manner to the collection of the State and Federal taxes necessary to operate the two programs contained in the Kerr-Mills law. The only difference is in the method of collection-in neither case is there any option on the part of the taxpayer. (e) Opponents of the social security approach have stated that the KerrMills provisions are sufficient to do the entire job, and that each State should adopt and place into effect these provisions. Unless the person recommending that action also states at the same time that he is willing for his property or sales or income taxes to be increased substantially to pay for such a program, the first recommendation cannot be really persuasive. (f) Social security will not supplant or replace the voluntary health insurance programs. While it is true that some voluntary insurance now being carried would be dropped if H.R. 4222 became law, it would appear that by relinquishing the high-risk high-cost group of aged, the insurance companies could offer either lower costs or greater benefits or both to the younger employed groups. Should this happen it is more likely that more voluntary insurance rather than less would be sold, corresponding to the increase in the amount of retirement insurance sold after the social security retirement benefit plan was started. Several weeks ago on a train ride from St. Louis to Jefferson City I found myself sitting next to a friendly insurance agent. This offered an opportunity to test my theory, because he had sold hospital insurance for several different companies. I asked him whether his company broke even on their policyholders over 65-did the premiums paid in by the aged equal the cost of the benefits given to the same group? His very quick answer was "definitely not." That, of course, means that part of the premiums collected from the younger policyholders must be used to pay the benefits for the aged policyholders. My next question was "If the company suddenly dropped all past and future sales of hospital insurance to persons over 65, could they lower the premium costs for the rest of the policyholders?" His answer was a very positive "yes." He likened the principle to what would happen to auto insurance rates if the companies suddenly found that they would no longer insure the male auto driver between the ages of 16 and 25. In both cases he thought there would be a definite drop in premium rates. Another question which needs to be faced in connection with voluntary insurance is one on which I have not study to quote from. Out of our total population, 67.1 percent have some form of health insurance, as reported by the U.S. national health survey. If you exclude from consideration those persons who work in an industry where the union contract calls for paid-up health insurance to cover them from the time of retirement to death, how many of us are now voluntarily buying health protection for the present and are also buying health protection which will be effective during our retirement? Even those in the middle and upper income brackets are involved here—I have yet to find such a person among my own acquaintances. What really are the chances that many of us will do this type of farsighted planning without being forced to it? More important, how many of those at the lower income levels will take this step--perhaps at the expense of present necessities? (g) Surely most laymen would want to agree with a statement made by the minority group of the Health and Medical Care Section of the White House Conference on Aging: "It is distressing to be told by organized medicine that the quality of care that the individual physicians renders will be influenced by the source of payments. We do not believe this is so." (h) The use of social security as a method for financing medical care will not bankrupt the social security trust fund. It is true that payments out of the trust fund have exceeded the income during the last several years, and, in fact, this is also expected through 1962. However, all forecasts after that date are to the effect that income will exceed outgo. The tax schedule which was revised by Congress in 1958 took into full account the long-range actuarial status of the program. The Eisenhower administration appointed a distinguished group of experts as the Advisory Council on Social Security Financing, including representatives from the fields of economics, business, and labor. Their report, which covered a yearlong study of long-term program commitments, was issued in January 1959, and contained this most important finding: "The Council is pleased to report that according to the best cost estimates available the contribution schedule now in the law makes adequate provision for meeting the cost of the benefits provided. We have found that the method of financing is sound and that no fundamental changes are required or desirable." With the large number of persons hav ing a vital interest in this fund keeping the sharpest kind of watch on it, I believe we can be assured that any measures passed by the Congress will not endanger the status of the fund. In closing, let me say again that these comments represent only one person's opinions and evaluations. They are offered in the hope that they may be of some help in arriving at a decision on this momentous question. We all want to make it possible for every aged person to rest assured that costly medical care will be paid for whenever it is needed. Let us use the most logical method, and let us make the decision on the basis of reason. NATIONAL GERIATRICAL SOCIETY & SENIORS OF THE GOLDEN GATE, Re public hearings on H.R. 4222 and S.B. 909. HOUSE OF REPRESENTATIVES, Committee on Ways and Means, 1102 New House Office Building, Washington, D.C. (Attention: Leo H. Irvin, Chief Counsel) GENTLEMEN: It is our deep regret that our president, Mr. Harry L. Stuver, was out of the city when your notice of public hearings on subject bills was received in San Francisco and did not return until too late to qualify for a personal appearance at your hearing, so, for this reason we send this letter, which we would like to have printed in the record. Comments and suggestions: None. You ask for comments upon the bills and request suggestions as to changes that may benefit, but, as we have not been furnished copies of the bills you are considering, we are not in a position to analyze the details. However, the President's plan is favored and a similar plan was proposed 10 years ago in 1951. The President's plan is a step in the right direction, irrespective of inequities, if any