of any of the Conference groups, of doctors and members of the AMA.

Mr. CURTIS. The gentleman said the whole Conference. I was simply correcting his statement. One group found one thing, and another group found another thing. The Conference as a whole passed no resolution.

Mr. DINGELL. I am willing to stand on my statement, Mr. Chair

man.

Mr. ALGER. I want to assure my colleague that while I did not hear his statement, I have read part of it, and will make a point of reading it further. I would like to comment on the remark my friend from Michigan, Mr. Knox, made. I would like to commend what the gentleman said to point out that our minds are open as to whether we are wrong. And I am constantly testing mine against the witnesses.

I did not want the gentleman's statement to stand as it was, because some of us have very strong views, having sat through this in the last session of Congress, but we are testing our understanding against the witnesses.

Mr. CURTIS. I have a unanimous-consent request, Mr. Chairman. This is a transcript of the movie of the British Broadcasting Co. The CHAIRMAN. That will appropriately go in the record at the conclusion.

Mr. CURTIS. This is about doctors and the national health service as they see it 10 years after.

(The above-mentioned transcript is on p. 1105.)

The CHAIRMAN. Mr. Lynn, we are pleased to have you with us today. You have with you Mr. Thayn, I believe.

If you will identify yourself for this particular record, you are recognized.

STATEMENT OF JOHN C. LYNN, LEGISLATIVE DIRECTOR, AMERICAN FARM BUREAU FEDERATION; ACCOMPANIED BY J. B. THAYN, ASSISTANT LEGISLATIVE DIRECTOR

Mr. LYNN. Thank you, sir.

My name is John C. Lynn. I am legislative director for the American Farm Bureau Federation, and I have Mr. J.B. Thayn, assistant legislative director, accompanying me.

Our statement is very brief, sir, and I believe with your permission I can do it quicker just to read it.

The CHAIRMAN. All right. We will let you go through it, then. You will be the last witness this morning. At the conclusion of your statement, the committee will recess until 2 p.m.

Mr. LYNN. The American Farm Bureau Federation, which represents 1,600,792 member farm families in 2,764 organized counties in 49 States and Puerto Rico, is a voluntary general farm organization. Members join voluntarily and voluntarily decide each year whether or not they wish to continue their membership.

Farmers' opposition to compulsory health insurance in any of its various forms is of many years duration. When proposals of this nature were made in the 1940's, we took vigorous exception to them, and have continued to do so. The most recent expression of the member delegates of the federation with respect to the particular

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issue involved in this bill was adopted in the convention in December of last year in the following language:

Social security programs should be designed to supplement rather than replace individual thrift and personal responsibility. The increasing cost of liberalized benefits are becoming a serious financial burden. We, therefore, recommend that existing programs be modified so that they will require no further tax increases.

Social security taxes should not be increased to pay medical costs for any portion of the population. The need for medical insurance should be met by expansion of existing private insurance programs without Federal subsidy. We are opposed to H.R. 4222 for the following principal reasons: (1) It transfers to an already overcentralized, overobligated Central Government responsibilities that can and should be dealt with in other and better ways.

The financing of medical care is essentially a responsibility of the individual and the family. If such needs cannot be met by the individual—either through private savings or through prepaid private health insurance-and if the members of his family are unable to assist him, then church and private welfare agencies have a role to perform.

In the relatively limited number of cases that cannot be satisfactorily dealt with by individuals and through private agencies, participation by local or State government is justified.

As a last resort-and only to share in the medical costs for the medically indigent should the Federal Government enter into the financing of medical care for individual citizens. The Kerr-Mills bill, enacted into law in 1960, already provides this type of aid.

The bill now under consideration, H.R. 4222, would have us abandon the traditional concept that medical care should be provided without cost only to those who lack the means to pay for it themselves.

Individual responsibility and family responsibility are cornerstones of the American way of life. We are not in favor of adopting a proposal to put a statute of limitations on individual responsibility and family loyalty.

(2) Financing medical care for the aged through the mechanism of social security would not provide "prepaid insurance" in the usual meaning of the term.

