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SPECIAL COMMITTEE ON AGING

FRANK CHURCH, Idaho, Chairman HARRISON A. WILLIAMS, New Jersey HIRAM L. FONG, Hawaii ALAN BIBLE, Nevada

CLIFFORD P. HANSEN, Wyoming JENNINGS RANDOLPH, West Virginia EDWARD J. GURNEY, Florida EDMUND S. MUSKIE, Maine

EDWARD W. BROOKE, Massachusetts FRANK E. MOSS, Utah

CHARLES H. PERCY, Illinois EDWARD M. KENNEDY, Massachusetts ROBERT T. STAFFORD, Vermont WALTER F. MONDALE, Minnesota

J. GLENN BEALL, JR., Maryland VANCE HARTKE, Indiana

PETE V. DOMENICI, New Mexico
CLAIBORNE PELL, Rhode Island

BILL BROCK, Tennessee
THOMAS F. EAGLETON, Missouri
JOHN V. TUNNEY, California
LAWTON CHILES, Florida

WILLIAM E. ORIOL, Staff Director

DAVID A. AFFELDT, Chief Counsel
VAL J. HALAMANDARIS, Associate Counsel
JOHN GUY MILLER, Minority Staff Director

PATRICIA G. ORIOL, Chief Clerk

SUBCOMMITTEE ON HEALTH OF THE ELDERLY

EDMUND S. MUSKIE, Maine, Chairman FRANK E. MOSS, Utah

PETE V. DOMENICI, New Mexico HARRISON A. WILLIAMS, New Jersey CLIFFORD P. HANSEN, Wyoming EDWARD M. KENNEDY, Massachusetts EDWARD J. GURNEY, Florida WALTER F. MONDALE, Minnesota

EDWARD W. BROOKE, Massachusetts VANCE HARTKE, Indiana

CHARLES H. PERCY, Illinois CLAIBORNE PELL, Rhode Island

ROBERT T. STAFFORD, Vermont THOMAS F. EAGLETON, Missouri

J. GLENN BEALL, JR., Maryland
JOHN V. TUNNEY, California
LAWTON CHILES, Florida

Barriers to Health Care for Older Americans:

Part 1. Washington, D.C., March 5, 1973.
Part 2. Washington, D.C., March 6, 1973.
Part 3. Livermore Falls, Maine, April 23, 1973.
Part 4. Springfield, Ill., May 16, 1973.
Part 5. Washington, D.C., July 11, 1973.
Part 6. Washington, D.C., July 12, 1973.
Part 7. Coeur d'Alene, Idaho, August 4, 1973.
Part 8. Washington, D.C., March 12, 1974.
Part 9. Washington, D.C., March 13, 1974.
Part 10. Price, Utah, April 20, 1974.
Part 11. Albuquerque, N. Mex., May 25, 1974.
Part 12. Santa Fe, N. Mex., May 25, 1974.
Part 13. Washington, D.C., June 25, 1974.
Part 14. Washington, D.C., June 26, 1974.
Part 15. Washington, D.C., July 9, 1974.

Part 16. Washington, D.C., July 17, 1974.
(Additional hearings anticipated but not scheduled at time of this printing.)

BARRIERS TO HEALTH CARE FOR OLDER AMERICANS

TUESDAY, MARCH 12, 1974

U.S. SENATE,
SUBCOMMITTEE ON HEALTH OF THE ELDERLY OF THE

SPECIAL COMMITTEE ON AGING,

Washington, D.C. The subcommittee met, pursuant to notice, at 10 a.m., in room 5110, Dirksen Office Building, Hon. Edmund S. Muskie, chairman, presiding.

Present: Senators Muskie, Hartke, Chiles, Fong, and Pell.

Also present: William E. Oriol, staff director; Elizabeth Heidbreder, professional staff member; John Guy Miller, minority staff director; Margaret Fayé, minority professional staff member; Patricia Oriol, chief clerk; Gerald Strickler, printing assistant; Joan Merrigan, clerk; and Dorothy McCamman and Herman Brotman, consultants.

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OPENING STATEMENT BY SENATOR EDMUND S. MUSKIE,

CHAIRMAN

Senator MUSKIE. The subcommittee will be in order.

This hearing continues the inquiry of the subcommittee into barriers to health care for older Americans, a series we began 1 year ago this month with hearings on the administration's Medicare cutback proposal, and have continued in other hearings last year in Washington and around the country.

Today and tomorrow we will hear testimony on the administration's national health insurance proposal—the comprehensive health insurance plan. Before we hear from our witnesses today, I would like to make some brief points about national health insurance and the elderly.

First, I note with pleasure that every concerned group in the Nation has recognized the need for enacting a program of national health insurance. The defects of our health care system, for all citizens, are so severe that they can only be solved by a nationwide plan which insures every American access to sound health care. The public, health professionals, the administration, and Congress all agree that national health insurance is a top priority for America.

Second, I would like to note that agreeing on an adequate national health insurance plan will be a difficult and complicated process. Cooperation and a willingness to reason, by all parties involved, will be essential for the process to be successful. I am gratified that the administration has exhibited the necessary spirit of cooperation. I hope it continues.

Third, I believe it critical for us to keep in mind, as we consider the various national health insurance plans which have been proposed, that they must be judged by their effectiveness in dealing with the entire range of problems which beset health care in America. The health care needs of the elderly, with whom this subcommittee is primarily concerned, and of all other groups in America, will only be satisfied when we insure that benefits are adequate to cover individual health needs; that health costs are financed equitably; that costs are kept under control; and that all the health services our people need are actually available to all our citizens, regardless of geographic location or economic status, in well-planned, rational, institutional, and organizational form.

We cannot immediately legislate the total reform of our health system which should be our ultimate goal. But we should keep that ideal goal in mind, and aim to achieve it in the near future.

The fourth and final point I wish to make goes to the immediate concern of these hearings: The effect on the elderly of the administration's health insurance proposal. In our consideration of national health insurance, we must hold firm to a basic premise that we will not accept cutbacks in health care for the elderly.

Regretfully, examination of the administration's proposal reveals that it violates this standard. The administration's proposal on balance would actually lessen the health care coverage which our elderly now receive under Medicare. These cutbacks come in the form of new deductible and coinsurance charges which would force the elderly to pay more out-of-pocket costs for health care now covered by Medicare.

CHART 1.

MEDICAL CARE BILL PER AGED PERSON AND
PROPORTION COVERED BY MEDICARE, FY 1966-1973

$1200

[graphic]

1000

PAID FOR BY MEDICARE

45.5%

43.3%

142.4%

42.4%

I

31.8%

1966

1967

1968

1971

1972

1973

1969 1970
FISCAL YEARS

Source: Social Security Administration

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