(c) Give minimum social security benefits to all 70 years or older if they were unable to work for social security units while they were still active. Then they, too, can take care of their own health insurance.

(d) Urge all people to invest in some form of health insurance if they have not already done so.

We would appreciate it if you would include our statements in the printed record of the hearings.

Miss JOHANNA ZIEGEN HAIN,
Miss WILHELMINA ZIEGEN HAIN.

JULY 6, 1961.

Hon. WILBUR D. MILLS,

Chairman of the House Ways and Means Committee,

House of Representatives,

Washington, D.C.

DEAR SIR: Please insert this letter in the committee hearings on the King bill (H.R. 4222) as it is my belief that the health benefits for the aged should not be put under the Social Security Act.

Thank you for your consideration.

Sincerely yours,

Mrs. SANDRA J. HOFFMAN.

STATEMENT OF W. RULON WILLIAMSON, RESEARCH ACTUARY, WASHINGTON, D.C.

Illusion

COMPULSORY CHARITY THROUGH SOCIAL SECURITY

I am attaching four pages from last week's Saturday Evening Post (July 29, 1961) to show the treatment of three-dimensional subjects in two-dimensional pictures. Two pictures on page 64-"Solid and Hollow" and "Day and Night”— indicate the intentional creation of illusion. In "Solid and Hollow," as one looks at an upper surface, on which one could walk, it changes to the under side of an arch. In "Day and Night," one can see the flying geese headed east into the night, till suddenly the background between the geese becomes geese flying west into the day.

Social Security

The "welfare state" is full of such surprises. Social insurance, called applied Christianity by Bismarck, seems, at times, to have led into World War I and World War II, that Christian impulse in Germany seeming to become "The Road to Serfdom."

The night of personal inability and incapacity, local community ineptitudes, over-extended local budgets, invite aid from sovereign States and then from National Government. But as the day grows bright with the multiplicity of aids, the hand of help falters as it is obvious that, in the long run, the person to be helped is the person taxed for the help. The magic of outside aid changes to more taxation, inflated prices, steadily enlarging need.

Social security, as used in discussing this bill, has narrowed from the whole fleet of illusions-old-age and survivors insurance, unemployment compensation, aid to the needy aged, aid to the needy children, aid to the needy blind, aid to the permanently and totally disabled, aid to crippled children, miscellaneous vendor payments for medical care-to that single illusion, "old-age and survivors insurance." OASI is the senior member of the completely national programs, which move beyond the parochial limitations of town, county, State, to a National Government of 50 States. (Even more alluring, in the shadows comes

the goal of moving out into world government.)

The camel's nose under the tent flap

OASI began to operate through the Social Security Act of 1935 as old-age benefits. Tax collection and benefit payment started in 1937. It became OASI through the amendments of 1939, effective in 1940. At that time, an important security anchor was the reserve (now called the trust fund). It was to grow from nothing on hand at the beginning of 1937 to $47 billion in 1980.

That first year, 1937, the tax was half a billion dollars. The benefits were a million dollars. We had saved dollars of high purchasing power against the threat of future old-age need. Here was high resolve-communal resolve.

In 1939, the employees, the personal payers of taxes, were joined by wives and children as dependents of the employees and as potential dependent survivors

of those employees at the deaths of such employees. By 1950 the million dollar benefits had grown to a billion dollars-the taxes from $0.5 to $2.7 billion. We weren't scared yet, and the trust fund stood at $13.7 billion enough for 14 years of benefit-payment at the 1950 rate. There were even high-level pronounce ments of overfunding.

Then came amendments-biennial amendments.

In 1960 the taxes had reached nearly $11 billion. The benefits and operational expenses had also reached $11 billion. The trust fund was $20 billion-falling off from a higher figure—and not enough for 2 years payments at the 1960 leve The yearly margin of taxes over benefits and expenses had disappeared. More over the 1939 emphasis upon benefits for early deaths had piled up death bere fits somewhat larger than the interest received on the trust fund, twice as higt in the year 1960.

On ahead this actuarial reviewer sees possible benefit outlay to those now covered-some record of personal OASI taxpayment-thus barring from corsideration the coming taxpayers from the baby boom of the last 15 years of $2 trillion-spread over 50 years, the average recognition of coming liability would be $40 billion a year.

H.R. 4222

The camel isn't way in yet-though the progress is noteworthy. Under H.R. 4222 is another proposal for benefits to the aged. Some of the medical costs of the aged are to be added under the social security approach of OASI. This could be either another camel gently nosing under the tent flap, or the same camel moving the hump in. At the end of 1960 some 8 million primary-age bene ficiaries were on the OASI rolls. A study I have recently made would indicate that these extaxpayers had paid personal taxes approximating 3 percent of the total age benefits paid and yet payable to them and their dependents.

