Council of Jewish Federations and Welfare Funds "The board of directors of the Council of Jewish Federations and Welfare Funds approves in principle the use of the mechanism of the old-age and survivors insurance program for financing an expanded program of health services for persons 65 years and over. "Provision of health services to the aged by Jewish institutions has become a matter of growing concern. Increased costs of medical care and the increased demand for these services by the aged place great strains upon the physical resources of Jewish institutions and increase institutional deficits substantially” (H. p. 708). Governors' conference (52d annual meeting, 1961) "Whereas the Governors' conference for many years has been acutely aware of the growing number and complexity of problems faced by our increasing population of senior citizens, including health and medical care, employment and income maintenance, provision of suitable housing, and enrichment of leisure time activities; and "Whereas the most pressing of these problems is the financing of adequate health and medical care: Now, therefore, be it "Resolved by the 52d annual meeting of the Governors' conference, That Congress be urged to enact legislation providing for a health insurance plan for persons 65 years of age and over to be financed principally through the contributory plan and framework of the old-age survivors and disability insurance system * **" (S. p. 161). Group Health Association of America ***** no voluntary insurance plan of any sort can create the necessary resources to provide adequate coverage for this older age group. It is just a question of trying to get blood out of a stone."***"It is * ** gratifying to see the Federal social security system used as a solution to the problem of more adequate health care for the aged. **** "*** this bill would not control medical practice. It would make medical practice as the doctor wants to practice it more available" (H. pp. 563–567). Life magazine "Unquestionably, many other Americans *** are in real need. The average $72 a month they draw from social security scarcely provides food and shelter, much less for the medical expenses which increase with age. Few are in a position to meet the cost of chronic illness from which many suffer * * "Can their need for medical aid be provided by private, voluntary Blue Crosstype plans? These are expanding, but can never meet the whole need. Premiums for the aged as a separate group are prohibitively high. The least burdensome method of insurance is for the whole society to spread the costs over the whole working life cycle. The cheapest and most logical way of doing this, whether by the Forand bill or a better one, is by extending the existing system of social security. "To provide this, aid need not be 'socialized medicine,' as opponents claim, since payments could be made through private channels and patients select their own doctors and hospitals as before" (editorial, Apr. 25, 1960). National Association of Social Workers "The total system of social insurance, in order to fulfill its social purpose in American life, should protect all workers and their dependents against the major economic hazards of modern life and should provide benefits adequate to maintain a reasonable standard of living commensurate with the Nation's productive capacity and sense of social justice * "We have studied the arguments against extension of OASDI to health care. We cannot agree with them. The patient's free choice of hospital or physician is not curtailed. It is not a free service. It does not have to reduce the quality of care. It will not discourage medical education, research, or advancement. It is not socialized medicine. It is not a system or regimenting doctors or bringing them under bureaucratic control" (H., pp. 144–145). National Consumers League "*** the Forand bill deserves the support of all those who wish this country to improve its welfare program *. Surely a $450 billion economy can divert a billion dollars per year to provide important hospital services to its older citizens, and the funds are diverted rather than added" (H., p. 384). National Council of Jewish Women "Based on our direct experience in services to America's senior citizens in communities across the Nation, the National Council of Jewish Women believes that increased social security benefits are essential to living in health and dignity in the later years. One of the greatest gaps in the economic security of the aging is the inability to meet the high costs of medical care in the years of reduced income and increased medical needs. A priority step in expanding our social security system must be the inclusion of medical care benefits for the aging" (January 1960). Nationwi Insurance Cos. "The cost of voluntary insurance policies cannot be borne by older persons alone. Realistically, the most that can be hoped for is that somewhat more than half the aged can pay premiums of about $100 per year. A $100 annual premium cannot cover more than a fraction of the aged medical care needs. * * * Private insurance companies can design health insurance packages to meet the important supplemental areas of medical need not met by the existing legislative proposals. *** With a balance of effort on the part of both industry and Government, a program can be built which will provide for every citizen's health needs in his old age. The social security system can provide the foundation for a comprehensive private-public health insurance system; it is the function and the opportunity of private, voluntary insurance to build on this for completely adequate health care at reasonable cost" (April 7, 1960). The New York Times "We believe that the arguments for using social security are overwhelming. Governor Rockefeller has done well to say that the administration plan could result in a very serious fiscal situation, very high costs, and cumbersome administration' and to urge that medical care for the aged be an added health feature of the social security system, with those who benefit contributing to their own protection. * * * "There