OVER 65 PATIENTS... HOW THEY PAID DEVIATIONS FROM THE AVERAGE. IN TEN HOSPITALS

PAID BY BLUE CROSS

100%

The CHAIRMAN. Thank you, Doctor.

Are there any questions?

Mr. SCHNEEBELI. Yes.

The CHAIRMAN. Mr. Schneebeli?

Mr. SCHNEEBELI. Dr. Harer, thank you and congratulations upon a well documented and good statistical statement. I think it is an excellent argument for the Kerr-Mills plan.

As you may know, I am on the board of managers of the largest hospital in north-central Pennsylvania and in that capacity and in that responsibility we are very happy in this hospital in having the Kerr-Mills legislation to take care of many of these indigent cases which previously the hospital had to absorb and consequently we were compelled to charge higher rates to the other people.

This is another facet to this important legislation, and having this personal responsibility I can testify to the proper benefits that can accrue from this legislation.

Thank you again for your very fine testimony.

The CHAIRMAN. Any further questions?

Dr. HARER. Mr. Chairman, may I comment on that, please, very briefly?

You may happen to know that the hospital to which you refer is one of the ten included in this survey.

Mr. SCHNEEBELI. Thank you.

The CHAIRMAN. Any further questions?

Again, Doctor, we thank you, sir.

Dr. HARER. Thank you.

The CHAIRMAN. Mr. McLain, you have been before the committee in the past. We appreciate your appearance before the committee again.

Mr. McLAIN. Thank you.

Mr. KING. Mr. Chairman, George McLain and I have known one another for about 30 years. He got in touch with me the other day and complained a little bit about being limited to 5 minutes.

The CHAIRMAN. I don't blame him.

Mr. KING. And without saying any more I think Mr. McLain now realizes that 5 minutes is a long time.

Mr. MCLAIN. Yes.

The CHAIRMAN. What we have done, Mr. McLain, is to divide evenly the time between those who are for and those against the proposal, except for the Government witnesses, Members of Congress, and departmental people.

We are trying to do it within a period of 8 days. It is a strain on all of us to do it that way. We appreciate your cooperation and that of all the witnesses.

Mr. MCLAIN. Thank you very much.

The CHAIRMAN. You are recognized, sir.

STATEMENT OF GEORGE MCLAIN, PRESIDENT, NATIONAL LEAGUE OF SENIOR CITIZENS, AND CHAIRMAN, CALIFORNIA LEAGUE OF SENIOR CITIZENS

Mr. McLAIN. My name is George McLain, with headquarters at 1031 South Grand Avenue, Los Angeles, Calif. I'm president of the

National League of Senior Citizens, an organization with a membership in every State, consisting of a total of more than a quarter million elderly American citizens.

I'm also chairman of the 24-year established California League of Senior Citizens, and a longtime active member of the Governor's committee on aging. During all these years I have worked in the legislative field in behalf of the elderly. In our two-story headquarters building in California we maintain a daily social welfare counseling service dealing directly with the economic, health, and housing problems of thousands of elderly. Both organizations are nonprofit corporations.

For 23 years we have maintained a network of daily radio broadcasts throughout California. We have published the Senior Citizens Sentinel, a 20-page monthly tabloid with worldwide circulation. The league holds regular meetings throughout the country. It is recognized as the Nation's most active and authoritative organization solely dedicated to the cause of the aged, blind, and physically disabled. All of our efforts are financed through memberships, subscriptions, and donations.

In behalf of those I represent, I wish to thank Congressman Cecil R. King of California for having the courage and fortitude to introduce H.R. 3920, otherwise known as the Hospital Insurance Act of 1963. At the last session of Congress, Mr. King introduced the health insurance benefits of 1961 and brought down upon his head the wrath of the American Medical Association, the drug interests, and insurance companies. In order to further punish him, a medical doctor filed as a candidate in Congressman King's district in an effort to unseat him. Fortunately for the welfare of the majority of the people of our State, Congressman King was reelected. Rather than being cowed into submission, he again felt inspired to champion the cause of the people by introducing H.R. 3920, the Hospital Insurance Act of 1963.