Cost guesses

Over the last century, the mortality rates by age have shown a certain orderliness and improvement so that life insurance during working years (say up to age 65) is a sounder and sounder proposition. Although the death rates now seem to rise a thousandfold from age 10 (0.0005) to 110 (0.5000), the invention of life insurance in its 21⁄2 centuries of operation has aided men in self-sufficient dealing with that increasing risk by level-premium life insurance, wisely offering the choice of paid-up protection from prior thrift. The improvement in mortality and in life insurance rates works in reverse in connection with annuities, but self-sufficiency takes both provisions in its stride.

That orderliness of death rates is somewhat less satisfactory in permanent total disability rates. It has sometimes seemed that keeping damaged lives alive might increase PTD rates. I have observed one experience with PTD rates, where after 13 years with an experience of 20 percent of the expected claims, the rate became 200 percent only a few years later.

But when we come to a whole set of various medical expenses on the older people, although the records have been greatly developed in recent years, they still need much more interpretation to make them in any sense comparable with the mortality rates.

Looking backward at the prognostications among Government-handled projections under the more orderly risks suggest to me that the hope that dependable measurements can be made of the benefits to be paid by passing the bill over to the younger taxpayers may be "pious and humanitarian," but hardly "actuarial." Were these medical care outlays to result in only a 10 percent increase in OASI benefit-payment yet to follow in 1962 by a 10-percent increase after the 4-percent tax increase of 1961, that yearly boost is too much. (I do assume that a second boost of near-gratuities to the present-1961-aged will not be seriously considered.) We have been given fair warning of persistent intent to keep on raising the OASI benefits. As our attention flags, they will apparently be presented. Let me restate, baldly: OASI taxes have, in the 24th year, reached 22 times the taxes of the first year. OASI benefits in the 24th year are 11,000 times the benefits of the first year. For the last 10 years the average yearly increase in benefits has been a billion dollars. The personal OASI tax has risen from $9 to $80. This leaves out the disability picture.

Compulsory charity

The program has been built by the illusion that personal budgeting has failed and will fail; that the local community is unable to manage its relief budget; that the sovereign state must pass over its constitutional prerogatives to the

National Government; that the only way to deal with the aged-only 1 percent of whom reached the poorhouse by 1930-is to make charity recipients out of virtually all the aged. In the bookkeeping of OASI about three-fourths of the tax take is gone, leaving about one-fourth in the trust fund. We are told that benefits are first paid by the employers' taxes so that perhaps all the employers' taxes have been spent and about half the employees' taxes. This might cut down the personal thrift content of the 8 million primary beneficiaries' taxes to 12 percent of the potential family benefit take. The OASI experiment is clearly unfinished business.

The British in 1832-about as far after the Napoleonic Wars, as we are after World War II-did some very sound thinking to put their local responsibility into focus. Newburgh in 1961 is doing the same thing. To prate of dignity in dole receiving is illusion.

This generation of aged dole receivers have become the geese flying left. If the Young Americans for Freedom live their philosophy, we may soon see the geese flying right. It is all in the way you read the picture.

Oh, yes; I am opposed to H.R. 4222.

STATEMENT OF GILBERT W. GOODELL, MOUNT RAINIER, MD.

Honorable members of the House Ways and Means Committee, I was born in Washington, D.C., July 5, 1930.

I will start this off by saying my father won the Silver Star on the battlefield in World War I, and was in the Medical Corps when he won it. I carry the middle name of a doctor who was a friend of my father's, and I have an investment of approximately $14,000 in medical bills and lost wages, etc. I at all times carried medical insurance, but most of my expenses were diagnostic which most plans do not cover.

This testimony will take two forms: (1) I will describe the living hell I went through for 31⁄2 years and am still on the outer fringes of, and, (2) I will mention some legislation I believe will help to correct the situation. All these laws may not be feasible now, but I know from my own experience something will have to be done sooner or later. I also hope to arouse some public interest as I know this just didn't happen to me alone. Most people are complacent until something like this happens, then they figure what can you do about it? My aim is to show them.

It all started sometime in September of 1957, in Pittsburgh, Pa., when I had what was diagnosed as a case of "flu." Dr. Verner Calloman, Jenkins Arcade, Pittsburgh, treated me and I seemed to recover after 2 weeks. I had a second attack later in October, although a lighter one. During the first attack I developed an allergy to penicillin, although I had taken it on previous occasions without reaction. I wish to note here that many liver diseases mimic the flu.

I received an injury to my chest in October after some guy had dug his hands in after an argument. I thought for a long time this injury to my chest was causing my trouble. In fact I thought so until I started getting proper treatment. I have in my possession X-rays which show without a doubt that there are bruises in this area. These X-rays were taken 2 and 3 years after injury and many doctors had looked them over. I have had them read since and was told they were bruises, as I pointed out the area that hurt to present doctors. Mayo Clinic as well as many others noted nothing.

