enumerated will meet the problems which H.R. 4222 seeks to solve, and many other problems as well. Actually, all H.R. 4222 would do is to launch the Federal Government on a gigantic costly program of compulsory governmental health insurance with its many attending evils.

1. Maximum operation of the health care program of the Ohio Division of aid for the aged has our active support. This program has been in operation for recipients of aid for the aged since 1946. During the fiscal years 1959 and 1960 approximately $26 million was spent by the division for health care activities. Under the program, those aged persons who can finance all necessities except health care costs also are being assisted.

Additional funds under the Kerr-Mills law enacted by Congress in 1960 are available for the Ohio health care program for the aged. The Ohio General Assembly has voted an appropriation of $15,878,000 for the health care of the aged in Ohio for the fiscal year 1961-62, an increase of about $3,500,000 over what was spent for these activities during the fiscal year 1959-60. A similar increase is anticipated for the fiscal year 1962-63. This will permit expansion of the program so it can do a better job, not only for aid for aged recipients but also for the so-called aged medically indigent. The general assembly decided that no new legislation in Ohio would be necessary at this time inasmuch as Ohio already is participating in the Federal Kerr-Mills program.

There is reason to believe that the present Ohio law and the present Ohio health care program are entirely adequate to meet demands until the next session of the Ohio General Assembly.

Requests for medical-only aid have not been numerous. It is anticipated that the number receiving medical-only assistance might average between 6,000 and 7,000 a month during the next biennium. It is our considered opinion that the present health care program can satisfactorily take care of both groups of aged persons-pensioners and those who need only health care assistance. If it does not after 2 years of trial, efforts will be made to have the Ohio General Assembly at its next session take what action may be necessary to bring the program up to par.

We like the Kerr-Mills approach as it (1) helps those actually in need of help with benefits based on need and local determination; (2) is voluntary, not compulsory, so supplements, not supplants, individual voluntary health insurance or prepayment health care plans; (3) is administered on a local basis; (4) is much more economical than the Kennedy program; (5) gives more assurance that the quality of services will be high; (6) minimizes interference in the patientphysician relationship.

2. Continued active support is being given by our association to Ohio Medical Indemnity, Ohio's Blue Shield plan; Ohio's Blue Cross plans, and the various other private voluntary medical and hospital insurance plans operating in Ohio. They are being asked to expand their coverages for those 65 and over. Ohio's physicians took the lead in this field early in 1960 when they assisted Ohio Medical Indemnity in setting up a special medical care policy for Ohio's senior citizens. This activity resulted in a program so attractive and so reasonable in price that more than 60,000 persons 65 or older enrolled during a 10-day enrollment period. The Ohio State Medical Association asked its members to make their charges the same as the indemnity benefits when the financial situation of the insured 65 year old indicated.

Conferences have been held by officials of the Ohio State Medical Association with officials of Ohio's Blue Cross plans, offering assistance to the Blue Cross plans in efforts to work out uniform statewide hospital costs coverage at reasonable amounts for the aged-a program similar to that set up by Ohio Medical Indemnity.

3. Efforts are being exerted to have the following additional methods of providing voluntary insurance coverage for the aged expanded and popularized: Continuation of insurance on older active workers under group plans; Continuation of group insurance on workers who retire and on their depend

ents;

Continuation on an individual policy basis of coverage originally provided by a group insurance through conversion of the group coverage on termination of employment or membership in an insured group, with premiums on the individual policies commensurate with the decreased income after retirement-the differences being made up, perhaps, through larger premiums during employment; Issuance of group insurance on groups or associations of retired persons: Continuation into later years of individual insurance purchased at the younger

ages:

Issuance of insurance that becomes paid up at age 65, enabling the policyholder to pay for his protection during the productive years.

4. A revised attitude is being encouraged regarding compulsory retirement during the productive years. The disabilities of senescence should not be accepted as inevitable and unavoidable. The U.S. Department of Labor statistics show that older people can maintain productive standards, can meet physical requirements, are often more efficient than the average younger worker, and almost always have abilities and experience which should not be wasted because of an arbitrary retirement based on chronological age. We must cease assigning our aged to the shelf. Efforts to educate the retired person to psychological acceptance of the "retired state" should be stimulated as this might well relieve many of certain other problems which accompany retirement.

5. Many more opportunities for gainful employment must be offered aged Ohio citizens and we have joined others in trying to bring this about. The placement services of the State employment service should be expanded to provide services to greater numbers of aged. Greater effort should be exerted in Ohio to get employers and labor union officials to help solve this problem. Policies should be modified regarding mandatory retirement at age 65 or any other arbitrary figure. Part-time employment of retired skilled personnel, if full-time employment cannot be arranged, would in many cases be beneficial to the individual as well as industry.