Congressman Aime Forand, a former ranking member of your committee, couldn't stand the vicious pressure brought against him after having introduced medicare bills in two sessions of Congress. The pressure was so intense that it endangered his health. He decided not to run for reelection. The committee, as well as the Nation, lost an experienced and able Member of Congress. For that reason, I feel some comment about the courage and fortitude shown by Congressman King is imperative. He is again reaffirming his recognition of the desperate need of humanitarian legislation as embodied in bill H.R. 3920. This, in spite of the fact that opposition to this bill has millions with which to finance its campaign as against the literally millions of penniless citizens who desperately desire this bill to become law.

Whenever a great step forward is contemplated one hears strong arguments for it; and strong arguments against it. All legislation designed to meet the needs of the majority of the people has its proponents and opponents. When the issue is unresolved, the demand becomes greater and greater. This is clearly demonstrated by the increasing support behind the passage of H.R. 3920. I trust that you gentlemen will resolve in favor of its passage. If you do not, medical

and hospital care for the elderly will become a major and a most bitter issue in the next primary and general election.

Apropos, it was most interesting to note a private study group, including three former Eisenhower Republicans, two of whom were former Secretaries of Health, Education, and Welfare, issued a release last week calling for a compulsory medical care program for the aged, which is considerably broader and more demanding than the benefits provided for in H.R. 3920.

The collaboration by Senator Jacob A. Javits, Republican, of New York, and Senator Clinton P. Anderson, Democrat, of New Mexico, on the findings of this study group as a basis for new medicare legislation certainly indicates that the issue of hospital and health care for the elderly has become a matter of great concern to the leadership of both the Republican as well as Democratic Members of Congress. In further urging passage of H.R. 3920, allow me to comment on the Kerr-Mills bill. We in California have taken full advantage of this legislation. It has been very helpful in providing funds for hospitalization and convalescent care. We note that during the fiscal year of 1961-62, 90 percent of the expenditures made in the field of medical assistance for the aged among the States were made in California, Massachusetts, Michigan, and New York.

This means the American Medical Association did not keep its promise the promise made to Congress that they would work in all of the other States to get the legislature to enact effective legislation to fully activate the Kerr-Mills bill.

In 1962, prior to the tabling of the Anderson-Javits bipartisan medical care bill, Senator Dirksen, of Illinois, pledged on the floor of the Senate that if the measure was defeated he would introduce an amendment later on to a tax bill to modify the means test relating to the Kerr-Mills law. Unfortunately, for reasons best known to himself, Senator Dirksen's pledge was not kept.

The Federal matching funds from 50 to 80 percent, according to the per capita income of the State, to pay the cost of providing medical care, did not encourage the States to participate as anticipated by the authors of the Kerr-Mills bill. Perhaps more enthusiasm would be shown if this law was amended to provide Federal funds from 75 to 100 percent for the initial 30 days for hospital and convalescent

care.

Congress made the same error in the Kerr-Mills law as it did in our Public Assistance Act. They allowed the individual States to invoke their own concept of a means test. So, here again, we find in the Kerr-Mills bill, as in the Public Assistance Act, the establishment of the Elizabethan poor laws where hardly any of our 50 States are uniform in their test required of an applicant seeking medical care under the Kerr-Mills bill. The test, in my opinion, should be based upon the net annual income of the aged applicant. It should not be concerned with their real or personal property holdings, if any. Recently I spoke in Oklahoma City before the State convention of the Oklahoma League of Senior Citizens, who are affiliated with our national league. I was appalled at the appearance of these oldsters. I was amazed at the stories these people told of their lack of medical care. In California, I am used to seeing elderly people with most or some of their own teeth, or a reasonably good set of dentures.