In November of 1959, I was working on the Pittsburgh Press, when I had what I thought sure was a heart attack, Dr. Calloman put me in the hospital (Allegheny General) for heart tests, etc., and reported negative findings. I had similar attacks several times before I left Pittsburgh in December 1957. Dr. Calloman said I would spend a lot of money trying to find out what it is. This statement turned out to be so true that I wonder if he didn't advertise in the Medical Journal to keep a lookout for me. Seriously, I wonder if it is standard medical practice to keep people running around years looking for a cure when simple tests, properly done, would find the cause-in my case a liver dye test.

Some doctors spend years of their lives perfecting a test to show up some disease, others on how to cure disease, and some doctors will not even give you the test when you request it, as I did many times and, I emphasize, was willing to pay for it. I paid all of my medical bills except when they were pushing me around as I will describe in the order of occurrence.

I went to New York in 1958, working both the New York Herald Tribune and New York Times. Work was slow and I was at the bottom of the slipboard,

so I decided to go back to Pittsburgh in the spring. I had what I thought another heart attack just before I left. I saw no doctor in New York this time. I at no time felt right; my heart was skipping and I was constantly dizzy. I went back to Dr. Calloman who sent me to a heart specialist at Allegheny General Hospital, who reported it was nerves, and definitely not a heart disease. One night in July 1958 I was working at the Pittsburgh Post-Gazette, and as I came back from lunch I started feeling faint. One of the fellows said I was white as a sheet and that I had better go to a hospital. I decided to go with him, after not being able to reach Dr. Calloman.

This was Mercy Hospital in Pittsburgh; the doctor examined me and said he could find nothing wrong with me. He did say I'd better stay overnight. This overnight stay turned into 2 weeks and first internal X-rays. The only thing I noted strange was that they kept taking blood practically every day. If there was anything wrong with the blood they did not tell me about it. Blue Cross refused to pay all or any part of the hospital bill.

That fall I went back to New York and was working on the New York Times again. I discussed my situation with one of their doctors who sent me up to see Dr. Hirsh Robert Liebowitz, and I will say that he might have found my trouble but I told him because of the expense we would do a few things at a time and then I had to leave New York because of the newspaper strike in December of that year. When I went to Dr. Leibowitz I had severe cramps as well as other complaints and he cleared the cramps up.

After the strike began another fellow and myself went to Cleveland. I decided to give the Cleveland Clinic a try. Here Dr. Rossmiller performed the same tests as were done in Pittsburgh-all negative. He then decided that I should see a psychiatrist there. This was because they might try to hypnotize me out of it. I had so much pain I did not care. The psychiatrist said I was not the suggestive type; he could find nothing wrong either. One day I called Dr. Rossmiller from the hotel and I told him my heart was skipping bad. He started to tell me to come in, but changed his mind and told me to take an aspirin and put a hot water bottle over my heart. He or one of the other doctors made the statement one time that they had sick people to treat in referring to me. One of their heart specialists, while he was examining me said that I could not feel or hear my heart skip. Just then it skipped and I told him so; it skipped again and I told him so. He finally admitted that in some cases you could feel and hear it skip; however, he would not say what the cases were. Dr. Rossmiller made the statement that I was doing nothing but buying doctors Cadillacs. I guess I did that. I figure I would try something on them I knew I needed. Dr. A told me in 1947 that I would need a septum operation or I would possibly get sinus trouble. This was following an automobile accident in which I broke my nose. I was not driving. I knew my sinus was getting very bad as I could feel that, too. So I asked them in Cleveland about the operation. They said I definitely did not need the operation, but they would do it to please me. I said goodbye. It was now apparent I would get no help from them. A Dr. Sidney Lobe of Cleveland was called to my hotel one night and gave me hell for calling him on Sunday. I didn't call him, the hotel did; and anyhow he did not mind separating me from $10 on Sunday. He had me come to his office one visit and asked, “Who did this to you?" What was done I have not figured out yet. His report was negative, too, except for congestion of the lungs.

I had my father make an appointment with Dr. John Lyons, of Washington. D.C. Dr. Lyons had done a small operation on my face a few years ago; nothing connected with this, I do not believe. He seemed like a good man then and I still think so. Dr. Lyons and I discussed the situation and he said it did not appear that I was nervous to him. He sent me to Dr. Bertle Nelson. Dr. Nelson put me through the same tests and X-rays as I had previously and said I had a nervous bowel and gave me some medicine which I found out later was another tranquilizer. I had many tranquilizers before and many after and none were to give me any permanent relief. Dr. Nelson said I could drink moderately if I wanted to. I went back to Cleveland and the first couple of days I drank moderately. It did not bother me, and then one day I had pains so severe across my chest that it awakened me out of a sound sleep. The next day my heart started skipping again very severely. I called Dr. Nelson and he said he would have to run some more tests. In the meantime I was involved in a traffic accident in Cleveland and had to wait a couple of months to come back here.

