Complete Physical Check Free at Northeast Community Geriatric Clinic HE FACILITIES of the Clinic were estab Tlished 1959 to provide diagnostic medical examinations to the aging in an at- Services of the medical and administrative Clinic sessions take place on Thursday of Northeast Community DISSTON AND HEGERMAN STREETS PHILADELPHIA 35, PA. DR. SEYMOUR PIwoz, Medical Director JAY B. HURST, JR., President Mrs. SCHATZ. I would also like to publicly thank Congressman Green for the wonderful articles he has been writing consistently in the Philadelphia press in support of medical care for older people and to let him know that the older people are very appreciative and that they read these things and pass them on to all their friends and relatives. Mr. KING. Now that you have made that known, I wish to thank you, too, Mrs. Schatz. Are there any questions? Thank you again, Mrs. Schatz. Mr. Dover? Mr. Dover is not present. Miss Donnelly, I understand you will present the testimony of Mr. Tucker. Miss DONNELLY. Yes, sir; I would like to beg the indulgence of the committee. I am a last-minute substitute and a very poor one. Mr. KING. Mr. Tucker, according to the sheet, is an official with the STATEMENT OF MISS JEAN DONNELLY, ON BEHALF OF THE SO- Miss DONNELLY. Yes, sir. Mr. KING. Are you also a Socialist? Miss DONNELLY. Yes, sir. Mr. KING. That is interesting. This bill has been referred to as a gift of the Socialists or something of that sort. Do you see any direct connection between the purpose of this bill and the philosophy you embrace? Miss DONNELLY. It will be covered in the statement. Mr. KING. You may proceed. Miss DONNELLY. My name is Jean Donnelly and my office address is 303 Park Avenue South, New York City. I am a member of the Committee on Medical Economics of the SP-SDF. This is the committee that prepared the Socialist Party's recent 20,000-word study, "The Case for Socialized Medicine," copies of which were sent to all of you. I appear today on behalf of the Socialist Party. The American Medical Association and its allies have consistently argued that H.R. 4222, and the Forand bill before it, are socialized medicine, or at least a first step toward socialized medicine. These people have even had the effrontery to defend this opinion by quoting the Socialist Party out of context, and when they did so, they several times commented, "If the Socialists don't know what socialized medicine is, who does?" For once we agree with the American Medical Association. We are the experts on socialized medicine. It was thanks to our sister parties of Britain and Sweden that the people of those countries now enjoy the enormous benefits of socialized medicine. So let me state an expert viewpoint firmly and clearly and for the record: H.R. 4222 is most emphatically not socialized medicine. We support it for humanitarian reasons because it is better than no bill at all, but it is a conservative bill. It is a watering down and a weakening of the Forand bill, which was itself a conservative bill. It is inadequate to the needs of our old people, and it utterly fails to confront the needs of the rest of the population. At best it is a stopgap, temporarily relieving for some people some of the pressures of rising medical costs. When viewed against the totality of this Nation's medical needs, this bill seems like trying to bail out the Atlantic Ocean with a teaspoon. It is, of course, perfectly true that this bill will establish administrative machinery under social security which theoretically could be expanded in all directions into a genuine system of socialized medicine. It is equally true that the Socialist Party will agitate for such expansion. But again it is true that if, for instance, the VA hospital system were expanded in all directions we would also have socialized medicine. And for that matter, our post office system presumably could be expanded in all directions into complete socialism. You do not for that reason oppose the post office or the VA hospital system, and it is perfectly ridiculous to use this as a reason for opposing H.R. 4222. Let me try to shed some light on this bogeyman of socialized medicine. The millions of Americans who want socialized medicine do not want it because of the efforts of the Socialist Party, nor of all the idealists in the country put together. The impetus for medical reform is economic. It comes from the fact that people, ordinary people, have deep and genuine grievances on the subject of medical costs. When you examine the reasons for the crisis in medical costs, you discover that those reasons are going to be with us for a long time and that this crisis in medical costs can be expected to keep on mounting. You also see why it is that we label H.R. 4222 a feeble stopgap, and why it is that your committee will continue to face, year after year for as far ahead as can be predicted, bills