Lee, Russell V., M.D., Lee Clinic, San Jose, Calif.. Prepared statement----. Long Ernest C., Aletha Lodge, prepared statement-- McLain, George, chairman and president, respectively, California Institute of Social Welfare, and National Institute of Social Welfare Los Angeles, Calif__ Page 888 886 992 825 Prepared statement.. 821 McNamara, Hon. Patrick, a Senator from the State of Michigan___ 767 866 Metcalf, John R., president San Francisco Homemaker Service, prepared statement.. 1003 Meuer, Mrs. Elizabeth T., prepared statement.. 995 O'Dwyer, Rt. Rev. Msgr. Thomas J., trustee, Catholic Hospital Association, prepared statement... 986 Perluss, Irving H., director, Department of Employment, State of California, prepared statement.. 805 Pieroy Mrs. Lloyd, prepared statement.. 1002 Price, Maj. Helen, Volunteers of America, Sunset Club, Long Beach, 983 Reding, Clarence, president, California Association of Nursing Homes, 854 851 Reid, James W., prepared statement- 1002 Reynolds, T. Eric, M.D., president California Medical Association__. 877 997 Ross, Arthur M., director, Institute of Industrial Relations, University of 803 Prepared statement.. 801 Russell, Mrs. A. M. G., chairman, California Citizens' Advisory Committee on Aging, Atherton, Calif.. 844 Prepared statement- 840 Samuel, Riley, prepared statement_ 1007 Schiffman, Beatrice C., director of services to older adults, San Francisco Council of Churches, prepared statement....... 993 Seaquist, Joe, prepared statement_ 1007 Shneidman, Dr. Edwin S., central research unit, Veterans' Administration 978 Prepared statement--- 970 Sloate, Nathan, Department of Mental Hygiene, Sacramento, Calif. 862 996 Smith, Earl W., Earl Smith Development Organization, El Cerrito, Calif. 835 818 Prepared statement_. 817 Sox, Ellis, M.D., director, County Health Department Health Center, San 929 Prepared statement____ 927 Stewart, Cecil A., executive secretary, California Pharmaceutical Association, prepared statement__ 988 Trager, Brahna, director, San Francisco Homemaker Services___. Vial, Don, assistant to the secretary-treasurer, California Labor Federation, AFL-CIO, San Francisco, Calif.... 797 Wedemeyer, J. M., director, Department of Social Welfare, State of California__. 771 Prepared statement-- 770 Weinstein, Dr. Harry, Mount Zion Hospital, San Francisco, Calif.. 938 869 Welch, W. A., prepared statement--- 998 Williams, Mrs. Myrtle, secretary-treasurer, California Institute of Social 826 THE AGED AND THE AGING IN THE UNITED STATES WEDNESDAY, OCTOBER 28, 1959 U.S. SENATE, SUBCOMMITTEE ON PROBLEMS OF THE AGED AND AGING, San Francisco, Calif. The subcommittee met, pursuant to notice, at 10:05 a.m., in the Nourse Auditorium, Hayes Street, San Francisco, Calif., Senator Patrick McNamara (chairman) presiding. Present: Senators McNamara and Randolph. Subcommittee staff members present: Sidney Spector, staff director. Committee staff members present: Stewart E. McClure, chief clerk; William G. Reidy, professional staff member; and Raymond D. Hurley, minority professional staff member. Senator MCNAMARA. The hearing will be in order. The complex problems faced by millions of American men and women who have stepped over the threshold of middle age into the so-called golden years were brought into sharp focus at our regional hearings recently held in Boston and Pittsburgh. These problems should be of vital concern to all age groups-for old age is the destiny of an increasing number of Americans. But for many of our senior citizens, anxiety appears to be the dominant theme. Financial insecurity probably heads the list of problems of the aged. The average income of the man of 65 is less than half of that of his neighbor who is between 45 and 65. Over one-fourth of the older men and nearly half of the older women subsist on incomes which are below that which is considered as substandard subsistence level. Three-fifths of our older people have incomes of less than $1,000 a year. Of the 16 million Americans aged 65 and older, only one in five has a paying job. If a man has the misfortune to lose his job at the age of 45, his chances of finding new employment are slim. The impact of automation on the employment structure has undermined especially the status of the older worker. An area of constant concern for older people is that of health. An older person spends more on health services than a younger person does, and this comes at a time when income has been sharply reduced. The aged use more hospital care, but two-thirds do not have any hospital insurance. Very few of the aged have comprehensive health insurance. Many of the aged live in totally inadequate rooming houses, often located in the slums. At our grassroots hearings we have come face to face with the real life situations. We have talked with the older people themselves to get their views on the many-sided problems of aging-and their comments have given us valuable insight. We visited the aged in hospitals, nursing homes, housing developments, and lodging houses. Here and there we saw encouraging signs of progress. But we also saw dismaying situations