Therefore, what you are now considering is not a proposal to add to the costs taxpayers have to meet, but a proposal to redistribute part of their costs in a fairer way. By adding very slightly to everybody's social security tax, you will greatly diminish everybody's chance of being bankrupted by medical bills and forced into indigency in their old age.

You have been told that this problem can be met by private insurance plus charity. As to private insurance, here it is enough to observe that it is caught in the same general crisis that affects all medical costs. Premiums have already priced themselves out of convenient reach for most old people, even assuming they were allowed to buy private insurance. As to charity, let me ask if there is one person in this room who will say that he would glady accept charity.

There has been a further suggestion that we could solve our problems by having the Government underwrite private insurance. This is one of the most vicious proposals I have ever heard. As a taxpayer I actively resent the suggestion that my money should go to underwrite the advertising of insurance companies and their executives' expense accounts.

There are two deficiencies in H.R. 4222 that call for special comment. First, this bill continues the major defect of American Medical since it focuses on remedial care for sick people rather than preventive care for well people. People cannot be educated to go to doctors while they think they are healthy so long as it means spending money. Most people will spend money on a doctor only in the face of dire need. Yet, preventive care is technologically possible, and in the long run is less expensive. This bill should specifically authorize payment for annual checkups in doctors' offices.

The other thing that bothers us about H.R. 4222 is its termination clause. Very few people need more hospitalization than this bill provides for, but those who do need it are precisely those who need it most desperately. All their needs added together would not appreciably increase the costs this bill already contemplates. The termination clause is in our opinion inhumane and unjustifiable, and I wish to close my testimony by proposing that you do away with it. Mr. KING. Thank you, Miss Donnelly.

I think you have been an apt substitute for Mr. Tucker.
Are there any questions?

Miss Donnelly, you know, 8 or 10 months back, the American Medical Journal, or their house organ covered the fact with perhaps the largest headlines I have ever noticed in that journal that the Socialist Party had endorsed H.R. 4222. You would know the reason why that was given wide publicity, I daresay.

Miss DONNELLY. Yes, sir.

Mr. KING. In recent years with so many young people coming along, they do not take too much interest in politics. In their minds there is not a great difference, which is unfortunate, in the true Socialist philosophy, and the modern Russian communism philosophy. Many speakers will join them pretty closely together.

I take it you have studied the history of your party a little bit. Is it not true that perhaps the most vicious or potent enemies of communism at its commencement were the Socialist Party members. Miss DONNELLY. The Social Democrats, yes, sir.

Mr. KING. And they still despise them.

Miss DONNELLY. Yes, sir.

Mr. KING. I am from the great city of Los Angeles. I am particularly sensitive to some of these charges because as a Democrat my party has been associated with them a little more than other parties, other than yours. In our great city, incidentally, I might say until just recently we have not had a Republican administration and this was sort of an accident, this recent one, but way back when I was a boy the people of my city with the encouragement of the administration of the city chose to take over and on themselves the generating and transmitting facilities of the private companies. I was too young to know then whether there was much of a cry about it, but I knew in more recent years one of the world's greatest airports has been taken by the people of my city. They own it, they furnish it, and it will probably be one of the greatest.

We had one of the greatest harbors in the world and the city has seen fit to manage and own it. There has never been a cry so far as I know in my city, which is made up of fine people, both liberal and conservative, but when it comes to matters in the national picture, it seems that everything that most people do not desire or like somehow or other they bring in your party's name and associate it with the effort. Sometimes it probably could lead to what they predict it would, but in other cases there is no reason to believe that. So again I can just say it is interesting to have you here, and I am glad you came. Miss DONNELLY. Thank you very much.

Mr. ALGER. Before you leave, I appreciate what you say, Mr. Chairman, and I certainly respect your different views. There is much you have just said with which I cannot agree, but I respect it.

Miss Donnelly, I must say your statement is a startling one. We have been talking about medical care for sick people and you advocate care for those who are well-preventive medicine. I grasp what you say about periodic checkups in order to prevent sickness. I think that is rather unique.

Miss DONNELLY. This is practiced in Sweden and they have had a decrease in the number of persons requiring hospitalization.

Mr. ALGER. They have many practices in Sweden to which we do not subscribe but perhaps we might be moving in that direction.

Mr. KING. If there are no further questions, that concludes the session for today. The committee will recess until 10 o'clock tomorrow morning.

(Whereupon, at 4:45 p.m. the hearing in the above-entitled matter was recessed, to reconvene at 10 a.m., Thursday, July 27, 1961.)

HEALTH SERVICES FOR THE AGED UNDER THE SOCIAL

SECURITY INSURANCE SYSTEM

THURSDAY, JULY 27, 1961

HOUSE OF REPRESENTATIVES, COMMITTEE ON WAYS AND MEANS, Washington, D.C.

The committee met, at 10 a.m., pursuant to recess, in the committee room, New House Office Building, Hon. Wilbur D. Mills (chairman of the committee) presiding.

The CHAIRMAN. The committee will please be in order.

Our first witness this morning is the Honorable Aime J. Forand, who for many, many years served on this committee, from the State of Rhode Island.

He retired at the end of the last session of Congress voluntarily. We have been missing him this year on this committee.

We welcome you back. I am sure each member of the committee joins me in telling you how pleased we are to have you with us this morning.

STATEMENT OF HON. AIME J. FORAND, FORMER REPRESENTATIVE IN CONGRESS FROM THE STATE OF RHODE ISLAND

Mr. FORAND. Thank you very much, Mr. Chairman.

Mr. MASON. Even the Republican side of the committee welcomes you back.

