workable solution to the problems of the medically needy, those citizens who can take care of their daily needs but who could not pay a medium- or largesized medical bill; they prevent the further intrusion of Federal Government into an area being adequately cared for by voluntary means; and they effectively curb the propensity in some quarters of government for a national program of socialized medicine. The CHAIRMAN. Mr. Baskin, we appreciate your staying with us this afternoon long enough to present this testimony. You say you have been here 2 or 3 days. You know that this is about the usual hour for the committee to quit. Mr. BASKIN. I think it was 5 after 7 last night. The CHAIRMAN. Without objection, the committee will adjourn until 10 o'clock in the morning. (Whereupon, at 6:55 p.m., the committee recessed, to reconvene at 10 a.m., Thursday, August 3, 1961.) HEALTH SERVICES FOR THE AGED UNDER THE SOCIAL SECURITY INSURANCE SYSTEM THURSDAY, AUGUST 3, 1961 HOUSE OF REPRESENTATIVES, Washington, D.C. The committee met at 10 a.m., pursuant to recess, in the committee room, House Office Building, Hon. Wilbur D. Mills (chairman of the committee) presiding. The CHAIRMAN. The committee will please be in order. Our first witness this morning is our colleague from Arkansas. We are very pleased to have before the committee this morning the Honorable Dale Alford, who represents the Fifth Congressional District of Arkansas, residing at Little Rock. We appreciate having you here and you are recognized. STATEMENT OF HON. DALE ALFORD, A REPRESENTATIVE IN CONGRESS FROM THE STATE OF ARKANSAS Dr. ALFORD. Mr. Chairman and members of the committee, I ask unanimous consent, Mr. Chairman, to revise and extend my remarks. The CHAIRMAN. You have that permission. Dr. ALFORD. Thank you, sir. I am extremely grateful to you for this opportunity of being heard during these singularly important hearings. I have asked for this courtesy because I feel strongly that the bill you are considering is of unusual significance. In my view, H.R. 4222 is a measure cunningly devised for fishing in troubled waters. The bait is humanitarianism; the hook is loss of freedom. May I reemphasize this, Mr. Chairman? The bait is humanitarianism; the hook is loss of freedom. I say this as a physician, whose liberty to practice medicine freely is at stake. I say it also as a citizen elected to this House of Representatives. From both viewpoints, I urge the committee to reject this bill. By now you have heard many representatives of my profession testify to the damage this legislation could inflict upon the world's finest system of medical care. They are the Nation's experts on health, uniquely qualified to speak on matters affecting health. And from what I have read of their testimony, I can only add my fervent "Amen" to the case they have made. I shall therefore talk, not as a doctor, but as a Member of Congress deeply concerned with many of the bill's other aspects. 76123-61-pt. 3- -21 To begin with, we do not need it. Last year the 86th Congress voted the Mills-Kerr law into effect. Its implementation has been remarkable, and its potential for helping those of the aged who need help is unlimited. On this count alone H.R. 4222 is unnecessary. But there are other reasons of which the committee is well aware. There are existing welfare programs; there are unremunerated efforts of responsible men and women, working together within their communities to help solve the problems of the aged; and there is the magnificent record of the insurance and prepayment plans, which now protect 132 million Americans, cover more than half the aged, and provide an effective, expanding method of cushioning the costs of ill ness. Surveys also show that the majority of our older people are selfsustaining financially, and that their health is generally good for years. Why then, does H.R. 4222 propose a compulsory national health plan for those receiving retirement benefits under ŎASDI? To me, the answer seems plain: This proposal was designed to set precedents-not to help people. Its sole purpose is to introduce the large foot of the Federal Government into the door of freely practiced medicine. I cannot believe, Mr. Chairman, that a bill of such suspiciously limited benefits and such avowedly modest ambitions is seriously proposed as the be-all, end-all solution to financing health care for the aged. Those who support it admit as much, for in rare moments of candor they point out the measure's inadequacies and add: "This is just a beginning.' We are all aware that a philosophical battle rages in the United States between those who wish to cede more and more territory to the Federal Government, and those who believe we have already yielded more ground than we should. I suggest that the debate over social security