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7123 ·A5 19674

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RALPH YARBOROUGH, Texas

HARRISON A. WILLIAMS, JR., New Jersey

EDWARD M. KENNEDY, Massachusetts

•WALTER F. MONDALE, Minnesota

Part 1-Washington, D.C.

Part 2-New York, N.Y.

(Additional hearings anticipated but not scheduled at the time of this printing.)

II

CONTENTS

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Cervantes, Rev. Lucius F., S. J., Ph. D., professor of sociology, St. Louis
(Mo.) University, and assistant to the mayor of St. Louis_-_-

Guiney, Mary K., project director and planning consultant on aging to

United Community Services of Metropolitan Detroit----

Vincent, Sister Mary C.C.V.I., the Cardinal Ritter Institute, St. Louis, Mo.
White, Kerr L., M.D., professor of medical care and hospitals, the Johns
Hopkins University-..

Williams, Cary M., Suncoast Progress, Inc., St. Petersburg, Fla_

Cervantes, A. J., mayor, St. Louis, Mo.: Letter to Hon. George A. Smathers,
chairman, Subcommittee on Health of the Elderly, dated June 13, 1967__

Danforth, William H., vice chancellor for medical affairs, Washington Uni-

versity, St. Louis, Mo.: Letter to Alfonso J. Cervantes, mayor----

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Kern, Father Clement, Most Holy Trinity Rectory, Detroit, Mich. : Letter
to Hon. George A. Smathers, chairman, Subcommittee on Health of the
Elderly, dated June 17, 1967__

Slattery, Rev. Robert P., director, the Cardinal Ritter Institute, St. Louis,
Mo.: Letter to Alfonso J. Cervantes, mayor---

Zibit, Samuel, executive director, Jewish Center for Aged, St. Louis, Mo.:
Letter to Mayor Alfonso J. Cervantes__

135

134

"Are Doctors Profiteering on Medicare?"-by William A. Nolen, M.D_

Cases from the files of UAW medicare counselling centers.

"Doctors Urged To Combat Government Planning-New A.M.A. Head

Asks Steps To Fulfill Local Needs Convention Exhorted To Bar

"Threat' of Centralization," by Donald Janson, from the New York
Times, June 21, 1967__.

Excerpts from evaluation report of the well-being project for the
aging of the United Community Services of Metropolitan Detroit, by
the National Council on the Aging....

"Patients Wait for Hours for Hospital Treatment," by Jim Floyd,

Globe-Democrat, June 20, 1967---.

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"U.S. Health Care Termed Chaotic-Doctor Warns the House of Mono-
lithic Service Peril," by Harold M. Schmeck, Jr., from the New York
Times, June 23, 1967.

98

COSTS AND DELIVERY OF HEALTH SERVICES

TO OLDER AMERICANS

THURSDAY, JUNE 22, 1967

U.S. SENATE,

SUBCOMMITTEE ON HEALTH OF THE ELDERLY

OF THE SPECIAL COMMITTEE ON AGING,

Washington, D.C.

The subcommittee met at 8:45 a.m., pursuant to call, in room 1318, Senate Office Building, Senator George A. Smathers (chairman), presiding.

Present: Senators Smathers and Moss.

Committee staff members present: William E. Oriol, staff director; John Guy Miller, minority staff director; J. William Norman, professional staff member; Dr. Austin B. Chinn, consultant; and Patricia G. Slinkard, chief clerk.

OPENING STATEMENT BY SENATOR GEORGE A. SMATHERS, CHAIRMAN, SUBCOMMITTEE ON HEALTH OF THE ELDERLY

Senator SMATHERS. The meeting will come to order at this bright and early hour. Of course, Senator Moss and I have been working for an hour or two already today.

As we begin today's testimony-the first to be taken at several hearings on the subject of costs and delivery of health services to older Americans I would like to say that even with medicare paying a major part of their bills, many older Americans find that health services are still too costly, or too remote, or too forbidding for them to

use.

The elderly are the major victims of the gap that exists between the kind of health care American medicine can provide and that which is available. The prevalence among the elderly of a high chronic disease incidence, drastically reduced income, frequent lack of transportation to services, and a fatalism that equates each passing year with worsening health, is clear evidence that a callousness exists in our society in regard to health problems of the elderly.

I think, too, that there is a great gap between what we say we want in the way of health services for all Americans and what we actually have. Perhaps this gap is due to selfishness or unawareness. I prefer to think it is the latter though I might be wrong in light of the statement made by the new president of the American Medical Association at its annual convention on Monday. He seemed to oppose any Government health program on the grounds that such programs are socialistic. I think every responsible citizen-if he chooses to be discerning can make finer distinctions than that. We all recall when social security itself was called socialistic.

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The subcommittee will investigate our progress, or lack of it, toward several of President Johnson's health goals outlined in his January address on older Americans; and we will also ask many questions.

I am quite pleased that we are beginning our questioning only a week before the first of the National Conferences on Medical Costs. Our deliberations should help assure that the problems of the elderly receive adequate attention at the conference. More than that, I believe that the subcommittee and the conferees will benefit from exchanges of opinion and information.

In this introductory hearing, we can hope to sound only a few themes and gather only a small part of the information we need. But we are happy to say we have received wholehearted cooperation from the Department of Health, Education, and Welfare and from distinguished witnesses with much to tell us.

I would also like to say that, as former chairman of the Committee on Aging, I am pleased indeed to be able now to continue one part of the work of that committee, as the new chairman of our Subcommittee on Health of the Elderly. The new chairman, Senator Harrison Williams, has been both energetic and encouraging in showing his interest in the work of this subcommittee, and I appreciate his cordial leadership.

I particularly appreciate the presence of the distinguished junior Senator from Utah, Senator Ted Moss, who has long demonstrated his interest in the problems of the elderly.

Senator Williams.

STATEMENT OF SENATOR HARRISON A. WILLIAMS, JR., CHAIRMAN, SPECIAL COMMITTEE ON AGING

Senator WILLIAMS. Mr. Chairman, I want to take just a minute or two to comment on the timeliness and importance of the study you are initiating today.

It it quite apparent, I think, that in the wake of medicare we in this Nation are finally willing to reexamine our health resources and to determine whether widespread reorganization of health services is required.

And I might add that medicare's first birthday, now almost upon us, is as good a time as any to admit that health services for many older Americans today are minimal, marginal, and miles away.

Congress and the public can feel proud about the good done by medicare, but if anything medicare's record should make us wonder how we got along without it for so long.

Latest statistics show that 4 million persons had inpatient hospital services under medicare during its first year, and hospitals received $2.4 billion for those services.

Home health services went into action and served more than 200,000 people.

And, under medicaid, 25 million bills have been paid.

We can take comfort from that record, but a nagging question persists: How many individuals thus helped by medicare would have gone without hospital treatment if such programs had not existed?

And further, what services are still unavailable or too costly because we have not yet really mobilized medicine to help many of our elderly and others who need it the most?

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