Hospital Costs For example, the Department of Labor's Consumer Price Index since 1950 has gone up 26 percent, but medical charges have jumped 56 percent. One reason for the increased medical charges is that the fees of doctors have gone up 47 percent. But, even more important, is an increase of 125 percent in hospital daily charges. For the Older American, his major concern over medical care is the possibility of going into a hospital. This is true because the hospital bills are usually large, they can come without warning, and they usually must be paid all at once. Of the one in six aged persons who is hospitalized in a year, the hospital bill—not including doctor's and other expenses—averages about $525. How do older Americans now pay their medical bills when they are ill? Many are able to manage on their own, especially if they have insurance against some costs. Some seek help from others relatives if there are any and public assistance if relatives cannot help. Some get free care under other public programs and through private charity. Some borrow money. And there are many who do not get the care they need. The extent to which they go without care is unknown. But a strong hint of it is found in these facts: Nearly half the older Americans with arthritis, rheumatism, hernias, or who have trouble seeing or hearing are not now under care. And one out of seven with a heart condition is going without medical attention. Most of the aged when they do go into hospitals pay at least some of their bills out of income or savings. But a high percentage are unable to pay them all either with their own resources or through health insurance. For example: A 1957 survey of aged people drawing social security showed that, of those who went into a general hospital during that year, two out of five of the couples and three out of five of the nonmarried people did not meet all their medical bills from their own income, assets, and health insurance. Thus, we have a serious gap between the care most older people need and their ability to pay for the care either through health insurance or from income or savings. One deceptive feature of the health-care picture is the degree to which private health plans cover costs. While more than half of the aged have such coverage, much of this insurance is very limited. A study of the health problems of the Older American made recently estimated their health insurance does not meet more than onesixth of total medical costs of the insured or one-fourteenth of the total for all the aged. Another study of older people discharged after a short stay in hospitals from July 1958 through June 1960 showed that health insurance covered: • No part of the bill in over half the cases. Ever independent Independence should not be thought of as a gift. The Older American asks not for the gift of independence but the right-the right to an independent income, the right to maintain his health without the help of charity, the right to live with as much independence as his strength permits. The Older American asks, in short, for the right to opportunity-the opportunity to be independent, to provide for himself, to work if he wants, to stand on his own merit and ability. The Older American cherishes independence as he cherishes life. Let the opportunity for independence forever be preserved. Medical Assistance for The main reason coverage is not more complete relates directly to the income of most older Americans. The plain fact is they cannot afford the premiums for comprehensive private health plans. For broad health insurance coverage for a couple, the premiums even on a nonprofit basis are about $400 a year-one-sixth of the total income of an average couple. Two other main sources of help in paying the medical bills of the Older American are: Help from relatives and public or private assistance of one kind or another. An indication of the amount of such help is found in the study of social security beneficiaries who were hospitalized in 1957. About one in seven of the couples and about one in three of the unmarried patients relied at least in part for their medical care on private or public welfare. The number receiving help from relatives in one form or another was at least as large. Of the various types of help given, public programs are responsible for more than $1 in every $4 spent for medical care for the Older American. The most important single public program-considering the dollars the Aged spent-is the public assistance aid given through the Federal-State programs of old-age assistance (OAA) and medical assistance for the aged (MAA). In 1962, for example, about $635 million was spent by the States and Federal Government, on a matching formula, to provide public assistance medical care under OAA and MAA. About $390 million of the total was spent for medical care for people receiving old-age assistance. They received the help because they had little or no other income than their old-age assistance, which averaged about $60 a month. Approximately $245 million was paid out under medical assistance for the aged-the program commonly referred to as the Kerr-Mills program. The aged who received help under MAA are the "medically indigent"--by definition, those who are not so needy that they are eligible for cash payments through old-age assistance but who do not have money to pay medical bills. The MAA program in 1962 helped to pay medical bills each month for about 1 in every 200 older Americans, and the average monthly payments were just over $200. The program now operates in half the States. Further, of the $245 million spent under the program last year, 88 percent of it was spent in five States-New York, California, Massachusetts, Michigan, and Pennsylvania. Of the aged receiving help during a month, 73 percent were concentrated in the same five States, although less than one-third of the Nation's aged live there. EMPLOYMENT Employment plays varying roles in the lives of older Americans. For many, it is a principal source of income to provide the necessities of life. For others, it provides the therapy of usefulness, belonging, and well-being. To many older people, employment is the badge of status in the family and the community and the center from which |