Instead, this is a bill to compel workers, employers, and the selfemployed to pay taxes to enable the Federal Government to purchase health care benefits currently for millions of participants over 65 years of age whether they are financially in need or not.

Those paying social security taxes would not be prepaying for their own benefits; instead, they would be paying taxes for today's beneficiaries. Millions who have already retired would receive medical benefits without having contributed a dime toward payment of such benefits.

There is no contractual relationships established. Social security taxpayers must live to age 65 to receive any so-called benefits under the proposed legislation.

(3) Enactment of this legislation would lead to Federal control of medical care.

Both experience with other Government programs and simple logic reenforce this conclusion.

The courts have clearly established the principle that the Federal Government is authorized to control that which it subsidizes. It is naive to proceed on any other premise.

This bill provides for hospitals to furnish outpatient diagnostic services under contract with the Federal Government. This presumably would require that hospitals employ doctors. Furthermore, it appears that a patient desiring such diagnostic service would be required to utilize the services of a doctor employed by the hospital rather than his family physician. Otherwise, he would not be eligible for the service.

We think it is important to remember that, unlike other social security benefits that are paid in cash to be spent as the receiver wishes, this program provides medical "services" to be paid for by the Central Government itself.

(4) While originally applicable only to those 65 years of age and older, the proposed program most likely would spread to other age groups if the principle is adopted.

In addition to the fact that many of the proponents of this legislation historically have been in favor of compulsory health insurance for everybody, a program of the kind proposed has within its very nature built-in pressures for expansion. If the initial age is 65 and over, why not 62 and over, or 60 and over, et cetera?

Now is no time to launch an irreversible program with far-reaching adverse implications.

(5) The plan would be very costly and the costs would increase sharply over the years.

In Great Britain, for example, for the fiscal year ending April 1, 1961, the figures indicate that the National Health Service cost $2.2 billion, which is up 13 percent from the previous year and nearly double the figure for the 1949-50 fiscal year. The spending for this program the past year accounts for about 14 percent of all Government expenditures in Great Britain.

There are conflicting estimates as to what the cost of H.R. 4222 might be. Our experience with other Government programs would indicate that the costs are usually grossly underestimated. The fact that the Secretary of HEW in his testimony last week proposed that the income on which the social security tax would be applied be raised from $4,800 to $5,200-which is a further increase of $200 above the proposed increase submitted earlier this year-may be significant in this regard.

With the increases in social security taxes proposed in this bill, and those scheduled to become operative under existing law, a sizable and increasing percentage of all taxpayers will be required to pay more in social security taxes than they pay in Federal income taxes.

(6) The need for this legislation is not nearly as great as is pictured by its proponents.

This is not to say that there are not any problems in the field of medical and hospital care. We in Farm Bureau have been especially conscious of various problems in the field of rural health. Furthermore, no group has worked more diligently and persistently to promote widespread use of voluntary private health insurance among farm people than has the Farm Bureau.

We recognize that there may be instances where governmental assistance in meeting the problems of medical care is justified. This is especially true when catastrophic or prolonged illnesses occur. However, this is not true so far as a high percentage of our citizens over 65 years are concerned. Competent studies show that

(a) Many people over 65 have substantial incomes.

(b) Many of them own their own homes or have substantial investments.

(c) Their costs are lower than those of most families.

(d) Their family obligations, such as raising children and paying for their education, are less than in former years.

(e) Most of them are covered or could be covered by private medical and hospital plans.

(7) H.R. 4222 would lead to the decline, if not the end, of private health insurance, which has made such great strides in recent years. The percentage of persons who are providing for their own hospital care through private insurance is constantly rising. It has come from 9 percent in 1960 to 50 percent in 1950 to over 72 percent now. In a similar manner, private health insurance coverage for the aged has moved up from 26 percent in 1952 to 40 percent in 1957 and nearly 60 percent now. According to estimates of the Health Insurance Institute 75 percent of those over 65 years of age needing and wanting private health insurance coverage will be covered by 1965 and 90 percent by 1970. These estimates, of course, are based on the assumption that the Federal Government will not interfere with the orderly growth of private health insurance.

(8) This proposed legislation would jeopardize the high quality of medical care.

