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HEARINGS

BEFORE THE

COMMITTEE ON FINANCE
UNITED STATES SENATE

EIGHTY-NINTH CONGRESS

FIRST SESSION

ON

H.R. 6675

AN ACT TO PROVIDE A HOSPITAL INSURANCE PROGRAM FOR
THE AGED UNDER THE SOCIAL SECURITY ACT WITH A SUP-
PLEMENTARY HEALTH BENEFITS PROGRAM AND AN EX-
PANDED PROGRAM OF MEDICAL ASSISTANCE, TO INCREASE
BENEFITS UNDER THE OLD-AGE, SURVIVORS, AND DISABILITY
INSURANCE SYSTEM, TO IMPROVE THE FEDERAL-STATE PUB-
LIC ASSISTANCE PROGRAMS, AND FOR OTHER PURPOSES

47-140

PART 1

APRIL 29, 30 AND MAY 3-7, 1965

Printed for the use of the Committee on Finance

U.S. GOVERNMENT PRINTING OFFICE
WASHINGTON: 1965

For sale by the Superintendent of Documents, U.S. Government Printing Office
Washington, D.C., 20402 Price $1.50

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Becker, Dr. Carl E., member of governing council and past regional vice
president, American Nursing Home Association..

453

Bernstein, Philip, chairman, Committee on Social Issues and Policies,
National Social Welfare Assembly - -

263

Carson, Dr. Russell B., chairman, Board of the National Association of
Blue Shield Plans; accompanied by John W. Castellucci, executive vice
president of the association; and Dr. Donald Stubbs, chairman, govern-
ment relations committee_.

Carstenson, Blue, director, Senior Member Council, National Farmers
Union...

Celebrezze, Hon. Anthony J., Secretary of Health, Education, and Welfare;

accompanied by Wilbur J. Cohen, assistant secretary for legislation;

Robert M. Ball, Commissioner of Social Security; Robert J. Myers, chief

actuary, Division of the Actuary; and Charles E. Hawkins, Legislative

Reference Division, Welfare Administration__.

391.

352

Cobb, W. Montague, M.D., president, National Medical Association;
accompanied by Dr. Kenneth W. Clement..

Cruikshank, Nelson H., director, Department of Social Security, AFL-

CIO-

323

Forand, Hon. Aime J., former Representative in Congress from the State of
Rhode Island.......

Goodloe, Don B., legislative representative of the Washington, D.C.,

Teachers' Union, local 6, of the American Federation of Teachers__.

Hicks, W. B., Jr., executive secretary, Liberty Lobby.

Jordan, Edwin P., M.D., executive director, American Association of Medi-

cal Clinics..

Keene, Dr. Clifford H., vice president and general manager of Kaiser
Foundation Health Plan, Inc.; accompanied by Scott Fleming, legal
counsel; Arthur Weissman, medical economist; and Lloyd Cutler, of
Wilmer, Cutler & Pickering, Washington, D.C.

Kerr, Dr. Lawrence F., member, council on legislation, American Dental

Association; accompanied by Bernard J. Conway, chief legal officer,

King, Raymond E., Jr., chairman, Committee on Social Security of the
National Association of Life Underwriters; accompanied by Carlyle M.
Dunaway, general counsel; and David Patterson, counsel, the National
Association of Life Underwriters__.

Knowles, John H., M.D., general director, Massachusetts General Hospital.

Lichtenstein, Zalmen J., executive director, Golden Ring Council of Senior

Citizens..

225

459

408

III

McNerney, Walter J., president, Blue Cross Association; accompanied by Page
Bert Tollefson, Jr., Washington representative, Blue Cross Association...

Letter to the committee.

Noehren, Dr. Walter A., Sandy, Oreg--

Saltonstall, Hon. Leverett, a U.S. Senator from the State of Massachusetts.

Schlotterbeck, Karl T., manager, Economic Security Department of the

Chamber of Commerce of the United States__

Schreiber, Jack, M.D., Canfield, Ohio; accompanied by John J. McDon-
ough, M.D., Mahoning County Medical Society, Youngstown, Ohio___
Letter to Hon. Frank J. Lausche..

