safer in the hands of our own physicians than it would be if a third person were in the doctor's office with us.

Now let me state why we are against the King bill:

(1) Absolutely no one, it seems, knows how high the cost of such a proposal might be, if enacted. Each time our generation gets an estimate of the bill we are to pay, it is strangely increased. The thing that never changes is the sobering fact that we will still have to pay it. In effect, we are being asked to sign a blank check for goods of undetermined quality to be delivered at an uncertain date.

(2) We are now on the brink of a national emergency. This is a time when our national strength is being measured by both military and economic standards. Of course, we favor a strong America in both cases. Therefore, it is hardly logical to burden our economy with another welfare tax when our full potential is needed for national defense.

(3) We believe in the commandment, "Honor thy father and thy mother." We do not believe the problem of our aged relatives should be passed as the proverbial buck to the Federal Government.

(4) We are opposed to a national policy which would inevitably promote inflation. Our generation faces serious losses if legislation such as this is enacted. Just a little more inflation will make it just a little harder to get ahead. It will also immediately affect the savings of our parents and grandparents, the same people this legislation is supposedly designed to help.

(5) The King bill would violate religious freedom for individuals. whose consciences lead them to seek nonmedical systems of healing. These people might also be forced to pay taxes to support medical systems which are repugnant to their religious beliefs. We support the principles of religious freedom which are a part of our great heritage of freedom.

(6) Dividing Americans into special classifications, according to age, is akin to discrimination on the basis of race or religion. Those over 65 vary as widely as do the individuals in any other group. Their individuality should not be denied by Federal law.

(7) By empowering the Secretary of Health, Education, and Welfare to establish standards for the admission of hospitals and nursing homes as participants in this scheme, we will have lost our right to free choice of hospital. This also seriously impairs our right to free choice of physician.

(8) If the King bill becomes law, the Federal Government will be placed in direct competition with private voluntary insurance plans. More and more of our aged are joining such plans every day. Yet such private voluntary plans would be driven out of business in many cases. There are no antitrust laws to regulate Government monopoly. This is another blow struck by H.R. 4222 against free enterprise.

(9) If the Government is to be put into the medical business, why not also establish a compulsory national clothing service and maybe even an obligatory Federal food store? Soon all our needs and wants would be subject to Government regulation and whim.

(10) The entire principle of a compulsory health plan is distasteful to us. We want to be able to decide for ourselves whether or not to participate in a health plan-both before and after we are 65.

(11) We do not want to be legislated out of the best health care in the world. The King bill will lower medical standards by eliminating the incentives of competition.

These are by no means all the reasons for opposition to H.R. 4222. However, I hope they reflect our genuine concern for individual freedom and responsibility.

At a time when freedom is being challenged throughout the world, why should we retreat at home?

The CHAIRMAN. Mr. Phillips, we thank you, sir, and the group with you, for bringing to us the views of your organization, Young Americans for Freedom.

Are there any questions of Mr. Phillips?

Mr. ALGER. Mr. Chairman, I do not want to let the opportunity pass without telling the witness that so far as this member is concerned, this statement is like a breath of fresh air. At least there are some new thoughts expressed. We have had some fine witnesses on both sides of this argument, and some of us have chosen sides, by the way, because this is the second time we have gone through with pretty much the same witnesses and the same material. So I have already made my position somewhat clear, and I am trying to find out if I am right all the time by the opposition's views. And I must say you are presenting some ideas in these 11 or 12 points you have made, such as incentives, that have not been mentioned here, because they are intangible. It is hard to prove with statistics and charts. You and I know they exist, but you cannot put your finger on intangibles. Yet, they have made this country what it is.

Each of you, personally, I want to thank for appearing.

My colleague from Princeton and his wife, I can assure you. We need you. We had Dean Brown here yesterday talking a language that I think does not express your viewpoint or mine, nor preponderantly, that of Princeton University. He spoke in the pattern of Norman Thomas and Adlai Stevenson and the former Governor of Michigan, but not as you and I would speak.

I certainly am delighted to have all of you here, and I certainly appreciate this testimony. Thank you very much for appearing.

Mr. UTT. I just wanted to take this opportunity to congratulate you on your Sharon statement and to say that it has been framed and is on my district wall, and I read it every time I go home. I am very much impressed with it.

Mr. BETTS. I might say I am sorry there is no one from Yale here. Mr. PHILLIPS. Originally someone was to be down here, but we thought it might be bad taste.

The CHAIRMAN. Thank you again, Mr. Phillips.

Mrs. Goatley?

