as a delegate from the Philadelphia County Medical Society to the State medical, I introduced a resolution, as I mentioned before, asking that the Pennsylvania Medical Society instruct its delegates to the House of Delegates of the American Medical Association to request the AMA to come out in favor of social security for physicians.

I stood up on the floor of the House of Delegates of the Pennsylvania Medical Society and said:

If well over 60 out of a hundred of all the physicians in Pennsylvania voted in the secret mail ballot-voted in the mail ballot which I believe was secret in favor of social security-I think there must be many men here who are delegates who favored social security. I would like to ask these men to have the courage of their convictions and to stand up and be counted, and I, therefore, request of the speaker that a standing vote rather than a voice vote be carried out.

Senator DOUGLAS. How many stood up?

Dr. SCHAMBERG. I sat down. The speaker said: Well, this would require a motion, so from way off in the end of the hall, I couldn't see who it was, someone said, "I move that we have a voice vote."

Immediately there were at least 2 dozen seconds to that motion and it was overwhelmingly voted. There was a voice vote and the men who I am sure had voted in favor of social security coverage in the privacy of their own offices, were unwilling to stand up and be counted. I think this is germane to your question as to whether or not our postcard votes were signed.

If they were signed the results would have been more opposed to social security because apparently from my experience in the State society a number of physicians for some reason or other are unwilling to be identified.

Senator DOUGLAS. Will you verify the question as to whether the ballots circulated by the Pennsylvania Medical Society were such that the individual could be identified, whehter by number or name? Dr. SCHAMBERG. I will, indeed, and may I make sure that I have all of the data that you wish? You would like me to explain the difference between the Pennsylvania poll printed with my testimony and the numbers

Senator DOUGLAS. Both were in favor of inclusion?

Dr. SCHAMBERG. Yes.

Senator DOUGLAS. But the majority under your poll, which you cited, was much greater.

Dr. SCHAMBERG. You would like the explanation for the difference between those. You would like

Senator DOUGLAS. Was your poll conducted by the Honest Ballot Association?

Dr. SCHAMBERG. No. Both polls in Pennsylvania-and the difference may be that one of these refers to one poll and the other to the other poll-both polls in Pennsylvania in which the majority favored social security coverage were conducted by the Pennsylvania State Medical Society.

Senator DOUGLAS. Did the Pennsylvania Medical Society disown the first poll which gave a large majority for inclusion? Have they published it officially?

Dr. SCHAMBERG. Oh, yes; the results of both polls have been published and I can can get those for you very easily. You would also

like the results of the first poll taken by the magazine, Medical Economics.

I turned over to you the results of the second poll, and you would also like the results of the poll made by the medical tabloid newspaper, Medical Tribune, and you would like to know how many counties in New York.

Senator DOUGLAS. And in particular whether the big metropolitan boroughs were included.

Dr. SCHAMBERG. I know that the Borough of Manhattan was included, and was overwhelmingly in favor of social security coverage. (The following was later received for the record :)

MRS. ELIZABETH SPRINGER,

Chief Clerk, Senate Finance Committee,

JENKINTOWN, PA., May 18, 1965.

New Senate Office Building, 2227, Washington, D.C.:

Pennsylvania Medical Society held two mail polls on compulsory social security

for physicians; both anonymous.

1961, 4,729 favored; 3,720 opposed.

In 1959, 5,605 favored; 3,335 opposed.

In

IRA LEO SCHAMBERG, M.D.

Senator DOUGLAS. Thank you.

In the absence of the chairman I will call the next witness, please, Mrs. Gertrude S. Rost, of Orange, N.J.

Doctor, won't you sit up with Mrs. Rost?

STATEMENT OF MRS. GERTRUDE S. ROST, ORANGE, N.J.

Mrs. Rost. Mr. Chairman, and members of the committee, my name is Gertrude Sander Rost. I am the wife of Dr. Adolf S. Rost, a physician in private practice in Orange, N.J. Our son, Dr. Michael S. Rost, is a physician in Freeport, Long Island, is married, and has three children. Therefore, the desire of physicians for inclusion under social security and their need for it are familiar problems for me, from the retirement, as well as from the survivor benefit point of view.

Six years ago a physician's wife in my neighborhood told me about her husband, an M.D. in Newark, N.J., who had long been suffering from a chronic illness; he tried to practice part time but was finally forced to stop altogether.