are many positive advantages in using social security. For example, it would avoid what amounts to a 'means test' for eligibility-something abhorrent to Americans—and would automatically relate payments to ability to pay without investigation. Also, it would take effect nationally at once, while State cooperation might be far from unanimous and also slow in coming" (Editorial, May 10, 1960). Synagogue Council of America "The constituent organizations of the Synagogue Council of America endorse the proposal ** * that the Federal social security system be broadened to include hospital and nursing home care for persons over 65. Such costs account for a very large part of the total expenses of medical care for older people. Extension of Federal assistance would lift a heavy burden of expense and of fear from the minds of those who have surely earned at least this freedom from fear. "Jewish religious tradition makes mandatory the maximum care of those in final years of life. We urge that this minimum step of adequate medical assistance be undertaken for the elderly in our society without delay" (June 9, 1959). The Washington Post "While a man is employed he can enjoy the protection of some sort of group or private insurance program to cover medical and hospital bills if he becomes ill. The chances are, however, that when he retires he will no longer enjoy such protection; yet this is the time, obviously, when he will need it most-when, indeed, he is certain to need it sooner or later, which is what makes the cost of such private insurance prohibitively high for the aged. "The McNamara subcommittee came to the conclusion that this problem 'should have top priority for legislative consideration in 1960' and recommended in its report an expansion of the system of old-age, survivors, and disability insurance to include health services benefits for all persons eligible for OASDI. We think this conclusion is inescapable * * *. "That the American Medical Association would offer its usual doctrinaire opposition to this proposal was as much to be expected as a bill from a doctor after a visit to his office. Senator McNamara has observed that the AMA had 'nothing to offer but tired abuse.' This is not, by the wildest flight of the most neurotic fancy, 'socialized medicine' or 'political medicine.' It is simply a system, if the AMA could but calm its nerves enough to realize it, which, like Blue Cross or Group Hospitalization or any other insurance program, would enable a patient to go to the doctor and the hospital of his choice and pay the bills resulting from the care he needs in old age. It would help doctors, hospitals, and medicine in general. And it would enable American men and women to retire in their old age with more security and self-respect" (editorial, Feb. 20, 1960). A SELECTED LIST OF INDIVIDUALS ENDORSING PRINCIPLE OF HEALTH BENEFITS FOR Benjamin Spock, M.D., professor of child development, Western Reserve University, and 27 other physicians "*** social insurance against the costs of illness is in the best interests of the patient and the medical profession, as well as the Nation *** "The medical and hospital costs of older people can be made self-supporting only if they can be averaged out by level premiums over the adult lives of the insured and the risk distributed as widely as possible. For such a purpose, the OASDI system is uniquely suitable. Use of the social security system is fair and equitable because no person can claim immunity from the need for protection against the infirmities of age, illness, and loss of income" (S. p. 407). Walter Lippmann "*** What is wrong about its being compulsory that a man should insure himself against the needs of his old age? What is so wonderful about a voluntary system under which a man who doesn't save for his old age has to have his doctors and his hospital bills paid for by his children or public welfare funds? There is nothing un-American in the principle that the imprudent shall be compelled to save so that they do not become a burden to their families and the local charities, so that they can meet the needs of their old age with the self-respect which comes from being entitled to the benefits because they have paid the cost out of their own earnings" (Washington Post, June 16, 1960). James P. Dixon, M.D., president, Antioch College, former commissioner of health, city of Philadelphia “*** I urge support of legislation to provide health benefits through OASI, if we are as a nation truly concerned to meet health problems of older people and maintain humane standards of quality and quantity of health services. This would permit contributions of individuals through employed lifetime and give widest-flexibility in administration with least likelihood of regional and sectional variations in coverage and services" (S. p. 338). Hon. Nelson A. Rockefeller, Governor of New York *** Health insurance should be provided for as many as possible over 65 without reference to a means test. "The basic mechanism for achieving this should be the contributory social insurance system, supported by payroll taxes, which exists in the old-age survivors and disability insurance system. Basil C. MacLean, M.D., former president, national Blue Cross Association "A lifetime's experience has led me at last to conclude that the costs of care of the aged cannot be met, unaided, by the mechanism of insurance or prepayment as they exist today. The aged simply cannot afford to buy from any of these the scope of care that is required, nor do the stern competitive realities permit any carrier, whether nonprofit or commercial, to provide benefits which are adequate at a price which is feasible for any but a small proportion of the aged." (Feb. 5, 1960.) State Governors "We, the undersigned, attending the 52d Annual Governors' Conference urge that you and your committee amend H.R. 12580 to provide health benefits under the provisions of the old-age, survivors, and disability insurance system. Such a program would enable the citizens of our country to contribute small amounts during their working lives and have as a matter of