You may be seated, Mrs. Goatley, and you may proceed as you wish. STATEMENT OF MRS. WILLIAM GOATLEY, SECRETARY, L. & N. GOLDEN AGE CLUB

Mrs. GOATLEY. My name is Mrs. William Goatley from Louisville, Ky., and I am the secretary of the L. & N. Golden Age Club, of Louisville, Ky.

Our club is composed of approximately 160 members, all of whom are retired railroaders, wives, or widowers. We meet once each month.

on a Sunday and have programs, elect officers, plan trips, and in general maintain a program of wholesome activity that keeps our members interested in the club and other matters.

We organized this club in 1955, and I have served as secretary since the beginning of our group. Naturally, I am very proud of our club and the spirit of our members to stand on their own feet and to enjoy a life of fulfillment in our retirement years.

Mr. Chairman, I believe that most older people have no desire to receive a mere financial dole, nor do they wish to be segregated with those of their own age in nursing homes or other special homes for the aging. We want to continue our role in society, contribute to the community, and live our own lives in an independent and self-sufficient manner. We need to carry our own burdens insofar as possible and resent being set apart and classified as a segregated group of society. I do not believe that we have any special problems which would tend to set us apart and classify us as second-rate citizens. We do not want to be segregated from the mainstream of society, whether it be with respect to social activities, community affairs, citizenship, medical care, or what have you.

In this connection, we, as a group, are opposed to the King-Anderson bill—H.R. 4222-which proposes to provide medical care for a certain segment of our population under the provisions of social security. Our club was also opposed to H.R. 4700, the Forand bill, during the last session of Congress.

We are afraid that legislation of this sort, if enacted, would lead us into an eventual state of total Federal medicine. Can any of you assure me that this bill, if enacted, would stay the same as is now proposed in the bill? I do not think so, for most Federal programs have a tendency to grow rather than to diminish. The emphasis seems to be on more services, dollars or lowering of requirements. In this case of putting medical care for the aged under social security, we are again in the expansion stage, and at this time from dollars to services, which is a radical departure from cash benefit to beneficiaries.

I do not think the age limit of 65 as proposed in H.R. 4222 would long remain at 65. It would be lowered to 62, 60, and so forth, until all are covered by a Government-type health care program. If the indication of the rise in costs in these types of medical programs in other countries is a barometer, how high will ours go?

Furthermore, this bill would be a compulsory program for which all Americans covered by social security pay, regardless of whether they want or need the benefits provided.

This seems to be an important point to us-who is needy and who is not? In Kentucky, we have had the Kerr-Mills program in effect since January 1, 1961, which, as you know, is designed to assist only those in need as determined by regulations of the State. This is the way is should be-not controlled by the Federal Government, but in the hands of those at the local level.

Mr. Chairman, I know you have heard the above comments before, but to us they are valid and are worth reemphasizing if we are to preserve our traditional doctor-patient relationship which to me is very valuable.

As one who has numerous health problems, I consider the cost of our present-day medical care quite cheap. My personal experiences

with physicians, hospitals, and other allied personnel have been most rewarding, and only due to them is it possible for me to be here today. I have a heart condition known as coronary thrombosis which calls for a daily dosage of Hedgalin. One hundred of these lifesaving pills costs me $3.95 each 100 days, approximately 4 cents per day. To me this is cheap. I have had an operation for the removal of onehalf of my lung. The doctor's fee was $300, of which Blue Shield paid $200. In both instances, only through the advent of modern medicine am I still here, so, consequently, I have a deep and abiding interest in our system of medical care.

All of the members of our Golden Age Club receive pensions, and it is very discouraging to us to continually see that the purchasing powers of our dollars are continuously being eaten away by inflationary programs. It would appear to me that this should be an area of great Government concern, and that it should work toward sound economic programs that would tend to stabilize our dollars. With a sound dollar, we are more able to purchase the services we need, whether they be medical or otherwise.

In closing, I would like to express my appreciation to you and members of the House Ways and Means Committee for giving me the opportunity to present a few views on the subject of medical care for the aged. To me, this represents our democracy in action. I sincerely hope that each of you will give careful consideration to this proposed legislation prior to making any recommendations that could start us on a program of total medical care for all, regardless of any demonstrated need.

Mr. KING (presiding). The committee wishes to thank you, Mrs. Goatley, for giving us the benefit of your views.

Are there some questions?

There are no questions, Mrs. Goatley. Thank you very much, again.

Dr. Danilevicius.

STATEMENT OF ZENONAS DANILEVICIUS, M.D., CHICAGO, ILL.

