BARRIERS TO HEALTH CARE FOR OLDER AMERICANS SATURDAY, APRIL 20, 1974 U.S. SENATE, SUBCOMMITTEE ON HEALTH OF THE ELDERLY OF THE Price, Utah. The subcommittee met, pursuant to notice, at the College of Eastern Utah, Hon. Frank E. Moss, presiding. Present: Senator Moss. Also present: Val Halamandaris, associate counsel; Margaret Fayé, minority professional staff member; and Kay Thomas, clerk. STATEMENT OF DEAN MCDONALD, PRESIDENT, COLLEGE OF EASTERN UTAH President McDONALD. We are delighted to have you here at this college this morning. I am sure that aging is a thing in which all of us are interested, at least we are all getting older each day, and I am sure of considerable significance to us. Senator Moss, we are delighted to have you with us today, with your staff. I wanted to publicly extend our appreciation to you and your staff for the fine help you have extended to the college in the past, and the enthusiasm that your offices have given in helping us acquire some of the programs we currently have going. A recent grant of $60,000 through the Mine Education and Safety Administration, which was made possible by the efforts of many people, and certainly your office was very helpful, Senator. I am sure that you know that you are in a good Democratic country down here, and we hope that that will persuade you to come back regularly. The occasion of discussing the problems of aging is something that ought to give each and every one of us cause to stop and reflect, and to give some cognizance to the factors of time, and as we grow older, I am sure that time is something that we will all look to, and become a little envious of, as we see the days and years slipping by. One thought in this connection which impressed me, which I would like to leave with you, an anonymous author once said, "I expect to pass through this world but once. Any good therefore that I can do, or any kindness that I can give to my fellow creature, let me do it now. Let me not defer or neglect it, for I shall not pass this way again." On this occasion we have here today, it will never be replicated in exactly the same fashion, so, therefore, hopefully our discussions today will be fruitful and productive and beneficial to all of us, so at this time it gives me a great deal of pleasure to introduce to you our Senator, whom you all know well, and I shall not extend the introduction except to tell you, Senator, how delighted we are to have you here. I would like to turn the time over to you now, sir. [Applause.] OPENING STATEMENT BY SENATOR FRANK E. MOSS, PRESIDING Senator Moss. Thank you very much, President McDonald. I was going to address these people as ladies and gentlemen; but, with your encouragement, I will say Democrats. I am pleased to be back here at the college, and to be able to participate in this hearing. I wanted to especially commend President McDonald and Dr. Selman for their efforts in putting together a meeting of this sort so that people could learn some of the answers to problems that they have, and these problems center around the process of aging. As the President said so accurately, we all take an interest in that, because there is no way to stop the clock or the calendar, and we are all getting a little older, but beyond that facetious remark, the fact is that all of us are involved. In any way you look you see people who have problems incident to aging; therefore, our country, in the interest of the welfare of people generally, must concern itself with the problems and find ways to extend to our elderly or senior citizens the opportunities which we so diligently seek for younger people in our society. That is the reason this committee is holding public hearings today, and that is why it has concerned itself over a number of years in trying to analyze and define the problems and then to suggest solutions. The hearing this morning is to be an official public hearing conducted by the Subcommittee on Health of the Elderly of the U.S. Senate Special Committee on Aging. A full printed transcript of the hearing will be made available to all members of the committee, and of course, all Members of the U.S. Senate. It will be available to those who have an interest in the subject matter discussed, and at a later date any of you who wish to have a copy can secure one very readily by dropping a note to me, or to Val Halamandaris, your native neighbor here. Val has been with me for 12 years; is the associate counsel to the Committee on Aging on which I have served for 11 years and with whom I have worked very closely. Val has done a great job. I suppose one of the reasons we came to Price is that this is where he was born. We decided this would be a good place in Utah to start on what we hope will be a series of meetings of this sort to learn the facts, and to extend information and assistance to those in need. Our hearing is a part of the general seminar that was organized by the college, and by Dean McDonald, and I want to again commend the college for having the vision and the initiative and the desire to render service to the community that caused