right a paid-up health in surance policy to protect them during retirement years when their medical needs are likely to be greatest and income lowest." Hon. James T. Blair, Jr., Governor of Missouri. Social security experts (S., p. 162) 66# ** An extension of Federal old-age, survivors, and disability insurance to include hospital coverage would provide a systematic way of financing serious illness and prevent the exhaustion of the savings of aged persons and the consequent, often devastating demands upon the resources of their children. "There is every indication of the willingness of Americans to share the cost of basic health protection for their elderly parents and later for themselves by paying for such a program through their working years. If such health protection were available for older persons, private organizations would be enabled to offer more economical protection to the younger people in our population." Mr. Arthur Altmeyer, Madison, Wis., former Chairman of Social Security Board and Commissioner for Social Security. Mr. Joseph P. Anderson, executive director, National Association of Social Workers, member, Advisory Council, 1961 White House Conference on Aging. Dr. Eveline M. Burns, professor of social work, New York School of Social Work, Columbia University; former consultant to Committee on Economic Security and Social Security Board, and member of Advisory Committee to Secretary of Health, Education, and Welfare (1954). Mr. Wilbur J. Cohen, professor, Public Welfare Administration, School of Social Work, University of Michigan, member of the staff of the President's Committee on Economic Security (1934–35). Mr. Nelson Cruikshank, AFL-CIO, Washington, D.C.; member, Advisory Council on Social Security (1948-49) and Advisory Council on Social Security Financing (1958-59). Miss Loula Dunn, Chicago, Ill., member, 1959 Advisory Council on Public Assistance. Mr. Fedele F. Fauri, dean, School of Social Work, University of Michigan; former consultant on social security to House Ways and Means and Senate Finance Committees. Miss Helen Hall, National Federation of Settlements, member, Advisory Council of the President's Committee on Economic Security (1934-35). Mr. Seymour Harris, Littauer professor of political economy, Harvard University, consultant to President's Council of Economic Advisers. Miss Jane M. Hoey, New York City, director, Bureau of Public Assistance, Social Security Administration (1936-54). Mr. Raymond W. Houston, commissioner, New York State Department of Social Welfare, member, 1959 Advisory Council on Public Assistance. Mr. John Kidneigh, director, Graduate School of Social Work, University of Mr. Richard A. Lester, professor of economics, Princeton University, member, Mr. Norman V. Lourie, deputy secretary, Pennsylvania Department of Public Welfare, member of ad hoc advisory committee to Department of Health, Education, and Welfare. Mr. Charles I. Schottland, dean, Florence Heller Graduate School of Social Welfare, Brandeis University, former Commissioner of Social Security (1954-58). Mr. Karl de Schweinitz, Washington, D.C., former consultant to social security board, and professor emeritus, University of California. Mr. Herman M. Somers, chairman, Political Science Department, Haverford College, former consultant to Social Security Administration. Mr. John W. Tramburg, commissioner, New Jersey State Department of Institutions and Agencies, former Commissioner of Social Security (1953). Mr. George K, Wyman, executive director, Welfare Council of Metropolitan Los Angeles, former Deputy Commissioner of Social Security (1959). Mr. J. Douglas Brown, dean of faculty, Princeton University, Chairman of Advisory Council on Social Security (1937-38) and member of Advisory Council (1948-49). Mr. John J. Corson, McKinsey & Co., Washington, D.C., former Director, Bureau of Old-Age and Survivors Insurance. (S. p. 323) Mr. LOURIE. Thank you. The National Association of Social Workers which I represent is a professional membership organization composed of 30,000 members who are employed in governmental and voluntary social welfare type organizations. Today we are here to support H.R. 4222 which was introduced by Mr. King for the Kennedy administration. We feel there is now general acceptance that society has an obligation to provide food, shelter, and clothing to the individuals who cannot because of age, disability, or other limiting circumstances care for themselves or secure these for themselves. We hold with the President's Commission on Health Needs of the Nation that access to the means for the attainment and preservation of health is a basic human right and that we should be and are ready to implement this right. In an absolute sense, good health we believe is a condition to be desired over any other condition of life. With the phenomenal progress that medicine has made, health today, we believe sincerely, is a purchasable commodity. All of us take pride in the practicality of the American approach to social progress. We accept and appreciate the mosaic of health care that has been developed in the United States, the programs of health care for veterans, medicare programs for dependents of men in the Armed Forces, recently instituted programs for health service for Federal employees, hospital costs and physicians' fee coverage in Blue Cross and Blue Shield and a variety plan offered by insurance companies, also medical care programs for recipients of public assistance including assistance to the medically indigent, the aged, union management programs, cooperative health organizations, and others. These developments are certainly in the direction of our association's policy statement on health which reads in part A comprehensive national health program which will assure full health care to all individuals by applying the principles of group payment and tax support or the principles of compulsory national health insurance to a total range of health insurance measures is endorsed. As I indicated earlier we have made progress in providing health services to the employed, the veterans, and other special groups, even |