The question, Should physicians be included in the Federal social security program? Yes, 3,964. No, 1,962. Blank, 41. I further certify that of those voting a majority requested that physicians be included in the Federal social security program, indicating approximately a 2 to 1 vote. Whereas the poll by the State medical society shows 3,301 opposed and 2,780 for, a vote of about 5 to 4 against. When this issue was before the committe last year, I only knew of the poll by the State medical society and I then voted in committee against the inclusion of physicians. Later the poll by the Honest Ballot Association, which had not been introduced as evidence, came to my attention, and as a result, although there was not a rollcall, I voted for the inclusion on the floor of the Senate. Now, do you say, therefore, that over 60 percent of the physicians polled in these various studies have voted for inclusion under social security? Dr. SCHAMBERG. Voted for compulsory inclusion. Senator DOUGLAS. Compulsory inclusion? Dr. SCHAMBERG. Might I say, Senator Douglas, that the Pennsylvania State Medical Society and its house of delegates has been uniformly, throughout the years, very violently opposed to coverage of physicians under social security? Senator DOUGLAS. And yet you say Dr. SCHAMBERG. I am referring to your question as to whether or not we signed the postcard ballots. I would say knowing the State society was so opposed, if any man were concerned at idenifying himself as being not in concert with the State society he would be afraid to sign that he favored, and would not be afraid to sign that he did not favor social security for physicians. Senator DOUGLAS. This is the point I am trying to establish. It is well known that the hierarchy in the American Medical Association and in most of the State associations is opposed to compulsory inclusion under Federal social security, and the question which I want to raise is whether there were identifying marks on the polls taken by the State associations which might make individual doctors fearful of voting for inclusion. Can you furnish for the record copies of the ballot taken in Pennsylvania and make a summary of the form of the poll in other States? I think in all fairness copies of the statement I am requesting should be made available to the American Medical Association so that they may make any reply which they deem proper. Dr. SCHAMBERG. I have here a copy of the latest poll taken in the State of Pennsylvania, but as I understand it you would like— Senator DOUGLAS. This is April 28, 1965. Now, this seems to be a poll from the Pennsylvania Medical Society. The results differ somewhat from yours. What is the distinction between covered and noncovered? Dr. SCHAMBERG. Many physicians who have part-time employment, salaried employment are covered by social security. Senator DOUGLAS. I see. Then this report, under date of April 28, 1965, only a few days ago, signed by David H. Small, administrative assistant, Pennsylvania Medical Society, states that there were in favor 4,729, opposed 3,730, or 55 percent in favor, 43 percent against, 1.7 percent, no opinion. Your results seem to show 5,605 in favor, 3,335 against. And I am going to ask that this letter, which purports to be from the Pennsylvania Medical Society, be included in the record. I think this is very significant testimony because it comes from the association which is officially, I take it, opposed, yet it reports a poll of its members in favor. (The letter referred to follows:) Mrs. ERNA M. LAVES, 102 Connett Place, South Orange, N.J. PENNSYLVANIA MEDICAL SOCIETY, DEAR MRS. LAVES Since I work closely with our policymaking bodies within whose primary area your question falls, Mr. Perry has asked me to answer your recent inquiry concerning our position on the inclusion of self-employed physicians under social security. You've also asked for the results of the poll of the membership which was conducted on this question. The last poll of the membership on this issue was conducted in 1961 at the direction of our house of delegates. Cards were mailed to the then 10,350 active members of the society, and a total of 8,636 physicians replied. Of these replies, 39 could not be classified because of incomplete answers. The results of the poll were as follows: In 1963, the House of Delegates considered the following resolution: "Resolved, That the House of Delegates of the Pennsylvania Medical Society instruct the delegates from the Pennsylvania Medical Society to the House of Delegates of the American Medical Association to present and support at the next meeting of the House of Delegates of the American Medical Association a resolution favoring compulsory social security for physicians." The house voted to reject this amendment. Sincerely, DAVID H. SMALL, Administrative Assistant. Senator DOUGLAS. Do you have any more evidence on this point? (See pp. 962, 963.) Dr. SCHAMBERG. I feel that there is absolutely no question, based both on State polls, based on a recent 1965 poll carried out by a medical magazine known as Medical Economics. Senator DOUGLAS. You never mentioned that before, the poll by Medical Economics. That was not included in your body of your testimony. I would like to hear about that. Dr. SCHAMBERG. I would be very happy to submit this for the record. This is 1965. A sampling was requested by Medical Economics, saying, "Do you already have some social security coverage as a result of past or present employment? Yes, 53.5 percent. No, 38.3. Don't know, 8.2. "If you already have some coverage, some social security coverage, how do you feel about it." Of those who responded, 47.8 percent stated that they were glad to have it and wanted more; 33.5 percent said they were glad to have it but did not want any more. Adding those two figures 81.3 percent of the physicians who had some social security coverage were glad that they had it. The other two categories were "Would prefer not to have coverage," 16.7, and "Mixed feelings, 2 percent." Senator DOUGLAS. What about those who were not covered, the independent practitioners? Dr. SCHAMBERG. This is interestingly difficult. The question was asked, "If you do not already have some social security coverage do you want coverage for yourself?" 