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The passage of this type of legislation discourages thrift, initiative, and selfreliance. It encourages the Nation further into welfare statism.

1. Number of over-age-65 admissions during period Sept. 25, 1960, through Dec. 31, 1960---

2. Number of patients over age 65 admitted (2 multiple admissions). 3. Surgical admissions___

Medical admissions_

4. Patients' age: Median, age 74; range, 65–96.

100

98

848

5. Total hospital bill (average per illness). Hospital bills larger than $500----

Hospital bills paid by private sources__

Hospital bills paid by insurance or government sources_.

6. Total physician bill (average per illness).

Physician bill over $500--

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$214.02 4

90

10

$91. 65

1

6

70

20

10

Hospital

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Senator Anderson's figures are overestimated for one hospital in his State by more than 300 percent on the basis of this study.

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Southwest Presbyterian Hospital, Albuquerque, N. Mex., survey of 100 consecutive discharges from general hospital, selected solely on basis of age over 65

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(Appendix No. 2 is identical with article on p. 535.)

80 $244

$95

APPENDIX NO. 2

Hon. WILBUR D. MILLS,

CONGRESS OF THE UNITED STATES,
HOUSE OF REPRESENTATIVES,
Washington, D.C., July 31, 1961.

Chairman, House Ways and Means Committee, 1134 House Office Building, Washington, D.C.

DEAR COLLEAGUE: Mr. Al Doerr, secretary of the North Dakota Pharmaceutical Association, has forwarded a resolution adopted by this group expressing strong opposition to passage of the King bill, H.R. 4222.

You will observe in the resolution that the oppositions to enactment of this proposed measure are clearly and succintly stated. I would like to request that this resolution, adopted at the 76th Annual Convention of the North Dakota

Pharmaceutical Association, held in the city of Williston on June 6, be brought to the attention of the members of your committee during the consideration of this bill, and incorporated as a part of the committee hearings.

With kind regards, I am,

Very sincerely,

DON L. SHORT, Member of Congress.

RESOLUTION

Whereas the Congress of the United States has for several sessions considered various bills relative to providing and subsidizing the sickness costs of the aging and is currently considering the King bill (H.R. 4222); and

Whereas the members of the North Dakota Pharmaceutical Association consider the King bill to be socialized medicine for a large but special group of our population; and

Whereas the estimated cost for any of these plans is astronomical and unpredictable; and

Whereas the vast majority of individuals over the age 65 do not require Federal assistance; and

Whereas in North Dakota physicians have always contributed their services to the care of the indigent and semi-indigent of all ages; and

Whereas studies have failed to demonstrate any degree of unmet needs which would warrant Federal participation in providing care for all persons over 65 years of age; and

Whereas it is the sincere belief of the members of the North Dakota Pharmaceutical Association that the physicians of North Dakota have always desired to improve the medical care for all persons; and

Whereas the members of the North Dakota Pharmaceutical Association feel that political medical practice would hinder and not improve this medical care: Now, therefore, be it

Resolved, That the members of the North Dakota Pharmaceutical Association meeting in annual session in the city of Williston, N.D., this 6th day of June 1961, commend those Members of the Congress and all others who have maintained a steadfast opposition to furthering the cause of socialism; and be it further

Resolved, That the North Dakota congressional delegation be urged to oppose the passage of the King bill; and be it further

Resolved, That a copy of this resolution be sent to the President of the United States, the Vice President of the United States, the Speaker of the House of Representatives, the members of the House Ways and Means Committee, the Secretary of Health, Education, and Welfare, the Governor of the State of North Dakota, the honorable Members of the North Dakota congressional delegation, the president of the American Pharmaceutical Association, and to the president of the North Dakota State Medical Association.

STATEMENT SUBMITTED BY ORACE HANSON, PRESIDENT, MINNESOTA STATE
PHARMACEUTICAL ASSOCIATION, ST. PAUL, MINN.

The Minnesota State Pharmaceutical Association was founded in 1884 and has a current membership of more than 2,000 registered pharmacists. It is one of the oldest and largest societies of its kind in the Nation.

Broadly stated, its objectives are to encourage the maintenance of high ethical and educational standards in the field of pharmacy, and to support practices and legislation which promote the safe and efficacious distribution of drugs and medicines, thereby promoting public health and welfare for the benefit of all citizens of the State.

Recognizing that pharmacy is integrally related to the overall health services of the community, the association has for many years worked closely with State and community health professions in seeking to determine and fulfill the needs of our medically indigent and aging citizens.