Unable to leave him alone for more than an hour or two, his wife could not take a job. After a few years, they had spent their savings and are now entirely dependent on their only child, a daughter, who earns a modest living as a secretary.

"When do you think, Mrs. Rost, physicians will finally get social security?" she anxiously asked me. I did not have the heart to tell her that whenever it might come, it would be too late for them because her husband was no longer in practice.

Senator DOUGLAS. Mrs. Rost, this is true so far as cash benefits are concerned, but hospital and nursing home costs would be blanketed in. So he would be blanketed in under the provisions of the so-called medicare bill, plan A, and also on payment of $3 a month he would come in for medical and surgery benefits.

Mrs. Rost. This was 6 years ago when I talked to her.

47-140-65-pt. 2--29

Senator DOUGLAS. YES.

Mrs. Rost. It was then that I decided to do something about it. Serious illnesses, especially heart attacks, seem to be frequent among middle-aged physicians, perhaps because of long hours, tremendous responsibility, and tension connected with their work. I have here a letter from Dr. H. C. Van der Meulen, of Pella, Iowa. Dr. Van der Meulen counted the physicians who died in 1964, as listed in the Journal of the American Medical Association and discovered that 40 percent had died before the age of 65. A tragic and dramatic. example of this was the sudden death last year of Dr. Welch, then president of the AMA, who died at the age of 60, shortly after testifying before this committee.

More than half the retired M.D.'s who responded to a recent spot check by the magazine, Medical Economics, said they were forced out of practice for reasons of health, typically at the age of 68.

These facts certainly contradict the main argument against coverage of the AMA that doctors don't retired before the age of 72 and social security would be of little or no benefit.

The same Iowa physician, in another letter, refers to himself as belonging to "the little people." Coming from a physician, this may sound strange to many ears as the public image of the American physician is one of a man of almost limitless means. Certainly there are wealthy physicians; many others make a good living; others yet a modest one. There just is no universal picture as to physicians' financial circumstances and even the wealthiest one is as vulnerable to the hazards of life as everyone else.

The voices of physicians who want and ask for the protection of social security are growing louder and louder-in letters to Congress, in letters to the editor, and in medical publications.

I have here a short editorial, which I also respectfully submit to this committee, written by a physician in the Westchester County Medical Bulletin, New York, from which I quote:

The longer we delay acceptance [of social security], the more of us will retire, the more will become disabled, the more will die leaving young families without adequate savings and without the solid benefits currently taken for granted by virtually all our fellow citizens.

Senator DOUGLAS. Mrs. Rost, do you have the text of this editorial? Mrs. Rost. Yes.

Senator DOUGLAS. Will you submit that for the record?

Mrs. ROST. Yes.

(The editorial referred to follows:)

[Westchester Medical Bulletin, Westchester County Medical Society, April 1965]

THE NOSE AND THE FACE

In all our deliberations it is curious that there seldom arises a question which profoundly affects the financial position of all physicians, singly and collectively: our exclusion from social security. The matter is again to be considered for congressional action and it's high time it were openly discussed.

Social security is not only a very low cost retirement plan; it is also nononsense permanent disability and life insurance. Every other profession has accepted the plan; but exuding an aura of impenetrable wisdom, we, like the cheese, stand alone. Let us be realistic. In America of this midcentury it is difficult, often impossible, to accumulate capital equal to that represented, at 4 percent interest, by maximum social security benefits. For man and wife it

And that
Provided

amounts to at least $50,000, after taxes. "After" taxes, doctor. 4 percent interest is itself taxable. Social security payments are not. through private insurance, such income for retirement, for permanent disability, for one's widow and minor children would be staggeringly expensive. Whatever the reasons for our past rejection of social security, they could hardly have been economic; if moral, they could hardly have escaped the quixotic. The longer we delay acceptance, the more of us will retire, the more will become disabled, the more will die leaving young families without adequate savings and without the solid benefits currently taken for granted by virtually all our fellow citizens. It would be sheer obtuseness for any physician to fail to study objectively both the provisions and limitations of the plan. The time for decision comes again and concise information is readily available at your nearest social security office. The Advisory Committee on Social Security strongly recommends our inclusion; the House Ways and Means Committee approves. But the Senate Finance Committee is opposed, largely because of our past official position. And, therefore, doctor, never send to know whose face the nose spiteth; it spiteth thine own.

