Statement of--Continued Ives, Hon. Irving M., a United States Senator from the State of New McNary, William S., chairman, Council on Government Relations, McNeel, John O., medical director, Labor Health Institute.. Mitchell, Clarence, director, Washington Bureau, National Associa- Oregon State Medical Society. Pillars, Dr. Floyd W., member of the Council on Legislation of the Saltonstall, Hon. Leverett, a United States Senator from the State of Page 646 641 893 875 847 867 978 653 865 Sifton, Paul, UAW-CIO legislative representative, chairman, CIO legislative committee on social security. 930 Smith, Frank E., director, Blue Shield medical care plans. 647 Thye, Hon. Edward J., a United States Senator from the State of 973 Voorhis, Jerry, executive secretary, Cooperative Health Federation of 976 Wandell, William, associate director of research for the Farm Bureau 800 Additional information: Growth in number of people covered by hospital, surgical, and medical expense protection, chart___ 810 Health Information Foundation survey of medical costs and voluntary health insurance.. 991 Letter from Acrea, D. L., manager, Colorado Division, Reno, Nev., to Hon. 972 Buerki, Dr. Robin C., executive director, Henry Ford Hospital, Miles, Clarence R., manager, legislative department, Chamber of 970 1024 679 811, 838 Nelson, Herman E., New York Life Insurance Co., Boulder City, 973 970 913 Special acts affecting prepayment medical care plans-Survey through 1953. 983 Cutler, Raymond and Wendell, to Hon. George W. Malone.. 971 Deutsch, M. William, to Hon. George W. Malone. 971 Hammel, Paul A., Insurance Commissioner, State of Nevada, Las Vegas, Nev., to Hon. George W. Malone.. 972 Lucini, Red, to Hon. George W. Malone... 971 Mattson, D. E., secretary, Nevada State Insurance Agents Asso- 971 Stanley, Leon K., to Hon. George W. Malone.. 972 971 Young, James C., Las Vegas, Nev., to Hon. George W. Malone.. 971 PRESIDENT'S HEALTH RECOMMENDATIONS AND RELATED MEASURES TUESDAY, APRIL 13, 1954 UNITED STATES SENATE, COMMITTEE ON LABOR AND PUBLIC WELFARE, SUBCOMMITTEE ON HEALTH, The subcommittee met at 10:03 a. m., pursuant to call, in room P-63 of the Capital, Senator William A. Purtell (chairman of the subcommittee) presiding. Present: Senator Purtell (chairman of the subcommittee). Also present: Roy E. James, staff director; Melvin W. Sneed, and William G. Reidy, professional staff members. Senator PURTELL. The subcommittee hearing will come to order. The hearing of the subcommittee resumes today with primary emphasis on health insurance. The testimony will focus on the adminsistration's recommendation for a reinsurance program designed to encourage more extensive use of voluntary prepayment health insurance plans, although some witnesses, especially those not previously appearing before the committee during these hearings, may testify also on other related matters before the committee. Our first witness in this phase of the hearings will be the Secretary of Health, Education, and Welfare, who will present the administration's view on S. 3114. The bill will be inserted in the record together with the reports thereon by the executive agencies. (The bill, S. 3114, and the reports referred to are as follows:) [S. 3114, 83d Cong., 2d sess.] A BILL To improve the public health by encouraging more extensive use of the voluntary prepayment method in the provision of personal health services Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled, That it is the purpose of this Act to encourage and stimulate private initiative in making good and comprehensive health services generally accessible on reasonable terms, through adequate health service prepayment plans, to the maximum number of people, (a) by providing technical advice and information, without charge, to health service prepayment plans and to the carriers or sponsors thereof; and (b) by making a form of reinsurance available for voluntary health service prepayment plans where such reinsurance is needed in order to stimulate the establishment and maintenance of adequate prepayment plans in areas, and with respect to services and classes of persons, for which they are needed. TITLE I-GENERAL DEFINITIONS SEC. 101. As used in this Act (a) The term "beneficiary" means an individual (1) with respect to whom a carrier, pursuant to a health service prepayment plan, undertakes to pay in whole or in part for specified personal health services furnished to him by others, or (2) to whom, pursuant to such a plan, it undertakes to provide specified personal health services; (b) The term "carrier" means a voluntary association, corporation, or partnership, other than an instrumentality wholly owned or controlled by a State or political subdivision thereof, which is organized under State law, and which is sponsoring, or is engaged in providing protection under insurance policies or subscriber contracts issued pursuant to, or is otherwise engaged in operating under, a health service prepayment plan; (c) The term "Council" means the National Advisory Council on Health Service Prepayment Plans; (d) The term "fund" means the Health Service Prepayment Plain Reinsur ance Fund established by section 307; the term "account" means an account within the fund, established by the Secretary pursuant to that section; (e) The term "health service prepayment plan" means a set of specifications under which a carrier undertakes, through a class or classes of insurance policies or subscriber contracts (as defined by the Secretary) or both, to do any or a combination of the following in return for insurance premiums or prepaid subscription charges: (1) To reimburse specified beneficiaries or a class or classes of bene ficiaries (or others with respect to such beneficiaries) in whole or in part for expenditures incurred by them for specified personal health services; (2) to pay (directly or through another carrier or carriers) to providers of personal health services all or part of their costs or charges for specified personal health services furnished to specified beneficiaries or a class or classes of beneficiaries: Provided, That, if (A) such payments are to be made in accordance with a contract or arrangement between the carrier and the provider of such services (or between the carrier and another carrier through whom such payments are to be made) and (B) such contract or arrangement fixes the basis upon which the amount of such payments shall be determined, such contract or arrangement shall be deemed to be an integral part of the plan; (3) To provide, wholly or partly through its own staff or facilities, specified personal health services to specified beneficiaries or a class or classes of beneficiaries; (f) The term "personal health services" includes any services rendered to individuals by licensed health personnel, or, under the supervision of such personnel by auxiliary personnel for the improvement or preservation of physical or mental health or for the diagnosis and treatment of disease or injury; the use by such licensed or auxiliary personnel of any and all apparatus or machines designed to aid in the diagnosis or treatment of disease or injury; the provision of bed and board in general or special hospitals, convalescent homes, nursing homes, sanatoria, or other institutions licensed or designated as such by a State when care in such institutions is prescribed by such licensed personnel; the provision of drugs and medicines, dressings and supplies, posthese and appliances (including eyeglasses), when prescribed by such licensed personnel; and ambulance service; (g) The term "Secretary", except as otherwise specified, means the Secretary of Health, Education, and Welfare; and (h) The term "State" includes the District of Columbia, Alaska, Hawaii, Puerto Rico, and possessions of the United States. NATIONAL ADVISORY COUNCIL AND OTHER COMMITTEES SEC. 102. (a) There is hereby established within the Department of Health, Education, and Welfare a National Advisory Council on Health Service Prepayment Plans, which shall meet at the call of the Secretary but not less often than four times each year. The Council shall consist of twelve members appointed by the Secretary without regard to the civil-service laws, who shall be familiar with the need for, or the availability of, personal health services, and not less than four of whom shall be experienced in the administration of health service |