it to organize the seminar and allow us to take part in it. The hearing this morning will be a departure somewhat from the general formula we follow in Senate hearings. I say this because it was the desire of the committee staff and the college to allow questions and participation from the audience. Ordinarily in a hearing we have certain selected witnesses who sit and talk to the presiding officer, or the members of the committee who are sitting, listening, and questions are asked by the members of the committee back to the one person testifying, and that is really the extent of it. This morning we hope to have real audience participation. We will have experts available here on various subjects, and we encourage you, any one of you, who has a question or a problem, to ask that question of a person who can give the answer, and we may have more than one of our experts answer the question. Following the presentation of the experts, some of you may wish to make statements, some of you will, I hope, be ready with questions. INCOME AND HEALTH NEEDS OF THE ELDERLY As you know, we wish to focus on the income and the health needs of the elderly at today's hearing. I would like to begin my remarks which are a little longer than they ought to be, and I apologize for that, but I would like to begin by reading of what happens when good men and women, regardless of their age and background, are pushed up against the wall of injustice. This is a quote from a newspaper which I consider a classic: Topeka, Kans., police were called today to help restore order at a Methodist Home for the Aged, scene of a week-long revolt. Three militant octogenarians were arrested after a scuffle in the north parlor. They were identified as leaders of an activist group that seized control of the parlor 3 days ago and locked Mrs. Norma Sunderland, matron, in the closet. George Whitlock, 84-year-old spokesman for the "activists," told reporters the demonstration was staged to enforce demands that the old folks be given more role in management. "We have a bunch of young whippersnappers running things around here," he said, waving his cane indignantly. "We don't trust anybody under 65," he added, proudly displaying his "Senility Power" button pinned on his shawl. Two officers suffered minor injuries during the disturbance. One was hit by a runaway wheelchair and the other was jabbed by a knitting needle. The revolt began last week when a small group of hard-nosed superannuates held a "dodder-in" at which some burned their Social Security cards. Although peaceable in early phases, the protest movement took a violent turn when someone hit Emery Dains, home administrator, with a bottle of Geritol. Mr. Dains blamed the trouble on a misunderstanding caused by difficulties in communicating with the militants. "Some turn off their hearing aids when administrative personnel seek to explain policies, etc.," he explained. Mr. Whitlock reacted, "What is the sense of living a long time if some kid who's only 45 or 50 years old can tell you what you have to do?" This account is amusing, because it is well written, but it is painfully relevant. It is also perhaps a warning what could happen in America should the 20 million members of the geriatric set-the Nation's most shamefully neglected minority-use some of the techniques which get results for other groups who feel bypassed or abused these days. "It's hell to be old in this country." Someone said that not long ago. It's the simple truth-for most of our elderly. The pressures of living in the age of materialism and the pursuit of the good life have produced a youth cult in America. Our preoccupation with staying young knows virtually no boundary. We spend millions on elixirs and remedies all the way from pep pills to hair transplants and face liftings. Hang the expense. Drink Pepsi, drive a Ford, smoke Silva Thins, or do anything else anybody insists will keep you looking young. Why this obsession with youth? Some blame the movies. Others blame advertising for the kind of images sold to the public. The real reason goes deeper. Most of us are afraid of getting old. This is true. because we have made old age in this country a wasteland. It's T. S. Eliot's rats walking on glass. It's the nowhere, in between this life. and the great beyond. It's being robbed of your eyesight, your mobility, and even your human dignity. And yet every year more and more of us make it to our 65th birthday and beyond. The rate of growth in the ranks of our elderly has been nothing short of phenomenal. In 1900 there were about 3 million people over age 65 in America. By 1970 there were over 20 million, almost a 700percent increase in just 70 years. Moreover, it appears that we may be on the verge of a major breakthrough in identifying the aging process which will enable more millions of older Americans to live longer and longer. SEARCH TO UNLOCK THE SECRECY OF GROWING OLD How familiar are you with developments in the search to unlock the secrecy of why man grows old? I must say the older I get the more interested I become. The most popular present