6. More emphasis should be placed on preventive health measures such as regular exercise, proper diet, and periodic examinations. We are working with Ohio official health agencies and the voluntary health organizations on this.

7. Efforts should be stepped up to shorten the hospital stay for the elderly to lower costs for them or for the community. A considerable number of aged persons in Ohio general hospitals would be better off financially and psychologically in nursing homes, domiciliary homes, or in their own homes or the homes of relatives.

Through the joint efforts of the Ohio State Medical Association and the Ohio Hospital Association many hospital staffs have established hospital utilization regulations. As a result, unnecessary hospitalization is being reduced and hospital stays shortened for all patients, including the aged.

8. The need for community home care programs in many Ohio localities is evident. Long-term home care for the aged requires, in addition to the services of a personal physician, the following services: nursing, dental, nutritional, homemaker, housekeeping, and rehabilitative, as well as occupational therapy and physical therapy.

Through the leadership of the Committee on Care of the Aged of the Ohio State Medical Association, various organizations representing professions and others involved in home care programs for the aged have held conferences for the purpose of working out expanded home care programs in all parts of Ohio. 9. State and local political subdivisions, as well as private organizations, should endeavor to meet the need for more and better nursing home facilities and facilities for the care of the chronically ill. There must be upgrading of the standards of many of the existing nursing homes. Adequate standards should be enforced.

Representatives of the Ohio State Medical Association have served on advisory committees to official agencies administering Ohio's nursing homes law and responsible for supplying more facilities for Ohio's aged citizens.

Better ways of helping those desiring to build modern nursing home facilities or remodel existing facilities with the problems of financing are being explored. Also, the financial problems of many of the homes attempting to care for aged of low economic status are being studied and a solution sought.

10. A realistic attitude toward the total situation of the senior citizen is being encouraged. The effects of his socioeconomic problems on his physical status should be considered. This is not a matter for physicians alone but is a community responsibility.

11. All citizens are being encouraged to plan for retirement. However, should the individual or his family be unable to meet catastrophic needs, we agree that it becomes the responsibility of the local community to assist; the State and Federal Government if necessary.

I have gone into considerable detail to point up some of the more important activities which are being carried on in Ohio to meet the challenges of the aged citizens of Ohio and the planning which is taking place. The record shows that citizens of Ohio, including its 10,000 practicing physicians, are aware of the need for action and are exerting efforts to find solutions in a sound and eco

nomical manner. It is our considered opinion that Ohio is capable of meeting the health needs of its citizens who are 65 and over through present programs and that legislation such as H.R. 4222 is neither desirable nor necessary. Respectfully yours,

GEORGE W. PETZNICK, M.D.,

President.

Mr. CURTIS. I want to ask unanimous consent that the remarks I made on the floor of the House, with reference to the Gallup poll which has been referred to in a number of places in the record, be placed in the record at the appropriate place when I was interrogating Mr. Meany.

The CHAIRMAN. Without objection, it may be done.

(The abovementioned remarks will be found on p. 407.)

The CHAIRMAN. Mr. McLain, we remember quite well your previous appearances before the committee in representing your organization. But for purposes of this record, will you please again identify yourself?

STATEMENT OF GEORGE MCLAIN, PRESIDENT, NATIONAL LEAGUE OF SENIOR CITIZENS; CHAIRMAN, CALIFORNIA INSTITUTE OF SOCIAL WELFARE

Mr. MCLAIN. Thank you, Mr. Chairman.

My name is George McLain, with headquarters at 1031 South Grand Avenue, Los Angeles, Calif.

I am president of the National League of Senior Citizens, an organization including membership of more than a quarter million elderly American citizens.

I am also chairman of the California Institute of Social Welfare, and a member of the Governor's Committee on Aging.

For more than 20 years we have worked in the legislative field in behalf of the elderly. We maintain a daily social welfare counseling service dealing directly with the social and economic problems of thousands of elderly. Both organizations are nonprofit corporations. We are dedicated to the specific task of improving the life of 1 out of every 11 Americans, who compose the over 62 age bracket. These people have special problems in the economic, health, and housing

areas.

For more than a quarter of a century, my constant contact with the elderly has exposed me to the most intimate details of their struggle for continued survival.

I am proud to speak for the aged Americans, whose tenacious will to survive has inspired the need for legislative action. This, in effect, seeks the helping hand of brotherly love through organized society. I represent these elderly who, through their own persistency, have made me their spokesman.

Gentlemen, I will not repeat figures and statistics. These have been studiously compiled and presented by others. However, these facts vividly illustrate the vital need for enactment of the President's health insurance proposal as contained in H.R. 4222, the Health Insurance Benefits Act of 1961, introduced by the Honorable Cecil R. King, of California.

