Because I did not get an answer as to what assurance I had that they would not cancel the policy on me again.

Therefore, in accordance with the provisions of your policy, which gives the association the right to refuse to accept your renewal premiums, we are returning your $9 personal check to you.

Mr. CURTIS. What was the date of that letter?

Mr. SIMMONS. That was January 5, 1959. And that is when they refused to take my policy.

Mr. CURTIS. I can assure you I will follow this thing further on this one point.

I can see why they were trying to get you to take hospitalization instead of a loss-of-time policy, because that was to your benefit.

The CHAIRMAN. You can certainly understand the confusion in Mr. Simmons' mind if they accepted his premium for 6 or 7 years after he retired.

Mr. CURTIS. I certainly can.

Mr. SIMMONS. And the reason I took the policy was the very fact that they had this endorsement on it: "This policy is noncancellable." Because in 1925, I was insured with the Kansas City Mutual, which you know about, I am sure. I lived in Topeka. And a friend of mine was selling this insurance. And this was the very thing that I bought. I was young. I did not understand insurance like I do now. And they carried it through for 30 years.

Mr. CURTIS. Technically, they should have canceled your policy, not in the sense that they canceled it, but because your circumstances changed for that kind of insurance, that was of no avail to you.

Really, the error, as I see it, was that they should not have accepted premiums at all after 1952, because you did not have an insurable risk.

Mr. SIMMONS. I know. And I admit that they did pay me, because I have been sick all my life until I had my stomach taken out.. And I have had the best life I have ever had in these last 18 months.. Mr. BURKE. I was wondering whether you had ever applied for a refund of the payments you paid in after retirement.

Mr. SIMMONS. Gosh, I did not know I had one coming.

Mr. BURKE. They apparently thought you were not entitled to any benefits. Was that the only check that you paid after your retirement? Mr. SIMMONS. This was the only one that they returned.

The CHAIRMAN. He paid from 1952 through 1958, having retired' in 1952, I believe you said.

Mr. SIMMONS. Yes.

Mr. BURKE. The insurance company then still has your money? Mr. SIMMONS. No, they returned it. I have the check here. They did not cash the check.

Mr. BURKE. They returned the one check for $9. Did they refund your money from 1952 to 1959?

Mr. SIMMONS. They have got that money.

Mr. BURKE. Why do you not ask them for it back? If you were not covered for that period, certainly they should not hold on to that money. They are morally responsible to return it to you.

Mr. SIMMONS. And they paid on this policy, too, during that time. The CHAIRMAN. You write and tell them you paid a premium on this house after you sold the house.

Mr. SIMMONS. I would be tickled to death. I could use the money. Mr. ALGER. I will not question at this time of day, but I think you kind of left us out on the limb when you said on page 7 that you are not looking for something and you feel you have earned a right. Do you not realize you and 14 million people are going to get this free; that everyone else is going to pay for it?

Mr. SIMMONS. May I call your attention I was just reading that from the Florida statement.

Mr. ALGER. I thought maybe you wanted us to believe that.
Mr. SIMMONS. No.

Mr. ALGER. All right.

Mr. SIMMONS. It is the insurance company that got something for nothing.

The CHAIRMAN. Thank you again for coming to the committee. (The following letter was received by the committee:)

Hon. WILBUR D. MILLS,

MUTUAL BENEFIT HEALTH & ACCIDENT ASSOCIATION,

Chairman, Ways and Means Committee,

House of Representatives, Washington, D.C.

Omaha, Nebr., August 18, 1961.

Dear Mr. CHAIRMAN: On August 1, Mr. Eugene S. Simmons appeared before your committee and testified concerning the loss-of-time contract he had held with our company.

In the questioning of this witness, a question arose as to whether the company collected premiums from the witness when in fact he had no coverage. The company has had no knowledge of Mr. Simmons' retirement in 1952. The first knowledge we had that he had retired was in September of 1958 when we advised him that he no longer needed loss-of-time protection since he had retired. We urged him at that time, and on two subsequent occasions, to purchase hospitalization insurance, which he had never carried with our company. It is true that during the years 1952-58, the company was offered premiums by Mr. Simmons, and we accepted them, in the total amount of $192. All the company can do, Mr. Chairman, is to rely on the policyowners to advise us of their job status and hence we accepted these premiums.

