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cannot deal with the red-tape, the "lost claims", the low reimbursements, the appeal process and the general Many have multiple insurance policies.

confusion.

I feel that much of the confusion Medicare beneficiaries
have could be avoided if they were able to have their
questions answered knowledgably by personnel in their
physician's offices who have a keen understanding of
the Social Security system and Medicare as well as a
working knowledge of supplemental insurance plans. I
have personally spoken to numerous physician's office
personnel who do not understand Assignment of Benefits,
do not know current deductible amounts for Part A or the
definition of a Benefit Period. These people care very
deeply, as I and my staff do, about our senior citizens
whose lives they touch each day. Their contact is more
frequent and intimate than a visit to a distant SSA offi
I encourage physicians to take responsibility for provid
ing continuing education for their professional recepțio
ists and other staff members.

I propose that the Social Security Administration conduc seminars and workshops specifically for medical office p sonnel regarding updates and revisions in Medicare and other SSA programs.

Medicare was designed to meet the health care needs of t individual. Has it done that?

re so complex icians or hosThey m further.

Better utilization of Home Health Care Services would pr vide a substantial savings to the Medicare program and h to preserve the dignity of the recipient. The services

skilled nurses, approved as providers, could show a substantial savings through Community Nursing Centers as proposed by Senators Packwood and Inouye in a bill recen ly introduced.

Legislation signed into law by President Reagan extendin Medicare coverage to Hospice care as of Novenber 1, 1983 will not only save the Federal Government hundreds of mi lions of dollars in health care costs but allow benefici ies a compassionate alternative to hospital care. The P chological needs of the patient and his family will now dealt with in a humanitarian and cost-effective way.

I do not believe the Medicare benefits are structured

properly. How can a person relying on Social Security benefits in 1984, $4,860.00, as his/her only source of i come be expected to survive even one average hospital st with the Administration's proposed Medicare changes? The out-of-pocket expenses for an average hospital stay would amount to more than one-quarter of the total income for the year. How can we let this happen to the people who have worked and suffered and fought wars to keep us free?

The fiscal 1984 budget is really just shifting costs to t elderly and disabled. If the deductibles continue to inc as well as the co-insurance amounts and the premiums they will be forced to enroll in the Medicaid program. We car honestly expect them to do otherwise if they are to survi

One of our clients, Mary Husted, an 82 year old childless widow underwent cancer surgery in August of 1981. She re

covered enough to return to her home in the remote area
of Hornell, New York. Mary could not manage alone and
was forced to rely on others to care for her. But, she
had what she wanted, she was home. Home health aids were
made available but the expenses were ruled ineligible by
Medicare as there is no participating agency supplying
the services and billing Medicare in Stuben County. Mary's
care did not, therefore, meet all the criteria for benefit
Appeals were filed. Again, denials. Letters to her Con-
gressman were written with only an oral negative response.
All efforts to obtain reimbursement were fruitless.

She re

Mary was forced to draw upon her life savings. She wanted
to maintain her independence. As she watched her money
disappear she tried to do without the home health aids
and do more on her own as much as possible. In February
of 1982 Mary, alone, fell and fractured her hip. Hospital
ized for some time, Mary was eventually allowed to return
to her farm home. She again hired home health aids to ass
her. She was adamant she would not die poor and again re-
fused the help she needed as long as she could. As her
money dwindled, so did her will to live.

Mary was buried two weeks ago.

Mr. and Mrs. David B. Gordon had their story published in
the September 27, 1982, issue of "Newsweek". Mr. Gordon,
a retired police officer, and his wife have a total annual
retirement income of $41,100.00, including Social Security,
Pension and Dividends and Interest. They have no debt.
Mrs. Gordon suffers from Parkinson's disease and its com--
plications and remained at home with her husband and paid

help until a few months ago when she suffered a stroke. She then required more skilled care which her husband, who lovingly gave of himself and often was unable to sleep more than an hour at a stretch, could not provide. The nursing home cost is $105.00 daily or $38,325.00 per year more than their entire net income.

"Other than Medicaid there is practically no insurance that covers extended care in a nursing home. Medicare will pay most nursing home expenses for up to one hundre days, but only under certain conditions---".

"Mr. Gordon must spend all his savings and liquidate all assets except for $2,600.00 for himself and $2,600.00 fo his wife, enough to bury them, in order for his wife to be eligible for Medicaid. Ilis pension will be attached. If he works, he won't be able to keep his salary."

"The odd part of this arrangement is that by making (then liquidate (their) savings, the government is depriving (t of the $1,000.00 a month in bank and dividend interest th could go toward (his) wife's upkeep. If that income coul

be retained, the nursing home cost to Medicaid would be $ or so a month.--- -Instead, it will cost the taxpayers,

-----

through Medicaid, more than $1,600.00 per month."

Are there any alternatives?

Yes.

Divorce was suggested as a logical alternative. But why should people who love each other be forced to divorce?

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Mrs. Gordon's greatest fear has been that that she might end her life in a charity ward as did her grandmother during the Depression. She is in a good nursing home and is well cared for thanks to Mr. Gordon.

Now, what about Mr. Gordon?

Mary and the Gordon's are not isolated cases.

Are

Hlas Medicare been insuring too much or too little?
not Medicare recipients currently paying more than their
"fair share"?

I thank you for the opportunity to testify and for your kind attention.