Mrs. Rost. In this connection I would like to read for you a letter of which I have a photostatic copy. It was written by the president of our New Jersey State Medical Society on September 11, 1964, to the chairman of the House Ways and Means Committee. While stressing his opposition to medicare, he writes to Mr. Mills:

For your information and guidance, I also would like you to know that the Medical Society of New Jersey urges the inclusion of physicians under social security.

Senator DOUGLAS. Would you submit that letter for the record? (The letter referred to follows:)

THE MEDICAL SOCIETY OF NEW JERSEY,
Trenton 8, N.J., September 11, 1964.

Ion. WILBUR MILLS,

Chairman, Ways and Means Committee,

House of Representatives Office Building, Washington, D.C.:

As president of the Medical Society of New Jersey, I thank you and commend you for consistently resisting the indiscriminate inclusion under the social security program of limited hospital services for all social security beneficiaries over 61 years of age. In the name of all our members and of our women's auxiliary, I beg you to continue to resist such undesirable and unfair legislative action.

For your information and guidance, I also would like you to know that the Medical Society of New Jersey urges the inclusion of physicians under social security. We do not oppose social security, therefore, as such; but we do oppose the so-called medicare program. Thank you for your fine work.

CHARLES CALVIN, M.D., President, Medical Society of New Jersey.

Mrs. Rost. I told this committee last year that most medical societies have some system for aiding needy physicians and their families or survivors. I am most aware of the situation in three States: New Jersey, New York, and Pennsylvania.

In New Jersey there is the Society for Relief of the Widows and Orphans of Medical Men of New Jersey. I have here a fund-raising letter from the Physicians' Home in New York, dated May 15, 1964, which states that, at the current rate, the monthly assistance to indigent doctors and their wives, widows, and dependents would exceed the previous year's aid by about 12 percent.

The most moving stories are provided by the Aid Association of the Philadelphia County Medical Society. Page 2 of the 1963 annual

report explains that "these are elderly physicians and wives or children who had no opportunity to contribute to social security etc. * * *, and who have exhausted their own resources."

Page 4 of the 1961 annual report tells of a 93-year-old physician and his wife, well over 80 years of age, who were granted desperately needed assistance. It took a great deal of persuasion on the part of the society to overcome the old people's pride.

Another report tells of a 35-year-old widow of a physician and her seven children who were also granted immediate aid. There are thankyou letters from elderly physicians' widows for a warm sweater or a used television set.

An 83-year-old physician's widow offers thanks for a Christmas check; the young daughter of a deceased physician, a college student, expressed gratitude for financial help; an elderly crippled physician and his wife give thanks for an increase in their monthly assistance I could go on and on with these stories, but in essence they are all the same, revealing proud people, hit by sickness, death, or other misfortune, and forced to accept charity which they would not need if they were not excluded from social security.

Senator DOUGLAS. Will you furnish the text of these statements. Mrs. Rost. I have them.

Senator DOUGLAS. From the Aid Assosciation of Philadelphia County Medical Association?

Mrs. Rost. I have the reports from Philadelphia and also have some papers.

Senator DOUGLAS. Mr. Chairman, I ask that these be made a part of Mrs. Rost's testimony.

Senator LONG. Yes.

(Mrs. Rost submitted four annual reports of the Aid Association of the Philadelphia County Medical Society, for the years 1960, 1961, 1962, and 1963, in which the cases referred to were mentioned. These annual reports were made a part of the committee files.)

Mrs. Rost. This brings me to a request which I respectfully submit to the members of this committee for earnest consideration, to have the inclusion of physicians under social security made retroactive as suggested by Dr. Schamberg. After so many years of anxious waiting, it seems cruel to see the door finally open and not to be allowed to enter immediately.

Young physicians, with small children, are particularly anxious to see social security coverage made retroactive. They are not yet in a position to carry substantial life insurance. Many of them are still repaying loans for their expensive education or for their equally expensive office equipment. They know that death may come to them just as unexpectedly as to anyone else and they want to be freed from their worry about their young families.

Please make physicians coverage effective January 1, 1965, just as the bill does in other cases, as for instance for benefits of children attending school beyond age 18. Since physicians file their tax returns by April 15 following their taxable years, there will be no problem of the taxpayment for every point of view. I repeat, please, do not let them wait for 2 more long and anxious years.

Considering the fact that physicians are the only professional group excluded from social security and have already waited for so many