During the same period of time Mr. Simmons applied for and was paid benefits as follows:

As you can see, Mr. Simmons was compensated during this period according to the terms of his contract and the tender now of a return of premiums to him would result in a financial loss to him since he would have to return the benefits checks he received.

I am submitting this information to you so that the record can be complete as far as this witness is concerned.

Sincerely yours.

JAMES E. BARRETT,

Vice President.

The CHAIRMAN. Mrs. Persinger and Miss Wickenden.

We are pleased to have you ladies with us today representing the Young Women's Christian Association.

Mrs. Persinger, will you identify yourself for the record?

STATEMENT OF MRS. RICHARD B. PERSINGER, CHAIRMAN, NATIONAL PUBLIC AFFAIRS COMMITTEE, YOUNG WOMEN'S CHRISTIAN ASSOCIATION OF THE U.S.A.; ACCOMPANIED BY MISS ELIZABETH WICKENDEN, TECHNICAL CONSULTANT, YWCA NATIONAL BOARD AND NATIONAL PUBLIC AFFAIRS COMMITTEE

Mrs. PERSINGER. I think I am representing all the women today. I am Mrs. Richard Persinger, and I appear in my capacity as chairman of the National Public Affairs Committee of the Young Women's Christian Association of the U.S.A., to present the official position of that organization on the pending question of health care for the aged. This lady is Miss Elizabeth Wickenden, who serves as technical consultant to the YWCA national board and our committee on all questions relating to social security and public welfare,

The CHAIRMAN. Would it be possible for you to conclude your statement in 10 minutes?

Mrs. PERSINGER. Yes, I certainly will.

The CHAIRMAN. Miss Wickenden has been before the committee on many other occasions.

We welcome you back.

Mrs. PERSINGER. Did you say to conclude it in 5 minutes?
The CHAIRMAN. In 10 minutes.

Mrs. PERSINGER. Yes, indeed. I know my place.

The YWCA has officially voted to place itself on record in support of the principle of extending the system of old-age, survivors, and disability insurance to include payments for health benefits for the aged. In line with continuing policy, this position was adopted by the National Board on April 5, 1961, on the recommendation of the Public Affairs Committee which had conducted an extended inquiry into all aspects of the problem. At our recent triennial convention held in Denver in May this action was subject to vigorous public debate and was supported by overwhelming convention vote as a part of our total interest in a "program of social security adequate to the needs of our aging population, and a coordinated public assistance program.'

The YWCA has a long history of support for social security measures. As early as 1934 it voted in convention to support legislation which included a consideration for old-age pensions. In 1936 we again supported the principle of a national old-age security program. In 1946 the convention voted to work for extension of social security and to reaffirm action to

cooperate with Government and other agencies to make available to all people, equally, adequate health services and low-cost medical care.

In 1949 the convention endorsed "an adequate health insurance plan" without specifying the respective roles to be played by commercial, nonprofit, and social insurance. Each convention since that time has voted to―

continue to support the social security program including extension to those not now covered

and to

continue to support the development of adequate health and disability insurance.

The more explicit position adopted this year in support of the extension of Federal social insurance to the financing of health services for the aged results directly from our concern with family life and the relationship between the generations.

Some might ask why a Young Women's Christian Association should be concerned with the health needs of the aged. But this question assumes that only the aged are concerned about or affected by the growing gulf between their health needs and their ability to pay for health services. Actually our basic ethical tradition makes this a general concern for the whole community and a specific concern for the younger members of an individual family. We in the YWCA have become interested in what the failure to meet this problem through social measures does to the younger members of the family. We are particularly disturbed by the impossible burden this so often places on the middle generation, the younger heads of families that cannot in all conscience let the medical needs of their aged parents go unmet even though they are already struggling with the heavy cost of raising their own children, and worrying about saving for their own old age. We feel that this conscientious, struggling, heavily burdened middle generation is often the real forgotten group in this situation. We feel, also, that too little attention is being paid to the tensions and problems which these conflicts produce for families with a natural affection and concern for their older members.

Last year in pursuit of specific examples of this problem we sent out an inquiry to some of our members and younger staff workers asking them to tell in their own words how long-term care of an older relative had affected their family finances and family relationships. But even our general understanding of the problem had not prepared us for the kind of tragic personal situations revealed in the replies we received from widely scattered sections of the country.