Standard, Samuel, M.D., on behalf of Community Council of Greater New
York, Inc.

Terrenzio, Joseph V., executive director, the Brooklyn Hospital; accom-
panied by Dr. David B. Wilson, director of University Hospital, Jack-
son, Miss.; and Kenneth Williamson, associate director of the American
Hospital Association___.

Thompson, Julia C., director, Washington office, American Nurses'

Association..

Volpitto, Perry P., M.D., president, American Society of Anesthesiologists,

Inc.; accompanied by John Lansdale, counsel__

Watts, Dr. Malcolm S. M., representing the American Society of Internal
Medicine; accompanied by Dr. James J. Feffer, and Dr. Joseph Wallace-
Wilbur, Dr. Richard S., Palo Alto Medical Clinic, Palo Alto, Calif.......
Young, Dr. Edward L., chairman of the Physicians Forum, Inc..
Zagri, Sidney, legislative counsel, International Brotherhood of Team-
sters, Chauffeurs, Warehousemen, and Helpers of America__.

333

349

448
1255

433

298

489

472

385

269

Additional continuing cost per year of administering the disability insur-
ance benefit provisions as they would be modified by section 303 of H.R.
6675---

217

Adequacy of Blue Shield Service__

405

American Hospital Association, letter of Kenneth Williamson, associate
director, to the chairman_.

332

Benefit disbursements under present law in 1964 and estimated benefit dis-
bursements under H. R. 6675 in 1967_

143

Comparison of health insurance provisions of H. R. 6675, S. 1, and H.R.
11865 as passed by the Senate in 1964..

126

Concurrent payment of workmen's compensation and disability benefits
under social security system_.-

151

Cost estimate for blanketing-in all persons aged 65 and over for cash
benefits__

155

Cost of selected retirement test changes taking into account the changes
made by H.R. 6675 in other provisions of the program.
Deductible and coinsurance under supplementary plan..

121

110

Disability offset provision in the social security law--

147

Distribution of licensed physicians some comparative figures in nine
States__

284

Earnings of people affected by the retirement test_
Effect of cash benefit changes. -

140

112

Effect of the Douglas amendment on hospital outpatient diagnostic

benefits

Estimated amount of benefit payments in calendar year 1964 to benefi-
ciaries residing abroad, by country or continent...
Estimated amount of benefit payments in calendar year 1964 to benefi-

ciaries residing abroad, under the present program and under the pro-
gram as modified by H.R. 6675, by country or continent..
Estimated number of people aged 65 and over eligible for social security
benefits by applicability of retirement test and amount of earnings in
1963.

Example of payment on nonfee basis for services covered in H.R. 6675--.

Exclusion of services of medical specialists from medicare__.

Factors associated with low-benefit amounts__.

Federal employee health benefits program enrollment statistics_.

Financing of two health insurance programs

Hospital insurance plan-four types of benefits.

Legislative Blue Shield retiree programs..

Major changes in cash benefit provisions_

National Blue Shield enrollment-...

OASDI tax rate on both employee and employer_.

Outline of a plan for prepaid financing of medical care for the aged_
Percent increase in incomes between 1939 and 1959__

Persons 65 and over protected under hospital insurance_

! ! ! ! |

159

Role of fiscal intermediaries in the administration of the proposed program
of health insurance for the aged___.

204

228

Supplemental report submitted by the Department of Health, Education,
and Welfare__

494

Supplementary plan-four types of benefits..
Treasury Department report on H. R. 6675_

109

519

Algase, Julia, legislative counsel, representing New York Hotel & Motel
Trades Council, AFC-CIO; accompanied by E. Sarni Zucca, secretary,
Dining Room Employees Union, Local 1; Vangel Kamaras, chairman,
Social Security & Tip Committee, Hotel Trades Council; and Fred
Ferrara, president, Local 11, Dining Room Employees---

Anderson, Cyrus T., representing International Union of Hotel & Restau-
rant Employees & Bartenders__.

Archer, Dr. Vincent W., Charlottesville, Va_-_-

1016

981

1027

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