"My mother fell and broke her hip about 2 years ago. Her Blue Cross policy pays $15 a day for the room, about one-half of the cost but nothing on the doctor bill which has been about $600 so far. She is taking therapy treatments at the hospital now which cost her $24 a week and is not covered by her policy.

"It would not be so bad if she were OK now, after all the expense and discomfort she has been through, but her doctor thinks the job will have to be done over again as the spike they put in her hip would not take hold. They are going to put a ball joint in her hip this time.

"I am sure her hospital policy would be canceled after her first hospital stay if it were not for the no-cut policy in the union contract.

"It is a shame when an insurance company can cut the benefits or cancel your hospital policy after they think you are a poor health risk. Old people can't help it if they get sick or hurt."-DONALD G. CROSS.

"My wife and 1 are certainly in favor of this bill because we have been plagued with medical and hospital bills until we do not know what to do any more.

"For the past 12 years I and my wife spent most of the money we earned on medical and hospital bills. Now I am unable to work because of my health (and I do not know how much longer my wife will be able to work) so what then will we do about our medical expenses? If Congress doesn't do something about the King-Anderson bill, I don't know how most of us elderly people will survive without this supplement."-Mr. and Mrs. CHAS. H. ERICKSON.

"When I retired I had to discontinue the group insurance. I was promised that I could have it on my own. They could bill me at home they said. But they never did. I contend that they dropped me. I am now paying over $250 a year for health insurance, and one of the policies still has a rider on it, which they refuse to take off. I am paying $92 for this policy and if I get sick with arthritis, I get nothing."-MARY H. STOLZE.

"My mother is now 85 years old and since she has been hospitalized before, the insurance company canceled out her policy and now I am paying the bill. Her sole income is a social security check for $40 a month. I hope my children won't have the same choice to make, to either pay the bills or put dad on relief."-E. SAXINE JOHNSON.

"I wonder if the legislators know when we get pains or feel sick we try to take care of ourselves instead of getting some information from a doctor. This is not myself only, but I know and hear of others doing the same thing."-Mr. and Mrs. CHRIS EIKAAS.

"I assure you, I agree with you that the Kerr-Mills bill is inadequate, in that one must use up his savings down to $750 in order to qualify. After that is gone, what happens, you would be obliged to go on relief, which is definitely not what we want. Insurance premiums for hospitalization and Blue Shield are high and cause a hardship even with limited social security and additional pension. I feel certain that you will do your utmost to procure for us a more satisfactory medicare plan."-SYLVIA CLASSEN.

These examples can be multiplied many times, Mr. Chairman, presenting a picture of, in some cases, dire personal need, and profound concern on the part of our citizens.

Many organizations, close to and directly reflecting the feeling of the people in Minnesota, have asked me to relay their feelings to the members of this committee. Here then are those statements.

ORGANIZATIONS SUPPORT KING-ANDERSON BILL

AFL-CIO Community Services, Minneapolis, Minn.

"With the options which are provided and with coverage provided to all persons not now covered by social security or railroad retirement *** it is an excellent start."

Group Health Mutual, Inc.

"Whereas hospital and medical care for citizens over 65 years of age has be come prohibitive in cost, and

"Whereas the need to provide for an adequate medical care plan for senior citizens has been proposed through the social security system: Therefore, be it "Resolved, That Group Health hereby reaffirms its support of the extension of the social security system to cover hospital and medical expenses of retired persons, and be it further

"Resolved, That copy of this resolution be sent to chairmen of appropriate House and Senate committees, our Congressmen and Senators, and the President of the United States, and be it further

"Resolved, That all delegates to this meeting be urged to write to their Congressmen and Senators urging their support of the President Kennedy medical care plan."

Carpenters Local No. 7, United Brotherhood of Carpenters & Joiners of America

"This is to call your attention to the fact that Carpenter's Local Union No. 7 of the United Brotherhood of Carpenters & Joiners of America is solidly behind the King-Anderson bill, H.R. 3920 and S. 880, and most urgently request you support and vote for the bill."

Apartment Building Service Employees' Local 78

"On behalf of all members of the Apartment Building Service Employees' Local 78, we urge you to vote for and help in every way possible to pass the King-Anderson bill."