I would like to read from some of these replies and include others in the record. I feel sure that all members of the committee will recognize at once from their own range of acquaintance the heartbreaking authenticity of these accounts of family devotion and sacrifice.

Both of my parents, aged 72 and 76, are still in their own home. My father is suffering from arthritis and my mother has a cancer. In order to care for their medical expenses they have had to deplete all of their cash savings. They do have some Blue Cross but it's paid for only part of the expense. My father is a minister, and despite very simple living habits he could save nothing until his three children had completed college. The thought of poverty in old age was a constant source of anxiety for mother all through the thirties, forties, and early fifties. When social security became possible for ministers father was able to complete enough work to benefit. The transformation in family attitudes was tremendous when it became apparent that his small ministerial pension would be augmented by a larger social security payment. Because a minister has a parsonage during his working life he is caught without a home in retirement. Relatives helped out, so that now they have a home. There they live very simply. They may be all right if no additional medical difficulties occur. My sole hope is that the dignity and happiness that they have had, now that they have social security, will not be wiped out by high medical costs. They do not want to borrow from me. But I feel that I must plan my finances to have something in readiness. This means I cannot tie up any savings that I can gather in any property or in any way that cannot quickly be cashed in. I only

wish there were some way in which my present social security deduction could be increased so that it would cover health costs. I know of no other responsible and dignified way to plan for excessive costs of disability.

The last 6 years have been a bad dream. Our family has been torn because we were not able to afford the kind of special care that my elderly mother needed and so tried to care for her at home. Four lives were damaged in the process.

Mother began to be senile around the age 79. At first she seemed only anxious, forgetful, and a problem requiring some extra attention. Then her lack of orientation and her insistence that she was right became a factor in undermining my 7-year-old's confidence in his mother. Grandmother told him his mother was out "gadding" when he knew she was at work. She tried to be helpful, but would interrupt the children's homework to ask the same questions over and over. She was never away from the family for she could not find her room or remember to stay in it even at night. The 7-year-old developed colitis, the older brother said he wanted to stay away from home as much as possible and my husband said he would take a room in New York.

The doctor said "commit her." The psychiatrist said "You can't," but he added, "no nursing home will take her either." A doctor with influence at a private home for the aged found a place for her but she refused to stay, wandered off, and they said, "She is too sick to be here."

The doctor recommended a private home run by a practical nurse who kept two or three elderly persons. The woman kept mother 3 days and said, "I can't keep her. I feel sorry for you." Another woman agreed to try to keep her. After a few weeks at $85 a week she said, "We have to watch her all night, too, so the price must be raised."

Mother had a blood clot form in her leg. The hospital had to have round-theclock nursing because she couldn't remember directions. There was no insurance for these costs, and her small amount of cash was soon depleted. My father had had a colostomy and later funeral expenses a few years prior to mother's disability.

We tried practical nurses, but they didn't want to stay. I tried a private sanitarium, but they said she must be committed to be there and the doctor thought there was no real ground for commitment. His nursing home would not accept senile patients. I tried Homeworker Service but this service did not want care of the aged.

I had been working part time to help with future college costs plus medical costs for my mother who had been living with me for many years. I am her only relative. I succeeded in placing her in a large modern nursing home that caters to senile patients. The cost of room, medicine, doctor visits, etc., was excessive. I tried to get help from public assistance but was told that since I earned a little more than the State allowed I couldn't get help. The fact that I needed to work for college for the boys and to pay my own pension plans was not acceptable because the interviewer said "Your husband should pay for these. If you weren't working at all we would help your mother."

Now I am working full time to help with nursing home care. Last year mother broke a hip and was hospitalized. A $47-a-month social security check is her only income.

No one understands the conflict a family faces in a situation such as this one. Hospital personnel and others have often said to me "You mean you put your mother out of your house because she is old and senile?" The minister's wife said, "Do keep her at home. That is where she belongs."

Money to pay for care and facilities that are adequate for care of the chronically ill, especially senile patients, is desperately needed.

My 85-year-old mother had a stroke in 1952 and broke her hip in 1955. She broke a second hip in 1959. We had to pay $3,000 exclusive of doctor bills when she was in the hospital. Now we pay $250 a month for nursing home care. My mother had to cash in everything that she had. There are no relatives to help her except me. The total cost over the past 8 years amounts to $15,000. All of my family was affected by these expenses and the emotional burden has been great. It has meant that I have had to continue to work to meet my share of financing.