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Commerce, the Secretary of the Treasury, the Secretary of Agriculture, the Administrator of the Housing and Home Finance Agency, the Administrator of Veterans Affairs, and the Chairman of the United States Civil Service Commission. (b) The Committee shall have the following functions

(1) to strengthen and coordinate existing programs in all departments and agencies of the Government to meet the needs of the older population;

(2) to advise the President with respect to recommendations for additional executive and legislative measures with respect to problems of aging; and

(3) to facilitate Federal-State-local relationships in the field of aging on an integrated, across departmental lines, basis. (c) The Assistant Secretary of Health, Education, and Welfare for the United States Office of Aging shall serve as the Executive Director of the Committee, and he shall utilize the services of the United States Office of Aging for staff purposes in carrying on the work of the Committee.

CUMULATIVE REPORT TO CONGRESS

Sec. 606. Not later than January 1, 1962, the Secretary shall transmit to the President for transmission to the Congress (1) a report of the experience of Federal, State, and local agencies in the administration of titles III, IV, V, and VI of this Act, together with such recommendations as he deems advisable.

CHAPTER II

THE HEALTH STATUS OF THE AGED AND THE FINANCING

OF ADEQUATE HEALTH SERVICES

One outstanding fact commands the attention of the subcommittee: Between 1948 and 1959 premiums for health insurance have increased 600 percent for persons of all ages—but in the same period of time, the incomes of aged family heads and of aged unrelated individuals have grown by only 48 and 44 percent, respectively.

In dealing with the current question of the most appropriate method of financing the costs of medical care for the aged, consideration should be given to (1) their health conditions, (2) the role of current insurance programs in meeting costs, (3) the role of the public assistance approach, (4) the elements of a positive health services program for older Americans, and (5) their income status, discussed in chapter III.

HEALTH STATUS OF THE AGED

Despite various attempts to obscure the basic facts, we are still impressed by the demonstrated data concerning the health problems of the aged. Our basic source of information on this subject is the careful series of studies conducted by the U.S. national health survey of the Public Health Service.

The National Health Survey, it should be emphasized, is the Nation's most reliable source of knowledge concerning the health status of all age groups. It consists of interviews in households selected on the basis of the most sophisticated scientific techniques of sampling and interviewing. For example, in a 24-month period ending in June 1959, the Survey covered about 235,000 individuals from 73,000 households. The research design allows for a continuous measurement of a wide number of health characteristics. The total nonresponse rate is only 5 percent, with 1 percent being refusals to be interviewed. he sampling errors are minimal.

The survey tends to understate much of the dimensions of the health problems of the aged, as regards hospital experience, for instance. To quote from the NHS’ report on health characteristics of older persons:

Since the mortality rate as well as the rate of hospitalization is high among older persons in the population, it is known that the hospital data collected by the survey considerably understate the total hospital experience for persons

45 years and older.1 Another reason for the survey's understating of the health problem stems from its exclusion of the institutionalized population, which includes at least 4 percent of the total aged population. Other than these two qualifications (exclusion of decedents and the institutionalized), the survey represents all segments of the country's population. Every segment, in terms of region, urban-rural residence, income, race, etc., is properly represented.

1 "Health Statistics: Older Persons, Selected Health Characteristics," Public Health Service, September 1960 (series C-No. 4), p. 3. Some of the titles from this study are reprinted in the appendix.

We have included this brief description of the national health survey because we feel strongly that its vital role in clarifying the current controversy over the financing of adequate medical care for the aged of the United States has too often been overlooked and neglected by the public and, indeed, by certain parts of the health profession itself

. Reliable knowledge is indispensable to good legislation. Other more limited studies, with small samples often selected poorly and excluding various population segments, and otherwise faulty (wording, thoroughness, period of time covered, etc.), have only confused and misled many individuals and groups in the country.

On the other hand, the national health survey was created by Congress to provide accurate and reliable knowledge on the health conditions and related characteristics of the American people. Its methodology and techniques are of the highest quality known to the field of survey sampling science.

Through its carefully detailed research, we have come to know the following, for example:

1. The rate of chronic illness (such as heart disease, cancer, diabetes, arthritis, etc.) among the aged is more than double that for those under 45 years of age-77 percent versus 34 percent.

2. Although they constitute less than 9 percent of the total population, the aged make up more than 55 percent of all persons with limitations due to chronic illness.

3. The average number of physician visits among the aged is 36 percent greater than for the general population.

4. The aged spend approximately twice as many days per year (15) in general hospitals as does the rest of the population.

5. The proportion of aged hospitalized in general hospitals for more than 1 month per year is nearly 60 percent greater than the proportion prevailing in the rest of the population, 38.8 percent as against 24.6 percent.

Data FROM U.S. NATIONAL HEALTH SURVEY, JULY 1957–JUNE 1959 Number and percent of persons 45 years and older with one or more chronic conditions

by sex and age: United States, July 1957June 1959

Number of persons

(in thousands)

Percent of population

Age

Both sexes

Male

Female

Both sexes

Male

Female

All ages, 45 plus....

32, 147

14, 703

65.0

62.4

67.4

45 to 54.
55 to 64.
65 plus..

65 to 74.
75 plus.

11, 199

9, 610 11, 338 7, 197 4, 141

6, 217
4, 457
5,030
3, 295
1,735

17, 444
5,983
5, 153
6, 308
3, 902
2, 406

56.5
64.4
77.3
74. 2

53.9 62.0 75. 2 72.7 80.5

58.9 66.5 79.0 75.5 85.6

83.3

Percent of persons with partial or major limitation of activity by residence and age:

United States, July 1957-June 1959

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Percent of persons with partial or major limitation of activity or mobility by family

relationship and age: United States, July 1957-June 1959

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Distribution of persons 45 years and older by age and chronic condition status.

United States, July 1957June 1959

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All ages, 45 plus..

100.0

35.0

28. 1

17.2

19.6

45 to 64.
65 plus.--

100.0
100.0

40.1
22.7

29.1
25.8

15.9
20.4

14.8 31.1

67714-61

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Percent of persons 65 years and older with partial or major limitation of activity

or mobility by family income

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Restricted activity days per person per year for persons 45 years and older by

age and sex

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