medicine for the aged is simply a single skirmish in that continuing battle. But I predict that this skirmish will become the rallying point at which the American people will pause to fight the matter out, for there is a growing realization that further retreat would be the prelude to disaster. This is a generous nation-perhaps the most generous in the world history. Its people will dig deep into their pockets to help their neighbors. They are ready with the helping hand when it is needed, and easy-going when honest mistakes are made. But when they are riled, they are the toughest people on earth, and I think they are now beginning to get riled at the waste of their tax dollars. The distinguished chairman of this committee is properly recognized as an outstanding authority on fiscal matters. I cannot claim a fraction of his knowledge or experience in this field. But I submit that there is a limit to the amount of money the taxpayer can and will pay, and that we are approaching that limit right now. We have already bequeathed a mountainous stack of IO U's to our children and grandchildren, and it is doubtful if they will appreciate the inheritance. Yet H.R. 4222 proposes that we run up an even larger tab and send the bill to future generations. This measure would simply raise social security taxes, ask young working people and their descendants to pay them in perpetuity, and earmark the money for the help of millions of older people who do not need help. It is one thing to help a neighbor in need, Mr. Chairman. It is another thing to ask a young worker to help everybody 65 or older simply because he has retired and receives benefits under social security. The people who will bear the brunt of this tax increase are already making the buffalo scream. They have children to feed and clothe and house. They have doctor bills and insurance premiums and mortgages and college education to pay for. They have taxes to pay-or else. All any member of this committee needs to do is watch the struggle of his younger constituents the next time he returns to his district. He will quickly observe that few young couples get very far ahead of the game. Why should they be asked, then, to pay the hospital bill for a man who may, for all this measure has to say about it, be a coupon-clipping millionaire living the life of Riley? Do I overtsate the case? Consider, Mr. Chairman, a single provision of the bill. H.R. 4222 provides that a person over 65, still at work, would be entitled to coverage for health purposes. Not having retired, this person is presumably as able to pay his own medical bills as he was at 50, or 40, or 30. Does it make sense to hand him unsolicited health services at the expense of a younger worker? I suggest that it does not. And I suggest that the committee consider carefully the justice of increasing social security taxes by 17 percent in order to provide medical benefits for millions of the aged who are able and willing to pay their own way. I say the tax would be increased by 17 percent. I should amend that statement. The tax would be increased by 17 percent for the time being. For it would go up as surely as day follows night as the program increased benefits, expanded coverage, and embraced an everenlarging number of older people. In conclusion, Mr. Chairman, I am unwilling to believe that the traditional virtues of self-reliance, initiative, independence, and thrift have disappeared from the American scene. Those virtues helped build this country, and they die hard. But die they will if the Federal Government sees its function as the ultimate provision of a welfare state extending from cradle to grave. If our native virtues disappear, Mr. Chairman, there will be little left of our Nation worth preserving, and we shall fall easy prey to enemies from within or without. History is filled with examples, but I should like to quote only one. These are the words of William Shirer, in his book entitled "The Rise and Fall of the Third Reich": Bismarck put through between 1883 and 1889 a program for social security far beyond anything known in other countries. It included compulsory insurance for workers against old age, sickness, accident, and incapacity, and though organized by the state it was financed by employers and employees. It cannot be said that it stopped the rise of the Social Democrats or the trade unions, but it did have a profound effect on the working class in that it gradually made them value security over political freedom and caused them to see in the state, however conservative, a benefactor and protector. Hitler took full advantage of this state of mind. In this, as in other matters, he learned much from Bismarck. "I studied Bismarck's socialist legislation," Hitler remarks in "Mein Kampf," "in its intention, struggle, and success." |