I came back to Washington in September of 1959 and went to work at the Washington Post. I am still employed there. My father was struck by a car out on Highway No. 1 in November of 1959. They did not hold the driver and

I was not satisfied everything happened the way they told me it happened. I still am not. I hired a private detective to check on it. Blair Smith, who used to be State attorney for Prince Georges County, told me he would have held the driver even if he knew he was not guilty. He said it was up to the court to decide and not the policeman. However, this was supposed to help prove me a mental case, as I will explain later.

Dr. Nelson asked me after my father's death if my father had left any insurance and I believe I told him, stupid as I was. It now was January 1960, and I began having extreme pain in my right jaw. Dr. Nelson sent me to Dr. Kaplin (dentist) who said it was extremely red in there, but there was no sign of tooth in the area. I thought it might have been a wisdom tooth. On the way home I figured something was causing the redness, so I went to Dr. Fleming of Mount Rainier, Md. He said I had an abscess and showed me X-rays. He said I should have it out immediately. (I was to wish many times later that I had left this one in.) Dr. Fleming sent me to Dr. Ferris of Riverdale, Md. I had the tooth extracted by Dr. Ferris and I felt pretty good for a few days. I went back to have the stitches removed and the dentist said that it looked infected to him and for me to keep my mouth clean. When he removed the stitches, one did not hurt at all but the other did. He gave me no antibiotics. A couple of days later I drank a couple of cans of beer and the whole side of my face turned numb. I couldn't feel a thing. This happened two times on the right side of my face and once on the left, and I began passing out. I called Dr. Ferris and he told me to come out Monday morning. I did, and he said it looked good to him. I went to Dr. Nelson and he said it looked infected to him. I went to a party some friends of mine were giving and had some drinks. I drove home and felt kind of odd. I can't describe it now. I parked my car in the parking lot, turned the lights and motor off and woke up 3 hours later. You can now imagine the panic I was in. The next day, a Sunday, I remember, I went to work and felt extremely dizzy so I called Dr. Ferris' residence and he told me to come out Monday morning. I called the Washington Hospital Center and a nurse asked me if it was still bleeding. I said that it was, a little. She said I should call my dentist right back and tell him so. (This was 3 weeks after extraction.) I did, and he still said to come in Monday morning and he would look at it. He said he did not remember me, that he must have had over 50 people last Saturday. (Imagine this: a dental surgeon with over 50 people, with 1 assistant, in 1 day. Some of these people must have had more than one tooth out. Is it any wonder he botched the job on me?) By this time, I was sleeping about 14 or 15 hours a day and I could not hear the alarm clock, so I stayed up all night to make sure I got there. Mr. Ferris said it looked fine to him. I said, "Well, it does not feel fine to me." I passed out many more times during the week and one night broke out in big red blotches. I went to Prince Georges emergency room, and they said I was allergic to something. I went in to see Dr. Nelson and he said that it still looked infected to him. I asked him to call Ferris up. Nelson did and made a note of it. Ferris or his office said to come in the next day or so. When Nelson looked at the tooth area he said he thought he felt bone there. When he put a stick over it to press, I became extremely dizzy. On the way home I became so dizzy I went to the Washington Hospital Center and an intern suggested I go back to my own dentist or to come back in the morning. The next day Dr. Ferris was not even there to talk to me and his assistant said, "No wonder it will not heal with everybody poking it." He suggested it might be sinus or something else causing it. I asked him if they could have left anything in there. Oh, no, he was sure they had not.

Now, as I explained before, I knew I had sinus trouble, so I figured I would see Dr. A about it. He said, sure enough, I had infected sinus and showed me the area on the X-rays. He said it might have affected tooth area. (During this examination I showed Dr. A a sliver of bone sticking out of tooth area.) I still have bone chip. Bone chips have come out three or four times since. Dr. A still said I needed septum operation. One day before the operation I was feeling extremely bad and called Nelson. He said he would have to start some tests over again. He took blood test and said I had an 18,000 white blood count. Dr. Nelson said it was OK to have operation after he reduced the count. Dr. A took count while I was in the hospital and did the operation which improved my sinus; it did not improve the tooth area, however. (I told Nelson I was going to have operation and he gave his consent.) After the operation my blood count went back up. Dr. Nelson gave me antibiotics. I said, "What do you intend to do about this?" He said, "We will just watch it." This worried me as I knew a person who had pain in the stomach, he had an 8,000 blood count and when they