for the mentally ill to die because of the lack of suitable services for the treatment of the aged.

Fifteen million of our aged citizens are beset by boredom and left with few outlets; yet those who do become hospital patients this year and have no adequate insurance against the soaring costs may find the psychic shock of expense to the pocketbook nerve almost as great as the physical shock of an operation to the body.

Medical progress has gradually lengthened the lifespan of our citizens— mainly through saving infants and mothers who die unnecessarily. Is it not equally vital that our aged, in whose ranks are found some of America's greatest spiritual, mental and skilled assets, should share in these benefits, which H.R. 4222 will provide?

If we reject this bill, we reject the aged citizens of America, and we allow precious human lives to be tragically and needlessly wasted. Most of our aged don't wear out. They rust out. They rust out for lack of adequate medical, nutritional, and health care, and for want of the simple necessities of life, vitamins, drugs, and doctor's advice.

This bill, regardless of expenditure, will not be a liability to our country. It will be an investment for the best future interests of our Nation.

We believe that we are free people under God and there is more than significance to help our sick, helpless, and needy aged citizens of America. Unless we honestly believe that faith in God gives meaning and purpose to human life, democracy will lose its effect and will be a magnet for communism.

Our greatest threat to our freedoms today is the misery, the suffering, the hunger, and the agonies of our own neglected citizens. No nation can be great

and no nation can be truly democratic that does not consider the needs of its people.

The officers and members of the Alabama League of Aging Citizens and the National Association of Senior Citizens of America, most seriously urge the passage of H.R. 4222, through passage of this bill, and would to that end again call to your attention not only the humanitarian aspect, but the needs of our Nation today for every available ounce of its energy and resource, not just to preserve our society, but that freedom and a better life might flourish for all in our society.

Yours very truly,

RUBIN M. HANAN, President.

ROCHESTER, MINN.,

July 8, 1961.

Representative WILBUR MILLS,

U.S. House of Representatives,
Washington, D.C.

DEAR SIR: I have just received a letter from James A. Blake, M.D., chairman of the statewide congressional committee (Minnesota), requesting that I contact you and my representative in Congress (Albert Quie) to urge you to oppose the King bill, H.R. 4222.

This I cannot do. In fact, I strongly urge you to favor passage of the bill. While I usually agree with the general aims of the American Medical Association, I often disagree with it about the proper way to accomplish these goals. In my opinion, lack of leadership on the part of the association in meeting the health needs of the Nation will inevitably lead to legislation that will be even more unpalatable in its views than is the King bill.

The fact is that we have an aging population. Indeed, modern medical care, which is a tribute in large part to the ability of the Nation's physicians in developing new methods, drugs, and techniques to further prolong life, contributes to this situation and will continue to do so. It is appropriate, then, that physicians should interest themselves in some practical way in which good medical -care can be made available to the aged.

Physicins must recognize that when an older person is poor he is very, very poor, and is likely to remain so. Also, since social security reflects to a great degree money earned by the toil of the individual in younger and more productive years, it is not a "pure handout." The psychological value of this circumstance to the recipient is obvious. For many persons social security payments represent the only way doctor's bills can be paid. Furthermore, if older citizens cannot meet their medical charges by social security they may be very well be obliged to accept services from tax-supported charity clinics, the purest form of socialized medicine in America today.

Please insert may letter in the committee's hearings.
Sincerely yours,

Hon. SAM RAYBURN,

W. N. TAUXE, M.D.

INDIANAPOLIS, IND., July 11, 1961.

Speaker's Rooms, House Office Building, Washington, D.C.:

Presently am attending triorganization scientific and clincial conference on rehabilitation. It came to my attention that bill H.R. 4222 presently being considered in House Ways and Means Committee specifically lists physical therapy, occupational therapy, or speech therapy as reimbursable therapies. I feel as a physician and a constituent of yours that this limits the doctor in prescribing therapy. A broader term such as "rehabilitation services" should be substituted. Such a change would be to the advantage of the patient and control would be left in the hands of the medical doctor.

Respectfully yours,

Dr. GEORGE R. ELLIS, McKinney, Tex.

WILBUR MILLS,

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

SEATTLE, WASH., June 28, 1961.

I have just learned that the American Nurses Association and the Washington State Nurses Association are officially on record favoring the King-Anderson bill which would mean welfare-type medical care for social security recipients, and that these groups plan to present statements urging its enactment at the hearings soon to be held by your committee.

Having studied this bill, it is my conviction that its enactment would lead to poorer, not better medical care for our elderly citizens, and that the KerrMills plan instead, is the proper solution for this program. I would like to commend you, personally, for your part in its enactment during the last session of Congress.