International Union of Operating Engineers, Locals 49, 49A, 49B, 49C, and 49D, Minnesota, North Dakota, and South Dakota

"The membership of local 49, made up of better than 10,000 members residing in Minnesota, North and South Dakota, have reviewed and discussed this legislation and are overwhelmingly in support of these bills. It is of vital importance to each of us as we grow older that some means of providing medical care for the aged under social security be adopted in order to offset the prohibitively high cost of insurance premiums which in many cases the retired worker with his limited income cannot afford."

The Commercial Telegraphers' Union Local No. 8

"We the undersigned members of the Commercial Telegrapher's Union, Minneapolis Local No. 8, are keenly interested in the health care needs of our parents and other older people.

"We are therefore in favor of the administration's Hospital Insurance Act of 1963, which has been introduced in the House of Representatives as bill H.R. 3920."

United Electrical Radio & Machine Workers Local 1139

"Membership meeting held November 14 unanimously endorse your support for King-Anderson bill. Membership instructed me to inform you we endorsed your candidacy on the vigorous position you took on medicare."

The Minneapolis Federation of Teachers, No. 59

"The executive board of the Minneapolis Federation of Teachers, Local 59, voted full support, as a matter of social betterment, for the King-Anderson bill providing hospital care under social security."

Sign Painters Local 880

"Resolved, That the King-Anderson bill on medicare for the aged be made into law with all possible speed."

American Federation of Grain Millers

"I want to assure you that this international union, and I am sure I can speak for every member of the international, is fully supporting the King-Anderson bill in every way possible."

Minnesota Council of State Employees, State, County & Municipal Employees Union Local 1011

"SC and ME Local 1011 assembled endorsed and supports the King-Anderson bill. We urge that you extend every effort to secure its passage."

Amalgamated Lithographers of America, Local 10

"Our organization, Amalgamated Lithographers of America, Local No. 10, has a program for its retired members who were previously covered by a jointly administered group program while they were working. The cost for the retired is in excess of $10 per month for the retired member and $10 per month for his wife, or a total cost in excess of $20. At the present time, the joint trust fund is providing one-half the program cost. As more and more people go into retirement it will not be possible for a fund of our small size to continue paying even part of the insurance program for the retired.

"I heartily endorse a broader program financed through social security which will meet the needs of the retired."

Hennepin County Welfare Employees, Local No. 34, American Federation of State, County & Municipal Employees

"The members of local No. 34, AFSC & ME, are very much interested in the passage of your bill for medical assistance to the aged under the provisions of social security because this would reach a great number of people who could care for themselves except for excessive medical bills. Most of the aged are able to pay their ordinary living expenses, but find themselves unable to meet hospital and physician care. We believe that this condition can be alleviated by the enactment of your medical care under the social security bill."

Letters of support also came from the United Automobile Workers of America, Amalgamated Local 125, and Communications Workers of America, Local 7200. These excerpts give the sense of the feeling of the overwhelming majority of the people that wrote me concerning the King-Anderson bill. I think I accurately reflect their views when I say that this type of legislation is essential for the welfare of the elderly and the peace of mind of those who love and care for them.

Mr. FRASER. Thank you.

The CHAIRMAN. We thank you, Mr. Fraser, for coming to the committee and giving us the benefit of your thinking.

Are there any questions of Mr. Fraser?

Mr. Burke?

Mr. BURKE. Congressman Fraser, the other day testimony was given here at this committee indicating that there was a condition prevailing throughout this country whereby doctors are sending elderly people into mental hospitals who are not mentally ill, but merely have reached an old age.

If this condition is prevailing wouldn't you say that it is bordering on being a national disgrace?

Mr. FRASER. Mr. Chairman and Congressman, let me say that this is a problem in our own State. We are committing many people to our State mental hospitals on the theory that they are too senile to take care of themselves.

The figures have demonstrated that too many of these die within 6 months after having been pulled out of their home environment and placed in a State institution.

This is a disgrace because we have no acceptable alternative to offer to those who find that the care of these people has become too difficult. I think that this demonstrates very forcefully the need to provide better facilities, and in the home community, for these people who ought not to be in mental hospitals-they have no business being there but who cannot be taken care of by their own family. They have reached a point where it is just not possible for this to be done. Mr. BURKE. But you understand that a person to be admitted to a mental hospital, a doctor has to certify that that person is mentally ill, and when a doctor does this and does it with the knowledge that this person is not mentally ill he does this for compelling reasons.