for medical reform which are increasingly less conservative. There are two chief reasons for rising medical costs. First is the explosion in medical technology. This means that hospitals require more and more equipment and more and more people to run the equipment; it also means that medical care becomes more and more hospital oriented. In 1946 there was a nationwide average of 3 hours worked by hospital employees for every 2 patient bed-hours. Now, in 15 years, that average has gone up to 5 hospital employee hours to every 2 patient bed-hours. By 1970 the ratio is expected to reach 7:2; in other words this ratio is not only increasing, it is increasing at an accelerating pace. The second basic reason for rising medical costs is summed up in the economic principle that as an economy industrializes, the relative cost of goods goes down and the relative cost of services goes up. In other words, rising medical costs are an expression of automation. As automation becomes more general, industry that cannot adapt to it becomes more expensive. Handcrafted goods costs more than factory-made goods; servants are replaced by household appliances; food is first canned, then frozen, and now we get TV dinners. And medicine, which continues to require the services of people, costs more and more and yet still more. Automation and progress in medical technology are both factors. which will be with us for a long time. What this means to most citizens is vividly illustrated in a recent April 10 issue of the maga zine Medical Economics. On page 1 there is a prediction that in this decade hospital costs will rise to $60 per patient-day. And, as if to put this figure in proportion, on page 2 is another item informing physicians that they can charter "A luxury cruiser with crew and meals for a cost of $30 to $50 per person per day." We do not in the least begrudge doctors their incomes which permit them to go yachting for less money than their patients pay for hospital beds. I think many doctors would change their minds about H.R. 4222, and about socialized medicine, if they were aware that under socialized medicine in England the average doctor's income is higher than it was before socialized medicine. But there is one thing we do feel bitter about, and that is the starvation wages paid to lowerechelon hospital workers. It is a fact, unveiled by the 1959 hospital strikes in New York and Chicago, that a good proportion of hospital workers earn so little money that they need public relief to feed their families. So here is a third factor in rising costs. The people who work in hospitals are entitled to a decent living wage, and increasingly, they are turning to unions to get it. At this point I would ask you members of the committee to reflect that the question before you is not whether the Government should subsidize or help subsidize hospital costs. The question is who should subsidize? At present hospitals are subsidized by the misery of hospital workers. That is, they are subsidized by the poor. The AMA tries its best to present H.R. 4222 and all other proposals for Government payment of medical costs as proposals critical of the free enterprise system of this country. In this the AMA is correct, for it is a simple and observable fact that in the area of medical care the private American economy is losing, has already lost, its ability to provide for the needs of the people. The AMA will also tell you that if we remedy this failure by the use of Government mechanisms, we are moving toward socialism. As to this point, the Socialist Party is uniquely qualified to observe that it is not necessarily so. For 60 years we have seen portions of our platforms carried out by other parties, and we are still thoroughly dissatisfied. It is our most basic contention that the crisis in medical cost is of such dimensions, and is so irremedial in its causes, that we are fast reaching a stage where only the Government can afford the cost of providing medical care for the people. Under present circumstances many old people simply do without medical care and if this bill is passed you will discover, as did the British in 1948, that there is a far greater amount of medical need in this Nation than we can measure under a system where cash is a detriment in the use of medical facilities. During the first year the British Health Service prescribed 814 million pairs of eyeglasses for a population of about 50 million, and there are similar figures for dentistry. Glasses and dental care are, of course, things one does without when money is hard to come by. At present old people who do pay for their medical care do so the hard way, by spending the savings they had accumulated in order to live decently in their old age. This is not an unusual circumstance, but the common lot of people over 65, three-fourths of whom have incomes of less than $2,000 a year. |