It is very unfortunate that the policymaking group of the ANA and WSNA is made up of a small number of administrators and instructors who on nonprofessional matters of this kind often do not reflect the views of the majority of professional nurses. As an active member and as president of my school's nurses alumni association (University of Washington), I know that most graduate nurses not only are unfamiliar with the unpublicized provisions of the King bill, but will bitterly resent the tax increase that its financing would require to meet its real cost. It is bordering on fraud to pretend that $9 million will cover the cost of nursing-home care, for example, for all of America's elder citizens, when our own State alone already is paying twice that much each year even without Kerr-Mills increased coverage. I do not think that there is any doubt that this bill would be detrimental both to nurses and to the ideals of nursing, which I recently attempted to portray in a book I recently coauthored, "So You Want To Be a Nurse."

I sincerely hope that your committee will be able to withstand the pressures which will be placed upon it favoring the passage of this ill-advised legislation. Its passage would be a tragic blow to the progress of the health care of the elderly citizens of America.

I would appreciate your insuring that this letter is made a part of the record of the hearings of your committee.

Sincerely yours,

ELEANOR HARTVEDT HALLIDAY, R.N.

MINNEAPOLIS, MINN., July 1, 1961.

Re H.R. 4222 and freedom.

Hon. WILBUR D. MILLS,

Chairman, House Ways and Means Committee,
House of Representatives, Washington, D.C.

DEAR CONGRESSMAN MILLS: My parents came from Denmark to this country shortly after the turn of the century, and for but one reason-freedom. Already at that time Denmark was becoming too socialistic for them. Today it is highly socialized, and the people in Denmark with whom I correspond because of my parents, are not happy. Denmark ranks next to Sweden in having the highest suicide rate in the world. Why? I think you know the answer as well as I do. Our freedoms are also gradually being taken away. I fought the fair housing law here in Minnesota on the basis of discrimination against property owners. It is not fair to property owners, who are the backbone of this country, to be hampered by a law of this nature. It is just another step toward Government control and it will discourage ownership of property. I felt we were making good progress in the field of racial relations in Minneapolis and this was being accomplished through the churches, the schools, and the community. I hit hard at the clergy in my letters to the editors and in my lobbying, for the clergy was the main force behind this bill. They should know that one cannot legislate brotherly love. You will recall that Gandhi once said "Prejudices cannot be removed by legislation. They yield only to patient toil and education." I understand, we rent to Negroes and other minorities.

76123-61-pt. 4- 19

I do not pretend to understand the various bills pertaining to medical care, but I do know that I am opposed to socialized medicine. This is just one more step toward the loss of freedom-both for patients and doctors. I know that my husband, my daughter, and I would not be alive today if our private physician in whom we had faith, and who in turn had his heart and soul in his work, and the freedom to act, had not been available.

We also understand what freedom really means since we have had our own business. It is a challenge. It has had its ups and downs, mostly downs, and it has not paid off moneywise, nor does it mean security, but it is freedom. The doctors, too, need this freedom to practice, to build up their own business and meet the challenge of their profession.

I am not opposed to aiding those really in need of medical care, but I do oppose aiding those who can take care of themselves. I hope you will oppose H.R. 4222 and any bill which tends to control our freedoms, and I hope you will insert this letter in the committee's hearings.

DEAR MR. IRWIN: Thank you for your letter of July 24. As indicated in the telegram sent to you on July 21, I am president of the Senior Citizens Council of Minneapolis, an organization composed of 33 senior citizens clubs in this city, having a total membership of over 2,000.

At a regular meeting of the council held on April 10, 1961, at which nearly all of the member clubs were represented, a resolution was unanimously adopted favoring the passage of the King bill, H.R. 4222, and a copy of the resolution was mailed to most of our Minnesota Congressmen. It was our wish that a rep resentative of our Senior Citizens Council might be permitted to appear before your committee in person and testify in favor of the bill.

We are aware of the fact that some opponents of the bill claim that many retired persons who are now receiving social security benefits have ample means and do not need hospital or medical benefits. That is true, but according to a survey in Minnesota conducted last year by the American Association of University Women, under the direction of the University of Minnesota, not more than 42 percent of the retired persons are so situated. At least 58 percent of the retired persons do need financial help to take care of hospital and medical expenses after retirement. The survey also showed that 53 percent of all people over 65 years of age had income of less than $2,000 per year and that 33 percent had a net worth of less than $2,500.

We submit that retired citizens do not wish to be treated as charity patients but prefer that deductions made during the earning years be accumulated as insurance to cover hospital and medical needs in their retirement years.

It is also charged that there are many who are not covered by social security. That is true, but social security has been expanded and no doubt can be and will be expanded further to cover those who are not now covered.

We do not think it is fair to say that this is a step toward socialized medicine. As we understand it, there is nothing in this bill which will prevent the bene ficiary from selecting the doctor or hospital of his choice, and the fact that the beneficiary must pay the first $90 of hospital expense will prevent any so-called chiseling.

We realize that there will always be cases of dire need that will have to be taken care of by local or county welfare boards, but we believe that the vast majority of senior citizens will be able to take care of their own hospital and medical expenses after retirement with the help that will be provided under the King bill, H.R. 4222.

It is desired that this statement be printed in the record in lieu of a personal appearance before your committee.

Very truly yours,

E. B. RINGHAM, President.