50.4 percent, just over a majority, said "Yes;" 28.6 percent said "No;" 11 percent were undecided. Senator DOUGLAS. Would you have copies of that made and submitted for the record? Dr. SCHAMBERG. I will be happy to submit this now. Mr. Chairman, I request that this be made a part of the record. (The information referred to follows:) [Medical Economics, Mar. 8, 1965] SOCIAL SECURITY NOW? MOST SELF-EMPLOYED M.D.'S ALREADY HAVE SOME "Do you already have some social security coverage as a result of past or present employment?" "If you already have some coverage, how do you feel about it? Source: MEDICAL ECONOMICS' survey of self-employed M.D.'s, 1965. "I still feel that Congress may amend the Keogh Act to provide more favorable retirement benefits for self-employed doctors. Once we accept social security, that possibility is gone." "We'll never get to use it. Most of the physicians in small towns will never get to use their social security (if they have it) because of the shortage of physicians and the unwillingness of most practitioners to quit working when their patients still need them." "We conservatives are licked, so we might as well go along with socialism until the majority becomes intelligent enough to kick it out." "With my family, social security would be worth $50,000 in insurance." "It seems impractical, if not unjust, for the Government to exempt a special group from laws that apply to everyone else." "An M.D. in his early 70's died recently. At one time he had been well-fixed financially, but he died broke, and our county medical society had to bury him. Social security would have been a Godsend for this man." THE OUTS WANT IN-BUT JUST BARELY "If you do not already have some social security coverage, do you want coverage for yourself?" CONSENSUS: IT'S COMING, LIKE IT OR NOT "Regardless of whether you favor or oppose social security coverage for all self-employed M.D.'s, do you believe they will be included in the social security program?" Yes__ No----- No opinion-‒‒‒ Percent 64. 1 17.9 18. 0 Senator DOUGLAS. Do you know something about Medical Economics? How would you characterize it generally? Dr. SCHAMBERG. Medical Economics is a journal which appears twice a month or every 2 weeks dealing with the medical coeconomic side of medicine. It, I feel, is a very honest magazine, it goes free to every practicing physician in the country. Senator DOUGLAS. Free? Dr. SCHAMBERG. Free. Senator DOUGLAS. Who bears the cost? Dr. SCHAMBERG. The costs are paid by the advertisers, and since the drug advertisers are more interested in advertising in a journal read by many physicians, Medical Economics, with its excellent staff proves of great interest to the majority of the physicians I know, and to myself. Senator DOUGLAS. What board runs it? Dr. SCHAMBERG. It is published in Oradel, N.J. Dr. SCHAMBERG. I believe so. Senator DOUGLAS. And if the income exceeds expenditure who gets the net profits? Dr. SCHAMBERG. I certainly do not. Senator DOUGLAS. I know you don't. does? Dr. SCHAMBERG. I really do not know. And I don't know. But I mean do you know who Senator DOUGLAS. Has it been regarded as a radical crusader for coverage of physicians under social security? Dr. SCHAMBERG. Definitely not, Mr. Douglas. In fact, like the letters in pages in Time, they are equally accused of being to the right and to the left. Medical Tribune is another tabloid type of newspaper sent at no charge to all physicians, and their nationwide poll, based on scientific sampling of possibly 2 years ago, agreed with the poll, with the two polls, the Medical Economics that most doctors of medicine want to be included under social security. Senator DOUGLAS. Would you submit that for the record? (The material submitted follows:) (Telegram subsequently received from Committee on Social Security for Physicians, 510 Madison Avenue, New York, N.Y., giving the following information regarding the poll of Medical Tribune: Medical Tribune poll conducted July 24, 1961. This was a nationwide, scientific cross section including physicians from all areas of the United States. All major types of practice, urban, rural and suburban communities. Poll was anonymous; 57.7 percent voted yes with heavier banking by physicians over RP. Documentation follows.) [From Medical Tribune, July 24, 1961] TRIBUNE PULSE OF MEDICINE REPORT-57.7 PERCENT OF PHYSICIANS VOTE "YES" ON M.D. SOCIAL SECURITY COVERAGE Social security coverage for self-employed physicans is favored by 57.7 percent of the 1,220 physicians who participated by responding to a Medical Tribune Pulse of Medicine poll on the issue. A total of 5,000 physicians in private practice received Pulse questionnaries to express their views. They represent a national cross section of Medical Tribune readers-physicians in all areas of the United States, in all major types of practice, and in urban and suburban as well as rural communities. The poll was completed during the week that the American Medical Association's House of Delegates voted 147 to 29 against compulsory inclusion of physicians and rejected (in a separate vote) a resolution asking for a nationwide poll of physicians. A summary of the poll's result according to age, community, and practice appears on page 24. Heavier backing for social security coverage comes from physicians 40 and and over rather than those under 40, and from urban and suburban rather than rural M.D.'s. Among specialty groups, only surgeons are opposed by a majority vote. Less than half want coverage, in contrast with more than 70 percent of dermatologists and psychiatrists. Geographically, proponents are most numerous in the Northeast, least numerous in the South. Offered a choice of statements about social security, many gave multiple answers but half agreed that all professional people should be covered; twofifths, that retirement is an individual problem; two-fifths that social security is actuarially unsound. About one-fifth think that social security for physicians would be a step toward socialized medicine; less than one-tenth, that the social security idea is good but not for physicians. Information made available by medical organizations and journals was cited by just over half as a major influence in helping them reach their conclusions. |