in nursing homes, rooming houses, and skid rows. It would appear that for many older men and women the cards are stacked against their enjoying a comfortable, satisfying, and meaningful American standard of life. We came away with a broadened perspective and a strengthened determination to come to grips with the total problem and recommend a constructive course of action geared to making the golden years worthy of the name. Despite the fact that a pitifully low income is a pressing problem, this thought was repeatedly expressed by the senior citizens with whom we talked: "We don't want charity. What we do want is the opportunity to help ourselves.” The automatic shelving of men and women at the black magic age of 65 represents a wanton waste of skilled manpower. From a practical standpoint, this represents a tremendous loss of human resources, a loss our Nation can ill afford. It is true that increased use of automation may result in fewer jobs. However, should fewer people be needed for work in factories and offices, more manpower will thus be available for urgently needed human services-if proper programs are undertaken. The mature man or woman with wisdom accumulated from years of living would be ideally suited to work of this nature. For the individual who is still vigorous, ambitious, and anxious to serve, permanent inactivity can be considered a major disease. Let's do away with the stereotype of the person over 65 as a doddering, weak individual who is incapable of doing little more than languishing in the proverbial rocking chair. This myth was directly attacked at our Boston hearings by a medical researcher who reported that, contrary to the accepted notion, at least 80 percent of the older people are physically and mentally capable of carrying on useful activity. Two out of every three people aged 65 today can expect to live to be at least 75; one out of every four will celebrate an 85th birthday. The important question is this: What will be the quality of these added years? The Government can help to give purpose and pattern to these years by encouraging and stimulating activity on the part of our older citizens-activity which is more than "keep busy" work but is, instead, a vitally needed contribution to the common good. For example, if our social security benefits were raised to a point at which a decent level of living were assured to the aged, they would have an economic base from which to engage in productive retirement activity. There are 1,200,000 Californians who are 65 years or older. The magnitude of the problem faced by the State becomes apparent with this statistic: 1 out of every 12 aged persons in the Nation lives in California. California can be proud of the headway that has already been made. Just to cite a few examples: California led the way in calling a Governors' conference on aging. California also pioneered by setting up a permanent State commission on aging with a full-time staff. Old-age assistance benefits provided by California are among the most liberal in the Nation. The medical care program for the aged in this State, with its consistently high standards and comprehensive services, has set a fine example for the rest of the Nation. California has also served as a proving ground for the Nation in its establishment of senior citizens' centers. I am pleased to see evidence of increasing activity on all levels— local, State as well as Federal-directed toward meeting the needs of the aged. The White House Conference on Aging which is scheduled to convene in January of 1961 can also serve as an important effort for studying the problems of aging. We in the Congress are concerned that the objectives we enunciated in adopting this legislation will be realized. What is done or is not done-in the next few years will have farreaching effects on every one of us, regardless of age. Wise action now can help to make the later years for all Americans meaningful— and truly the harvest years. Senator Randolph, do you have anything to add at this point? Senator RANDOLPH. Mr. Chairman, it is a privilege to be in California today and to accompany Senator Pat McNamara, the chairman of our subcommittee, for hearings on this challenging subject at the national legislative level, assigned to six members of the Senate by that body. It is not important for me to speak at this moment. We are rather tardy in beginning the hearing today. I wish to say only for the record that these so-called twilight years should be useful years. We, as a people, have been squanderers of many of our best resources, both human and natural, in the United States for a long period of time. Certainly, the senior citizens of the United States can, by stimulation, by certain proper direction, and by a very carefully planned program carried forward at all political subdivision levels, be aided, in degree, by government. It is for this purpose that the subcommittee came to San Francisco. Senator MCNAMARA. Thank you, Senator Randolph. We also have a wire from Senator John F. Kennedy of Massachusetts, a distinguished and important member of this