theory is that there is a master "blueprint" in each of our bodies called DNA which determines the shape of each of our future cells. The theory goes that as the blueprint is used millions of times it becomes ragged and the cells that are produced are slightly distorted. Research efforts are directed at eliminating this distortion. Another theory involves what are called free radicals which someone has compared to a "convention delegate away from home without his wife." Free radicals attach themselves to other molecules, just about any other molecule around, and bring about the eventual breakdown of this molecule. Scientists have found some chemicals which prevent the attachment of free radicals. In Illinois, Dr. Paul Gordon has developed a drug called isosine which is being tested at the Drexel Nursing Home in Chicago and in other cities under the direction of the Food and Drug Administration. In earlier studies the drug was given to old, decrepit rats, and they quickly began to function like young rats. They became once again interested in rats of the opposite sex; they were able to learn new tricks and remember all their old ones. Still other experiments with small animals such as rats and rabbits have been successful in expanding the life-span two to three times normal length. One of these experiments features lowering the body temperature of the animals by 2 degrees. Another cuts back on food. When animals were fed only every third day, their bodies produced greater amounts of adrenalin and longevity was increased. I don't want to leave you with the impression that these experiments offer any final answer to aging. We are getting closer to these answers, but we still have a long way to go. We've been looking for ages. Remember the many things man has done in the past to try to stay young and the many times that man has thought he has found the answer? For example, the ancients practiced "geronomics," which is the practice of inhaling the breath of young women. Dr. Elié Mentchigoff of the Pasteur Institute told us in 1877 that the answer was to eat "lactobacillus" or to have your large intestine removed. Most people elected to eat yogurt rather than have their intestine removed, but it obviously was not the final answer to aging. New developments in science and technology will from time to time, undoubtedly, add more years to life. This is good, but these developments will also serve to increase dramatically the problems confronting our older population. Let me speak briefly and more specifically of these problems. THE HEALTH NEEDS OF OLDER AMERICANS First, let us consider the health needs of older Americans. Medicare today only covers 40 percent of these health needs. Eyeglasses, prescription drugs and dental care are among the services excluded. Like-" wise, Medicare, for all intents and purposes, excludes coverage for long term or nursing home care. Only 70,000 individuals out of the 11 million that are in U.S. nursing homes on any given day have their care paid for by Medicare. In all, the average older American pays today out of pocket $292 a year for Medicare care or more than the total cost of his health care bill in 1965 when Medicare was enacted. To try to give him a better deal, I have cosponsored legislation to bring under Medicare coverage some of the items not now covered. I have also introduced my own bill, S. 1825, to broaden the scope of Medicare to provide in-home nursing services for individuals who can, be treated at home and to provide the full range of nursing home benefits for those who need such care. In short, the bill would cover anyone whose needs were more than board and room or short of hospitalization. This bill, or Senator Edward Kennedy's proposal which is similar, stands a good chance of being enacted next year. INCOME NEEDS OF SENIOR CITIZENS Second, let us look at income needs of senior citizens. In 1972, those of us who are members of the Senate Special Committee on Aging became disenchanted with President Nixon's reluctance to raise Social Security benefits despite the galloping inflation which was, and is, continuing to rip into the fixed incomes of our retired citizens. We helped push through a 20 percent increase in Social Security benefits against stiff opposition from the administration which paradoxically later claimed the credit for the increase. This increase had the effect of boosting millions of older Americans many of whom were never poor before they became old-up over the established poverty line. But there are still some 4 million of our elders with incomes below this minimum subsistence level. We must work to end this inequity. It is for this reason that I have cosponsored legislation to raise beyond the recently established $2,400 level the amount of money that can be earned by an older person before forfeiting part of his Social Security benefits. The ceiling level should be $5,000 or perhaps even removed completely because it discourages people from working who are willing and able to work. Not long ago the Congress authorized a two-step, 11-percent increase 37-767-75-2 |