do appear, and we have reason to believe that about 75 percent of the voters of San Francisco are in favor of it, and those who are opposed seem to have a personal financial interest in their opposition because of fear of taxation, or loss of salary, or for some other hidden reason which they alone can know about. The National Geriatrical Society has been in favor of: "A civilian branch attached to the Social Security Administration" ever since the National Geriatrical Society was incorporated in 1951, when the plan was first proposed by its president, Harry L. Stuver. His plan was and is somewhat similar to yours, differing only in the method of payment. He proposed that the method of payment should be direct from the U.S. Treasury to the party or parties-hospitals and such-who rendered service, on a plan similar to the way social security checks are now mailed out and income tax collected, thereby bypassing States and eliminating all possible duplication of records of accounts which can only add to the cost of operation. SELF-PROTECTION As to its self-protection—against padding of payrolls and such-The State of Oregon has a method in its indigent automobile accident fund which can be almost foolproof. In this plan, the responsibility of collection is placed upon the hospital or other person or persons who render service, to collect their bill with the added specification that: "If the doctor, nurse, ambulance driver, or others, could not collect their bill because of indigency within 90 days after service was rendered, the bill could be certified to the State and the bill is paid from the State's auto indigent accident fund which is built up and maintained by a tax of 50 cents, more or less, upon each recipient of an automobile drivers license. FUNDS As to your source of funds, Congress alone is permitted to raise or lower taxes. INJUSTICE OF SOCIAL SECURITY TAX UPON WAGE EARNER ONLY In your case, there are some who believe that: “Saddling all the cost of aid to the aged who did not contribute to the additional cost of such a plan upon those who receive a wage is an imposition upon those who work, from the simple fact that those who receive their income from investments-stocks, bonds, rents, etc.-and others not included in the social security program are exempted from a contribution while those who earn a daily wage are taxed, not only for their contribution to this medical plan but are assessed and compelled to contribute to all other welfare plans regardless of their qualifications. GRANT HIGHER INCOME TAX EXEMPTION One person said he thought a better plan would be to "grant a higher income tax exemption to heads of households who support aged parents." (Communication enclosed.) STATES DO NOT HAVE INDIVIDUAL RIGHTS "One Nation, Indivisible," is the slogan now, as it always has been. But its statement has a wider range of meaning. In days when travel was so slow and difficult, home government was sufficient because “Over the fence was out," but today, when people travel across State lines as birds when flying south, there must be ONE LAW FOR ALL CITIZENS AND THIS LAW MUST BE NATIONAL The legislative body of any one State should not have authority to deny to its residents (NOTE.-A resident of a State is a citizen of the United States and not a citizen of the State.) privileges granted or services required by the National Government for the good of the entire country, because citizens are an integrated part of the entire unit of one government, subject to call to duty to. the United States, and must be capable at all times to perform that duty. No State can deny a man his citizenship nor refuse his support to the National Government, therefore, each State should be required to furnish everything necessary, to each person residing therein, to suit his needs in his struggle toexercise his right to become President. STATES RIGHTS CANNOT SUPERSEDE THE NATIONAL NEED So, where States demand to exercise their sovereignty, then States should be held to pay the bill when its residents go over into another State and do damage to the people there. Hoping that the foregoing will be of sufficient importance to qualify for a printing in your record, I am, we are, Very respectfully yours, HARRY L. STUVER, President and Officer of Publicity. Below is an exact copy of the communication mentioned above. "GRANT HIGHER INCOME TAX EXEMPTION. "JULY 27, 1961. "DEAR SIR: I have just heard your most enlightening conversation on KCBS's: 'Viewpoint' and I have a criticism, but more importantly, I think I have what I think is an alternate plan which might be an improvement on the present pro-posal by the President. 76123-61-pt. 4-20 "Instead of the present proposal of Government aid to old-age pensioners which might, and rightly so, I think, assume the tag 'socialized medicine,' wouldn't it save much criticism of the President and his plan if he were to allow a substantial tax exemption to heads of households who must support an aged mother-in-law or father while trying to eke out a living in today's highly competitive business world? "Being only 24 years old, I am not directly involved, so there are discrepancies in my plan, i.e., it would not affect pensioners who are not dependent on a relative for direct and possibly total support (however, I believe a plan can be worked out to help these people) but even though I'm not an interested party, I do feel that if the President's plan is adopted, this would be another step away from our free enterprise system of democracy and toward socialism, a type of government that, I feel, is not best suited to freedom-loving Americans, of any age. "Thank you for considering the views of the public on this matter. "Sincerely, "WILLIAM L. BOWEN." Above communication received by Harry L. Stuver, from William L. Bowen, Apartment 1, 235 Emerson Street, Palo Alto, Calif., in response to an airways broadcast over KCBS on Thursday evening, July 27, 1961, attempting to outline the President's plan and asking for an expression of opinion from the listeners. HARRY L. STUVER. STATEMENT OF SOUTHERN CALIFORNIA COMMITTEE FOR HEALTH CARE FOR THE AGED THROUGH SOCIAL SECURITY To promote public understanding of the King-Anderson bill (H.R. 4222), the health insurance benefits bill of 1961, a group of physicians and medical educacators in the Los Angeles area organized the Southern California Committee for Health Care for the Aged through Social Security. Headquarters were established at 10578 W. Pico Boulevard, in West Los Angeles, where a volunteer staff was prepared to accept