subcommittee. Senator Kennedy is extremely sorry he could not be here with us today but I know that he will give careful study to the testimony of today and tomorrow. He has long been profoundly interested in the problems of the older citizens of this country and has made and will continue to make great contributions to the improvement of their conditions and status. Our first witness this morning will be Mr. J. M. Wedemeyer, director of the department of social welfare. I understand he is accompanied by Assemblyman Phil Burton, chairman of the California Legislature's Committee on Social Welfare. Will both those gentlemen be seated at the other table, please? We are very glad to have you here, Mr. Wedemeyer. We know that you have a prepared statement for us. We want to have it printed at this point in the record in its entirety. (The prepared statement of J. M. Wedemeyer follows:) PREPARED STATEMENT OF J. M. WEDEMEYER Gentlemen, may I begin by stating in behalf of Gov. Edmund G. "Pat" Brown his keen interest in your proceedings here and in the problems with which you are concerned. I shall not attempt to speak for him in the broad sense other than to say that he believes that everyone of the 14 million senior citizens of this State should have the right to expect decent housing, a reasonable income, and access to those health and related services which will let him continue enjoying the prerogatives of free and honored citizens. You are already quite aware of the kinds of limitations which restrict this opportunity in many ways and you will receive many more details during your stay here. As director of the department of social welfare I think I can best discuss our particular concerns as expressed through the programs administered by my department. My department has in the past been concerned primarily with two major aspects of services for older people. These are the program of old age assistance and the protective services involved in licensing and supervision of certain kinds of living arrangements used by older people in general as well as by the recipients of assistance. We in California have thought of our programs as progressive, liberal, and understanding when it comes to consideration of our senior citizens. Over the years we have expressed this in terms of the financial benefits provided under the old age assistance program. As a consequence California has invested a very heavy portion of its total public welfare dollars in underwriting a basic standard of living for a comparatively large number of our older people. In terms of basic living needs these have compared favorably with provisions made in most of the large States. Old age assistance is given as well to a greater number of aged people than in most other larger industrial States. Actual payments approximate $84. However, this is an understatement since California has traditionally allowed those who have had income from other sources to apply this when needed to items which would not be otherwise applied. The result has been that under this program we have underwritten a standard comparable to more than $110 a month, and this will shortly be increased due to recent legislation. While over the years these liberal provisions have assured a large number of older people of the basic security they need, they have also tended to obscure from public view many needs for which such payments are not adequate. The increasing importance of reconsidering methods of meeting these needs has been made extremely clear during the last few years with the rapid growth of the old age and survivors' insurance program. For example: In 1950 this State granted old age assistance to some 30 percent of the population 65 and over. Less than 4 percent of these recipients required out-of-home care. In 1959 due to the effect of the old age and survivors insurance program only 22 percent of our senior citizens require old age assistance, but more than 8 percent of these require out-of-home care. In other words, during this 9-year period the dependency rate for old age assistance has decreased 27 percent but the number of recipients who need out-of-home care has more than doubled. This, I think, is sufficient to illustrate the importance that attaches to increasing the portion of the total public expenditure which is devoted to: 1. Insure a proper standard of facility and service. 2. Realize a maximum of rehabilitative results. 3. Prevent the kind of physical and mental deterioration which often leads to such needs. This concentration of people on our assistance rolls who are there because of special needs represents a problem which cannot be underwritten in the usual sense by the existing public assistance program. But important steps have been taken. Prior to 1957 State responsibility for meeting these needs was acknowledged only to the extent the person had other sources of income. Any additional cost for those who had no income were met, if at all, through local agencies. In 1957 the State took its first step in acknowledging responsibility when it made a limited provision by which grants |