Representatives of the association have served on various bodies concerned with this problem, including interprofessional committees, and committees appointed by the State board of health, the State welfare department, and the Governor's conference on aging.

The association has consistently and vigorously maintained the position that the aged and the indigent should receive the same quality of drugs and medications and the same high level of pharmaceutical service as other citizens. At the same time, it has joined with the other health professions in defending the principle of free choice of health services.

It is only realistic to acknowledge that in many localities throughout the United States, aging and medically indigent patients are not receiving adequate and timely medical care. The health professions and our State and Federal Governments are rightfully concerned with the needs of these citizens.

However, the attitude of the Minnesota State Pharmaceutical Association toward the King-Anderson bill, H.R. 4222, must properly be based upon conditions in Minnesota, rather than elsewhere.

In studying the situation in Minnesota, we have had the benefit of the sta tistics compiled by the Minnesota State Welfare Department concerning the medical-economic status of persons 65 years of age and over.

This data, published under the title, "Minnesota's Aging Citizens, a County by County Statistical Report," indicates, among other things, that only 7 percent of all persons over 65 in this State are medically indigent. This figure represents only 0.7 percent of Minnesota's total population. The needs of these citizens are amply fulfilled by Minnesota's old-age assistance program which provides complete medical services, including drugs and medical supplies.

This statistical report further indicates that 87 percent of the people interviewed had no unmet medical needs, and only 5 percent could not meet their medical needs because of inability to pay. However, further questioning revealed that the persons included in this 5 percent were not aware of the health services available to them through the medical profession and the State welfare programs.

After careful examination of this and other pertinent information, it seems apparent that Minnesota's aging and medically indigent are now receiving adequate health service or have adequate health service available to them.

For this reason, the Minnesota State Pharmaceutical Association feels obliged to state its opposition to the King-Anderson bill (H.R. 4222).

Minnesota's experience illustrates that the medical needs of the aging citizen can be adequately met by the individual States, with the Federal Government fulfilling its responsibility by furnishing funds which are administered by the States.

Health, as has often been said before, is a uniquely personal matter. The needs of the individual patient can best be determined and fulfilled on the local level by physicians, pharmacists, dentists, and welfare officials who know his needs firsthand.

It cannot be denied that the health needs of our aging citizens constitute a national problem, but it is questionable whether a nationalized, rather than a localized program, is the most desirable answer to this problem.

Representative WILBUR MILLS,

IOWA PHARMACEUTICAL ASSOCIATION,
Des Moines, Iowa, August 2, 1961.

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

DEAR REPRESENTATIVE MILLS: The Iowa Pharmaceutical Association representing 1,557 registered pharmacists employed in 822 retail pharmacies, hospital pharmacies, educational institutions, service drug wholesalers and pharmaceutical sales representatives in Iowa, wish to again reaffirm our opposition to medical health care under a social security program.

As a representative for pharmacy, we are opposed to the King bill (H.R. 4222) now being heard before your committee. For all practical purposes, there is no basic difference between H.R. 4222 and the Forand bill H.R. 4700 introduced in the 86th Congress.

I would therefore call your attention to the statement of the Iowa Pharmaceutical Association given by A. Phillip Coontz, president of the Iowa Pharmaceutical Association in 1959 before the House Ways and Means Committee in June of 1959.

Mr. Coontz stated that pharmacy was not directly involved but indirectly through pharmaceutical service provided patients in hospitals but were cognizant that the program could be the initial step toward an eventual and inevitable socialization of our profession.

Irregardless of the title, King bill or Forand bill, the mechanics of socialized medical health care are present, irrespective of the statements made that the medical health care program under social security, proposed by the present administration, is not socialized medicine. The Socialist Party of the United States, who should be considered an authority on the definition of socialism, has stated that the proposed legislation is socialized medicine.

Mr. Coontz further explained that social security type medical health care legislation would lower the high standard of medical treatment, health education, and medical and pharmaceutical research. The results of individual and collective voluntary pursuits and initiative are much more productive than a compulsory, governmental demanding and control of an individual or collective endeavor. Under a governmental compulsory program, the loss of personal initiative and desire would without question, not provide medical care for the American people to the degree they have become accustomed or provide any more than a normal advancement in medical science and research.

The statement of the Iowa Pharmaceutical Association also stated that an additional tax burden would be placed on the working people which is the only alternative when associated with social security. They would be forced not only to pay for their own medical care but for people of means well able to pay for current health care. The only sane procedure is the payment of health benefits through the many types and increasing availability of private insurance medical health programs.