Of course I can understand why he does it, because there is actually no other place he can send this poor person.

Mr. FRASER. Yes, and I would say that probably the doctor does this most often at the request of the family or next of kin of the person involved. I think probably each State differs as to what qualifies a person for commitment, but my recollection is that in Minnesota senility is somehow written into our statute. I just don't recall it specifically.

I sat as an attorney in the Hennepin County office that provides for these commitments. I was representing persons committed and I found that too often it becomes just a practical judgment as to whether they can survive in the outside environment or not and what alternatives or options are open.

I think this entire problem could be correctly described as a national disgrace. I don't know that I would be willing to put the finger of blame on the doctors, however. My impression is that most doctors are trying to be helpful and to work with the families involved.

Mr. BURKE. I am not trying to put the blame on the doctors. I am placing the blame I think, on all of us. It is a responsibility that the entire Nation shoulders in very aspect. Our newspapers, our news media, our public officials, our doctors, our medical societies, everyone shoulders a blame and a responsibility for this terrible condition that exists in this Nation today, and I hope that when the AMA testifies here today they will come up here with some recommendations on solving this problem.

Thank you very much.

Mr. FRASER. Thank you.

The CHAIRMAN. Mr. Curtis.

Mr. CURTIS. Wouldn't you say that the answer to this particular problem is more adequate facilities-nursing home-type facilities— also registered nurses, and so forth?

Mr. FRASER. Mr. Chairman and Congressman, I agree with you, but I think you have to move one step back. In our community, we have, and this is true of most communities, the proprietary nursing home run for profit.

Mr. CURTIS. You have both.

Mr. FRASER. And the church affiliated or nonprofit nursing home, sometimes owned by the community. The problem is that the owner of a proprietary nursing home is not going to expand his facilities or is not going to enlarge the facilities or building new ones unless he thinks there are paying clients.

My point is that two-thirds of the paying clients are financed by welfare today.

Mr. CURTIS. Let me interrupt to say are you aware of the tremendous increase in the construction of private nursing homes in the past 3 years? I know it has been very great in my own State.

I have seen the national figures and I think they will be here for the record. I don't know of any field where there has been as much activity on both scores, one, your nonprofit, where we have the Hill-Burton, and the other, the profit institutions.

I want to say that 3 years ago or 4 years ago, feeling that this was a tremendous need, I helped to get through the FHA guarantee for nursing home construction that met high standards, and what pleases me immensely is that since that time we have had this tremendous increase and now the FHA technique is being put aside and conventional loans are being made to further this great construction.

We haven't done enough, in my judgment, but because this point was raised, and I think it is a very pertinent one, so often we think that the problem can be solved by simply, as I described it, throwing money at it, when if it is really lack of facilities, we have to then figure out how best to get the facilities and skills.

It may mean that money is needed in the area of providing facilities or in the training of skills, but it doesn't do the job unless we first identify what the need is and I think this is a very, very real problem.

I think we have been using our mental institutions as dumping grounds, but the answer I think primarily lies in the facilities. I think the point you are making is pertinent, that it may be, too, the ability of people to pay undoubtedly that lies behind it, and I would go into that problem, too. That is why I responded to the gentleman by saying that there is a tremendous increase in the construction of not only the nonprofit nursing home, but the profit type as well, because the clientele and the people who can pay apparently are there.

Mr. FRASER. Mr. Chairman and Congressman, I think the problem, and this, of course, I am sure you won't argue with, is you get two classes of clients who are able to get into nursing homes, those who are quite affluent, because if you are in a nursing home very long and require any level of medical supervision it is very expensive. Mr. CURTIS. Oh, no.

Mr. FRASER. It is in our community.

Mr. CURTIS. This is what I would like to look into.

Put it this way. We use terms instead of the actual figures. Let's get to the record, and I think we are going to, and if you can get it for me for this record in Minneapolis what the rates run, fine, because I have seen the statistics on many and they run around $200 a month, but some less.

There are some nursing homes, that are good ones too, around $150, but these schedules may vary. I don't know what they are in Minnesota and Minneapolis, but we do need to know that and then relate that to the budgets of these older people to identify the group that will fall in the category that you are concerned about and I am

too.