requests for speakers, offer information, and prepare literature for mailing. A factsheet explaining the provisions of the bill was printed and sent out to the approximately 5,000 members of the Los Angeles County Medical Association, stressing the fact that there was nothing in the bill that was detrimental to physicians nor to the doctor-patient relationship. With the factsheet went a list of the national organizations supporting the bill and a petition form, urging the members of the House Ways and Means Committee to pass the bill. The form had spaces for about 20 signatures, and more than 20 of these have been filled and sent to Washington. With the factsheet, also, went a form to be signed by those who wished to join the committee and were willing to authorize the use of their signatures. (Copies of all three are enclosed.) Many of these were returned, signed, to the committee. However, the committee also received many letters of commendation as well as donations, with the request that the writer's name be withheld. Although announcements of the committee's formation were sent to all the metropolitan newspapers and many of the local weekly papers in the area. press coverage has been limited; some interviews and discussions of the bill and the committee's activities have been seen and heard on local radio and television. The science editor of the Los Angeles Times reported on August 1, that "Fear of reprisal from organized medical groups is responsible for the failure of many doctors to publicly declare themselves in favor of legislation which would put medical care for the aged under the social security system, a local physician said ***." The committee's literature made clear that the philosophy underlying its activities was support of the King-Anderson bill because committee members believed that it was designed to meet a universal human need, adequately, simply, with respect for individual dignity, and with a fiscally sound approach. and because it provides a program that enables the wage-earner to provide for his own future health-care. Considerable public misunderstanding of the provisions of the King-Anderson bill has been engendered and its opponents have had significant advantages in the allotment of prime newspaper space and radio and television coverage. It has been the purpose of the Southern California Committee for Health Care for the Aged through Social Security, by every means available to it, to clarify the issues, document its arguments, contradict the false propaganda, deny the spurious innuendoes and make clear to the medical profession and the general public its firm belief that the King-Anderson bill is the only plan so far presented that offers a satisfactory program for securing health care fo rthe aged. SOUTHERN CALIFORNIA COMMITTEE FOR HEALTH CARE FOR THE AGED THROUGH SOCIAL SECURITY, Los Angeles, Calif. The retired citizens of our country have greater health care needs than any other segment of the population. They also have far less in resources for meeting these requirements. Until now, no help has been offered them in meeting these oppressive needs adequately and with dignity. The King-Anderson bill, the Health Insurance Benefits Act of 1961 (H.R. 4222), will be debated in the House Ways and Means Committee during the next few weeks. It was designed for the express purpose of helping the aged solve their health care problems in these days of rising costs. Through its provisions Congress would be following the constitutional mandate "to provide for the general welfare." It would fill a universal human need with an approach that is fiscally sound. A recent Gallup poll shows that 67 percent of the population favors this "pay-while-you-earn" solution for the half million elderly who, each year, become dependent on charity because their hospital bills have depleted their savings. The King-Anderson bill does not pay for the services of a private physician. In fact, in no way does it enter the field of the private physician. It provides only for: Full hospital costs (other than the services of a private physician) for up to 90 days, after payments by patient of $10 a day up to 9 days (minimum $20, maximum $90), to discourage unnecessary hospitalization. Costs of skilled nursing home services, following hospitalization, for up to 180 days. Cost of outpatient diagnostic services, including X-ray and laboratory services, after payment by patient of $20. Costs of home health services for up to 240 visits, including nursing care, physical therapy, and part-time homemaker services. The 1961 Health Insurance Benefits Act, therefore, will not in any way interfere with the doctor-patient relationship; not with the patient's choice of physician, not with the patient's choice of hospital, not with the kind of care the physician prescribes. Under this bill all participants in social security will be eligible, automatically, for the benefits (approximately 90 percent of persons over 65, or 141⁄2 million). There would be no costly investigation to determine eligibility, no exhausting of the patient's resources, no pauper's oath before health-care is provided. The costs of the program would be met by a one-fourth of 1 percent increase in the social security rate of both employer and employee (a maximum of $1.05 per month). There would be no drain on any tax funds. Most importantly, this kind of financing would give the senior citizen security and a feeling of selfsufficiency. Wage earners could, in their productive years, provide for their retirement, confident in the knowledge that they would not, in their old age, be a drain on their families or their communities. Because there has been a great deal of misunderstanding about the KingAnderson Insurance Benefits Act of 1961, the Southern California Committee for Health Care for the Aged, composed of experts in many interrelated fields concerned, has been organized for the purpose of presenting the facts to the public. The members of the committee would welcome requests for further information and earnestly solicit your support. Mr. LEO H. IRWIN, Chief Counsel, Committee on Ways and Means, Dr. ALICE SHEA, Coordinator. NEWARK YM & YWHA, Newark, N.J., August 8, 1961. DEAR MR. IRWIN: As president of Council Center for Older Adults, I am glad to have this opportunity of presenting the viewpoint of our membership on the vital issue of health insurance for older people. I should also like to request that this statement be printed in the record of the hearings being conducted by the Committee on Ways and Means. |