Dr. DANILEVICIUS. Honorable chairman and members of the Ways and Means Committee, my name is Dr. Zenonas Danilevicius. I am now a general practitioner in Chicago, but I was educated in Lithuania and practiced medicine there.

I would like to read only parts of my statement, because it is a little longer than the time allotted me. And I can have it on the record as it is?

Mr. KING. Doctor, you may be seated. Your entire statement will be made a part of the record, and you can handle the statement as you wish.

(The above-mentioned statement follows:)

STATEMENT OF ZENONAS DANILEVICIUS, M.D., ON H.R. 4222

Honorable chairman and members of the Ways and Means Committee, my name is Dr. Zenonas Danilevicius. I am now a general practitioner in Chicago, but I was educated in Lithuania and practiced medicine there.

It is a great privilege to be able to voice one's own opinion before this committee, especially to speak without any fear and with a feeling that your words are going to be listened to seriously on a legislative matter. Sad to say, there are not many such wonderful countries left in today's world-maybe not even

one where you would be able to use your freedoms so fully as in our great United States.

I am appearing before this committee today because I am afraid that H.R. 4222 would be the beginning of full Government control of medical care. Today, the best and most idealistic intentions are behind this bill which will provide hospital care and services to all those aged people under the social security system. But I'm convinced that this kind of program will be only temporarily limited to one segment of the Nation's population. Eventually, those following us will work successfully to extend the bill to include all segments of the population, and then we shall have full governmental socialized medicine. From personal experience, I know that when Government controls medicine, it is the patient, not the doctor, who will suffer the most.

I was raised in Lithuania and received my medical degree there in 1937. In 1940 the Russian forces took over the country. After a short reorganizational period of about 2 months with comic-opera-type elections and increasing police state terrorism, we were regimented into a pattern where we had Government medicine.

The result was a general deterioration in medical care. Here are some of the things that happened when every physician, nurse, medical technician, and other medical personnel worked for the Government and began providing so-called free medical care.

(1) Patients who did not need a doctor's care-those with minor, minute, or even imaginary ailments-started to flock into the clinics. Emergency patients had to wait hours to be seen, because you treated people in order, and you did not know how serious a case was until you saw the patient.

(2) Paperwork grew and grew. You had to have a record card entitling the patient to service; you had to fill out his record card; you had to fill out his call slip for purposes of accounting; you had to write a prescription in triplicate; you had to fill out a slip requesting permission to have a consultation; then you had to wait for an answer in writing. If the permission was granted, you had to fill out a consultation slip and maybe a long form requesting permission to hospitalize the patient. When you received permission to hospitalize a patient, you had to attach another form referring the patient to a hospital and giving details of your examination, diagnosis, and treatment because you were not going to see the patient at the hospital; some specialist would do that. At least 30 percent of the doctor's useful time was spent on paperwork and bureaucratic formalities. This paperwork and unwise use of personnel resulted in a shortage of physicians. However, with great sacrifice on the part of the members of the medical profession who did not pay any attention to official hours and who worked overtime without pay, we were able to help our fellow countrymen. The large amount of paperwork meant an increase in lay administration, supervision, and bookkeeping. Bureaucracy and costs increased immediately.

(3) Hospitals became overfilled and the bed shortage was worse than the doctor shortage. Sometimes emergency cases had to be refused admission to a hospital because there were no beds. Of course, many beds were occupied by those not acutely ill, but by those seeking such things as diagnostic workups and those who preferred hospital care to care at home. And once anyone got into a hospital, it was difficult to get him out. Everything had to be done through proper bureaucratic channels; superiors had to check the necessity of hospital stay; they had to get the opinion of the controlling committee; the committee had to submit its report; then the final decision had to be made and written out. Finally, the necessary forms were sent to the attending physician, who was made personally responsible if the patient was discharged from the hospital too early. Thus, physicians customarily would not hurry to get patients out of the hospital.

(4) A geographic distribution of medical personnel throughout the country was established. Thus, patients in a certain geographical area-perhaps a certain section of a large city-could go only to the outpatient clinics in their own area. Thus freedom of choice of physician was drastically curtailed. Free choice of physician was cut down even more because certain physicians were assigned to certain shifts. If you were not able to go to the clinic at a certain time, you were not able to receive treatment from the physician of your choice. Under this geographic setup, duplication of facilities naturally occurred and this again contributed to increasing the cost of the program.

(5) The patient-doctor relationship became cold and official, due to the general bureaucratic atmosphere, lack of an individual approach, lack of time, ne