As private citizens, who through the free private enterprise system, have progressed socially and economically superior to any other form of economy, we are increasingly concerned at the trend of creeping federalization of our everyday activities. The King bill (H.R. 4222) is creeping Federal control over medical care which cannot provide the professional economical control and administration by the or through the mechanics of our free and private enterprise system at local, county, and State levels.

The Iowa Pharmaceutical Association endorses and supports the American Medical Association and the Iowa State Medical Society Kerr-Mills law and worked diligently to secure passage in the Iowa General Assembly of its enabling legislation.

It is our sincere belief that such legislation should be given adequate time and effort to provide medical care for the near needy before further consideration is given other forms of medical care legislation.

Pharmacy has always and will continue to enjoy the opportunity to work with medicine to provide the best in pharmaceutical service for improved health services for the individual.

As representative for the Iowa Pharmaceutical Association, I would ask and consider it a privilege to have this letter entered in the proceedings of the House Ways and Means Committee hearings on the King bill (H.R. 4222).

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DEAR MR. CHAIRMAN: This letter is submitted in behalf of the Pharmaceutical Manufacturers Association on H.R. 4222, a bill amending the Social Security Act to provide for the payment of certain institutional care and home health services to aged persons over 65 eligible for social security or railroad retirement benefits. Payment for the services of physicians is not included.

This association is a nonprofit membership association, incorporated under the laws of Delaware, with its principal office in the city of Washington, D.C. At the present time, there are about 140 member companies which are engaged in the manufacture of prescription pharmaceutical products, and these companies produce in excess of 95 percent of the Nation's total production of such products. The Pharmaceutical Manufacturers Association is in favor of helping those who need help and therefore it supports the approach of the Kerr-Mills Act for

the medical aid of the aged law in providing medical care to aged persons ove that proposed in H.R. 4222. The Kerr-Mills Act enacted only last year by the Congress is a voluntary cooperative Federal-State financing program which provides medical care for every aged person over 65 in need. It supplements and does not supplant individual voluntary health insurance. It enables the States to set up the programs they believe are most suited to the needs of their own citizens.

Additionally, the benefits of the Kerr-Mills Act are not limited as to type or extent of care but are based on need and local determination. Under it, paymes: is limited to the care of people unable to pay their own bills.

This association would therefore urge that the Kerr-Mills Act be given the opportunity to demonstrate what it can do once it is in full operating effect in all the States. One year's time is hardly believed to be sufficient to make such a showing, especially when this is coupled with the phenomenal growth of the voluntary health insurance plans which are being extended to embrace those in the older age groups.

In the relatively short period of time in which the Kerr-Mills Act has been in effect, the acceptance by the States of its principles has truly been outstanding. A very substantial number of these, and two U.S. possessions, have enacted Kerr-Mills programs and more State legislatures still have pending before them proposals implementing this program. For the foregoing reasons, the Pharmaceutical Manufacturers Association is opposed to the enactment of H.R. 4222.

It would be deeply appreciated if you would make this letter a part of the record of the hearings on H.R. 4222.

Sincerely yours,

Hon. WILBUR MILLS,

AUSTIN SMITH, M.D.

GEORGIA PHARMACEUTICAL ASSOCIATION, INC.,
Atlanta, Ga., July 20, 1961.

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

DEAR SIR: We wish to request an opportunity to submit testimony for the record on H.R. 4222 on behalf of the Georgia Pharmaceutical Association, which organization represents the 2,5000 pharmacists practicing in the State of Georgia.

The Georgia Pharmaceutical Association is opposed to any Federal legislation to provide aged persons with health care other than such which may be established by absolute need since we feel such legislation will constitute a burdensome and unnecessary increase in taxation and lead to complete socialized medicine.

We also feel that such legislation is inherently detrimental to the principle and philosophy of free enterprise and the dignity of citizens of a free nation. Very truly yours,

Hon. WILBUR D. MILLS,

LEON BROWN, President. OLMSTED MEDICAL GROUP, Rochester, Minn., June 27, 1961.

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

DEAR REPRESENTATIVE MILLS: This is in reference to the King bill, H.R. 4222. I am 100 percent opposed to this bill. Previous legislation should be given a fair trial and should be kept on a voluntary basis rather than a flat blanket coverage.

Free enterprise cannot continue to exist unless individuals and local government are allowed to function. Efficiency is increased through the grassroots rather than through Uncle Sam thousands of miles from the problem. Rather, our local government and people should stand on their own feet.

I want opportunity not necessarily all security. Mr. Khrushchev will be glad to give us security with a ball and chain.

Let's not keep repeating mistakes from past history. Governments have tried this before and have failed.

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