To me the most important argument for H.R. 4222 is that it makes available to the beneficiary needed funds with which to pay hospital,

medical, and health services, as a matter of right. This to be regarded as something the individual has earned through years of employment during his productive cycles.

Americans inherently feel a desire to stand upon their own feet to the best of their ability. They look upon elected representatives to assist them in this desire.

Members of Congress, State legislatures, Federal, State, city, and county employees when questioned about their retirement funds don't hesitate to say, with justifiable pride, "I paid for it."

So, too, the American worker seeks the same privilege when asking Congress to include a medical care program under the structure of the Social Security Act. He, too, wants to say, "I paid for it."

In my opinion, H.R. 4222 is most modest in its provisions. It restricts inpatient hospital services to 90 days. The patient must pay, from his own resources, for any additional or more expensive services. H.R. 4222 will lift the morale of the average aged beneficiary. It will remove the uncertainty of trying to meet payments on a sickness or accident policy and protect his little nest egg from further depletion, if by chance he has been fortunate enough to accumulate one.

Personally, I am a firm believer in the power of healing by prayer. However, this does not blind me from realizing the necessity of a physician for certain corrections. And, above all, I most definitely recognize the rights of others in regard to their individual belief in, and need for, medical care and health services.

Fear hangs like a black heavy cloud over the graying heads of the aged when the thought of illness or hospital enters the domain of their sunset years.

To meet the exorbitant expenses of current hospitalization for himself or spouse, he is faced with taking a mortgage on his home, if he happens to have one, with very little chance of repayment.

If they are compelled to seek county hospitalization, the county will take a lien on the property. This has happened to many of the elderly. They have come to our headquarters in droves through the last 20 years tearfully pouring out their heart on this one issue alone.

Decisions like this must be made by citizens who have taken just pride in paying for a home so that it would be free and clear for enjoyment in their old age. These people have worked faithfully all their lives in the average and necessary occupations, and then finally, because of ill health in their midst, they find themselves backed up against the wall and forced to sign away their little home.

Believe me, gentlemen, it does something to them, and in most instances they would prefer death to the loss of their home, humble as it might be. From that moment on, regardless of all the medical attention, or all the medical care in the world, they deteriorate, lose interest in life, and wait to welcome the end.

The adoption by Congress of the provisions of H.R. 4222 will render moral, mental, as well as physical, benefits to the aged.

The bill will allow those who have had a serious ailment to recover under supervised conditions in a nursing home after the patient is transferred from the hospital.

The great majority of elderly persons now receiving Federal oldage benefits cannot afford this type of care.

The outpatient hospital diagnostic services covered by H.R. 4222 serve as a preventative to keep the elderly on their feet and out of the hospital.

The home visits, which include intermittent nursing care, therapy, and part-time homemakers services, will mean much to those of advanced age. This, in turn, will help a great deal to keep them out of expensive nursing homes.

Other speakers have, I am sure, fully explained that the majority of old-age beneficiaries under the Social Security Act cannot afford to pay for their own medical care.

The enactment of H.R. 4222 will remove the pressure which forces them to apply for public assistance. It will remove the horror and the stigma of the means test in order to qualify for the medical assistance program enacted by Congress last year.

The chart below-reprinted from the report issued by your Committee on Ways and Means regarding the Social Security Amendments of 1961-shows clearly that it is impossible for those who must depend primarily on their old-age insurance benefits to have anything left over to pay for today's high cost medical and hospital charges.

If the chairman has no objection, I will not read that chart, but I will ask that it be inserted in the record, as part of my statement. Mr. KING (presiding). Without objection, that may be done. (The chart referred to follows:)

Examples of monthly payments beginning August 1961

Mr. MCLAIN. Gentlemen, the inescapable conclusion resulting from my long experience in dealing with older men and women is that the state of their health becomes one of their most pressing problems. Το most of the elderly their economics is a twilight zone. They barely have enough money to squeeze by from month to month.

The fear of sudden illness or accident is a haunting and overwhelming one. Charity wards in county hospitals are the inevitable result of prolonged sickness for these unfortunate oldsters.

The cruel truism that health care in modern America lies within the reach of the very poor, or the rich, applies to our older citizens more than any other stratum of our society. Those who have some modest means, a little nest egg in a savings account, a home, or minor resources, must sacrifice it in order to get the care they need.

Illness means the most abject pauperism to the elderly, unless they are wealthy enough to absorb out of their own pockets all of the tremendous cost of medical care.

There has been some talk of so-called voluntary health plans with the big insurance companies and the American Medical Association painting a rosy picture of their alleged advantages.

But the cold facts are that the highly touted over-65 policies being sold in many States are priced out of reach of the average oldster and offer only the skimpiest of benefits besides.