It's one thing to recognize that there are problems in the health care field. It's quite another thing to adopt proposals which would make the situation worse rather than better.

So far as the Farm Bureau is concerned, we would rather build on the solid foundation of our past success than adopt a philosophy of government and a system of medical care which, on the basis of the record, are not as good as the one we now have.

The most important single thing which the Congress of the United States can do for the people on fixed income-whether they are over 65 or not-would be to deal effectively with the problem of inflation. This means reducing Government spending and the increased costs which inevitably follow either in the form of higher taxes or inflated prices.

Inflation is a creeping cancer that destroys the value of savings, pushes costs upward, discourages capital investments, produces unemployment, undermines confidence in our Government, and eventually leads to some form of authoritarian rule. Inflation is very much like a tax, a very cruel tax, especially on those least able to pay. And it is especially cruel to those for whom this legislation presumably is designed.

Farm Bureau members haven't succumbed to the delusion that there's some new magical way by which the National Government can solve the essentially personal problems of its citizens. Instead of going on a political safari in search of the pot of gold that is supposed to be found at the end of the "big-government rainbow," but which isn't there, we are in favor of building a greater America on the firm

foundation of our unparalleled success thus far. In doing so we sincerely believe we promote progress and protect freedom, in America and in the world, for this generation and the future.

We respectfully urge the House Ways and Means Committee to reject H.R. 4222.

The CHAIRMAN. Mr. Lynn, we thank you, sir, for bringing to us the views of the American Farm Bureau Federation.

Mr. CURTIS. Would you supply for the record a statement of how the Farm Bureau gets its opinion on measures of this nature? I know you have your farm group meetings and discussions. I would like to have that for the record.

Mr. LYNN. Very well, sir.

The CHAIRMAN. Without objection, that will appear in the record. (The information referred to follows:)

Our policies are developed through an extensive policy development program which involves study, discussion, and action by the members, and their elected representatives, at literally thousands of meetings each year. Every member has the opportunity to participate, and all are encouraged to do so. We do not claim this process to be perfect. We are constantly seeking to improve it; however, we are proud of the fact that our policies reflect the active participation of hundreds of thousands of members.

As a general farm organization-representing members who live in all important farming areas and produce all of the many farm products grown in this country-Farm Bureau must, of necessity, reconcile regional and commodity differences. Our goal is to serve the best interests of agriculture from an overall standpoint and to do so on a basis consistent with the national interest.

Mr. BETTS. I would like to compliment the gentleman on his statement. I happen to come from an area where the Farm Bureau is active, and I have attended their local meetings and seen them discuss issues and take votes. I assume this represents the views of the individual State farm bureau organizations. Is that correct?

Mr. LYNN. That is right.

(The British Broadcasting Corp. transcript previously referred to by Mr. Curtis follows:)

TRANSCRIPT OF MOVIE “On Call to a NatION," A BRITISH BROADCASTINg Corp. DOCUMENTARY

(Superimposed on film.) In the program that follows there are no actors. (NOTE. Since the physicians in this film are not identified by name, numbers have been designated to them. Since several of the physicians appear more than once during the film, their numbers, of course, are repeated to identify them.) (Scene shows doctor at his desk looking through mail and speaking to secretary standing at side of desk.)

Doctor No. 1: "This looks interesting. I think we might have a look at this. Stats report? Specialist's letter. And I must visit her. Now how many patients waiting?"

Secretary: "There are eight at the moment."

Doctor No. 1: "Eight? Well, I'll ring when I'm ready."

(Secretary leaves doctor's office.)

(Superimposed on film.) "On Call to a Nation." This is about doctors—and the National Health Service as they see it, 10 years after it started.

Narrator: "On the 5th of July 1948 an entire profession was changed overnight. The National Health Service began. For months before, the doctors of Great Britain had been caught up in fierce controversy. When the Government first announced their plan, the doctors refused to cooperate. They argued. The plans were modified. And when the Health Service finally started on that day in 1948, the doctors were still divided and uncertain. That was 10 years ago and today we take it all for granted."

(Scene shows waiting room in office of Doctor No. 1, with several patients sitting on a long bench along the wall of the waiting room. Doctor buzzes for