Mr. FORAND. I appreciate that deeply. I assure you that all of you are in my heart quite often.

Mr. Chairman, for the purpose of the record, I am naturally going to follow your procedure by giving my name. Aime J. Forand, former Congressman from Rhode Island, now living in Bethesda, Md.

I come before you this morning, Mr. Chairman, I do not believe that I have much new to say to the committee. I confess, first of all, that it feels rather peculiar, after having spent 18 years up there with you, to now be sitting here in the witness chair.

However, I dearly cherish the period when I was up there questioning the witnesses, arguing and debating with you, my colleagues, at the time, but today I am here in a very, very different position. I am here merely as an American citizen interested in the welfare of our aged citizens.

I might say before I go any further, Mr. Chairman, that I do not represent any group, organized or otherwise, with the exception hat I am speaking to you for hundreds, I might say thousands, of individuals throughout the country who have written to me since I left

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Congress asking me to continue my efforts in behalf of legislation providing for medical care under social security.

I might say in passing-and this is a tip to those of you who will retire sooner or later-somebody should introduce a bill, and see that it is passed, providing at least one clerk for a retired Member for the first 60 days, at least, following his retirement.

I do not mind telling you that I was happy that I was once a secretary, myself, and, therefore, was still able to operate a typewriter, but my mail has been running, during the first 60 days or 90 days of this session, between 50 and 75 letters a day.

I have always operated during my 38 years in public life on the theory that anyone who sits down to write me a letter deserves an

answer.

For that reason I will say to you that the first 3 months after I left Congress I worked harder than when I was up here on the Hill.

So, there is a tip for you: Before you retire see that help is provided for you.

Now, Mr. Chairman, these hearings, I am sure, will bring out a few new points regarding the existing problem of the health care of our aged. I do not believe that you are going to hear much new with the exception of the fact that perhaps the statistics will be brought up to date.

I do not intend to deal in statistics because I realize that at least the great majority, if not all, of the people, including the Members of Congress and the individuals outside, realize that there is a problem, but finding the way to handle that problem best is what troubles all

of us.

As I have said repeatedly in the past, for years now we have been talking, but we have had very little action. We have had a little action since I introduced my first bill in 1957, but those actions have dealt with so-called fringes rather than with the core of the problem. Now, we may stall and continue to stall for a while, but I say to you that eventually you are going to have medical care under social security, because the people want it and the majority rules in this country. And the Gallup poll of about 5 or 6 weeks ago showed that two out of every three persons who were interviewed have said that they would favor increased social security taxes in order to have medical care for the aged under the social security bill.

Now, since I first went to the State legislature--I have said this to the committee before, but I want to repeat it here since I first was elected in 1922, I have been interested in medical care for the aged, proper care for the aged, and I say to you now what I have said before, that I wish each and every Member of Congress would serve at least 6 months as a welfare worker so that he could know firsthand the trials and tribulations of the people of this country.

It is unfortunate in a way that so many have never had to struggle to make a dollar, or struggle to meet their obligations because you cannot feel, you cannot understand thoroughly the anxiety, the headaches, the worries of many of these older people today unless you, yourself, have had some personal experience with them.

I can say that without hesitation because I come from a very poor family. I am one of 16 children, as I have told the members of the committee before. I had to leave school before I finished the seventh

grade because my dad was totally blind and there were eight kids around the table that had to be fed three times a day at least, and I was bringing home $8 a week.

I know poverty, and I am not ashamed to say I have been through it and perhaps that is the motivating power behind my efforts to take care of those who are in need.

Now, the bill that I introduced in 1957, as I said, was merely a basis from which to work, and it had been formulated by a group of experts in the field of welfare.

That group included economists, labor people, welfare workers, some doctors, and several others who were interested in the field.

And after considering all approaches, it was decided that the only way that this problem could be adequately taken care of was through the social security system.

As you will recall, in executive session, I believe it was last year, when I sought to have Dr. Flemming give us the cost of operation of the several plans that were then proposed, he said that the plan the administration then was proposing would cost approximately $17 per case per year to administer, but that the proposal that I had advanced would cost only $6 per case because the social security system is geared to handle this additional item whereas in the other case special machinery would have to be set up.

Now, out of the 1957 bill you will recall we managed to get an increase of 7 percent in the benefits for the aged, for those retiring under social security, and a 10 percent increase for those who were receiving the minimum.

Then last year in the Kerr-Mills bill, we enacted some legislation that if the 50 States would only set up their machinery it would be helpful to another segment.

But, again, I say that is in the fringe. I believe that one thing that this committee should consider very, very seriously, is to make a determination of the term "needy" that could be used in each and every State because I believe that is the stumbling block in many areas, the stumbling block that prevents many people who, while they have a a few dollars, actually are in need when they encounter serious illness. Now, I understand that this year there was some type of bill passed that would again increase some of the benefits under the social security system.

I think that is good. It is a step in the right direction.

But, again, I say it does not get to the core of the problem because we realize that out of the 12 or more million receiving benefits under the social security system, over 700,000 of them have benefits that are so inadequate that it is necessary for them to get supplementary aid.

In those cases, and in many other cases, in fact, one serious illness wipes out the life savings of the individual and puts them in debt, puts their children in debt, so that they do not know when they will ever get up on top again.

Now, much has been said about voluntary insurance, but every survey that I have seen, and I have looked at many, indicate that at best only 70 percent of the people would have any type of voluntary health insurance by 1970, I think it is, showing that at least 30 percent never will have the proper type of health insurance.

The reason for it is in most cases that they cannot afford it, the rates are too high, and the benefits are too low.