comparison with the population of those 65 years of age and over. New York, of course, has the greatest population, and we are second with 14 million.

Here in California for many years the elderly people have been pretty active, and I had, of course, hoped that in all the phases of our activities, we might have an opportunity to present Mrs. Williams here with her views because she was a former State social welfare director. Incidentally, Mrs. Williams has her statement, if you will be so good as to have it printed in the record. I should like to make one correction. The statement says that she held this position in the State of California during 1948-49. It should be during 1949-50.

Senator MCNAMARA. With that correction, it will be printed in its entirety in the record at this point.

(The prepared statement of Mrs. Williams follows:)

PREPARED STATEMENT OF MRS. MYRTLE WILLIAMS, SECRETARY-TREASRUER, CALIFORNIA INSTITUTE OF SOCIAL WELFARE

Mr. Chairman, and members of the subcommittee, my name is Myrtle Williams. I am secretary-treasurer of the California Institute of Social Welfare, a nonprofit corporation dedicated to the needy aged of this State. I am a former director of the California State Department of Social Welfare, having held that position during 1949 and 1950.

I appear before you today to call your attention to the manner in which a giant bureaucracy has grown up around Federal-State public assistance programs, particularly in the field of old-age pensions. Wasteful duplications of services and duties, conflicting policies and a tendency toward "policing" the pension rolls have cruelly victimized hundreds of thousands of deserving old people in California. I assume the same is true in other States. Tax money is being shamefully squandered to perpetuate this Frankenstein's monster of redtape, while the old people are forced to exist from day to day on less than we pay to keep criminals in prison.

California's public assistance programs cost the taxpayers $40 million per year for administration alone.

How much better life would be for the elderly recipients of old-age pensions if some of this $40 million could be added to their meager aid checks each month. But bureaucrats jealously guard their welfare empires and woe to him who dares to tread on this hallowed ground.

In other words, California old folks are being sadly neglected while the mammoth administrative pyramid grows taller and taller.

One of the reasons for this is the dual administration system practiced in California public welfare programs. We have a huge State department of social welfare, with regional and district offices. It exercises supervisory authority over the various public assistance programs, including old age security, as we call our old-age pension in California. But we also have county welfare departments. Some of these are vast in size, too. Los Angeles County's bureau of public assistance is an example.

These county welfare departments actually administer the various public assistance programs on the local level. Old people must make their applications for aid at the county level. Investigations and determinations of eligibility are also made at this level. And it is the county who keeps in close contact with recipient throughout his case life, supposedly to make certain that all requirements are being met and that the law is being complied with. In practice, however, we find that the counties are much more interested in harassing these old folks off the pension rolls than in carrying out the laws passed by the Congress and the legislature of the State.

In fact, in some cases, the counties literally thumb their noses at the legislature if the lawmakers pass measures not to the counties' liking. This occurred in connection with our free medical care program, adopted by the State legislature 2 years ago. Several county boards of supervisors openly declared that they would not put the program into effect, on grounds that it was "socialistic." Up in Glenn County, one of the supervisors said, "We'll just thumb our nose at them," meaning the State legislators. The program is actually in effect in every

county of the State now, but it took precious time for some of these supervisors to resign themselves to the fact that the old people of California are entitled to the medical care voted for them by Congress and the State legislature.

Additional proof of how the dual-administration system penalizes the needy and old may be found in the files of our own welfare counseling service. The California institute, which is made up of elderly Californians, offers this free counseling service to all pensioners who come to us with welfare problems. Over the years, the California institute has recovered more than $300,000 which had been illegally withheld from oldsters by county welfare authorities. Often the money was held back on the flimsiest of pretexts, and the counties promptly settled when the California institute entered the case. At other times, it was necessary to carry disputes on appeal all the way to the State social welfare board. Needless to say, these wrangles cause anguish and hardship for the old people, and result in a shameful waste of tax money in the lond-drawn-out hearings, appeals, and so on. In fact, it has been estimated by the State department

of social welfare that each appeal carried to the State social welfare board costs the taxpayers some $500.

These are just some of the ways in which the bureaucrats in welfare persecute the needy and squander the taxpayers' money. I could cite other methods, but I know the committee's time is very valuable and the facts I have already disclosed should suffice.

As for a solution to the vexing problem of how to hold down welfare costs and improve the lot of the oldsters who must depend on Federal-State old-age pensions, I propose the following:

1. Federal legislation requiring every State to administer its public assistance programs on a statewide basis. This would eliminate county and municipal welfare departments for all but local welfare programs, and result in vast savings to the taxpayers. A hint of how great these savings would be may be seen in a recent statement by Thomas Bell, welfare director of Kern County. He said that the county's cost of administering old-age security cases now averages $5.13 per month. Think of it. The county spends $5.13 per month per case after all of the State's administrative work is done. Therefore, county administration costs alone represent a substantial percentage of the average monthly payment of $77.92.

Since Kern County's administrative cost is said to be representative of the State as a whole, we may assume that almost $12 million per month is spent by California's counties in processing and investigating 259,850 cases in the old-age security program. Over a year's time, this amounts to some $18 million. Most, if not all, of this outrageous waste of tax money could be averted if the public assistance program were administered by one agency-the State.

Not only would a tremendous sum of money be saved every year by the adoption of State administration, but efficiency would be improved. I believe I am qualified to discuss this subject, since I was director of the State department of social welfare during a 14-month period when we had State administration of social welfare in California. Although 14 months is a brief period upon which to base long-range conclusions, it is interesting to note that complaints, appeals, and disputes over welfare problems dropped significantly. This was because under the State plan, welfare programs were administered objectively, following both the letter and the spirit of the law, free of the restrictive influences of local politicians whose own beliefs frequently lag far behind the State and national policies in social questions. Costs were reduced, efficiency was improved, and recipients and taxpayers alike got a break. It was a pretty important break for the county taxpayers incidentally, amounting to some $24 million per year. This is the amount of local taxes paid for welfare programs before and after the period of State administration. During State administration, this money was provided by the State from a small increase in the sales tax. This small increase, by the way, remained in force even after State administration was discontinued. I believe it now goes into the general fund. So the county taxpayers are again picking up the tab for local welfare costs, and they're still paying the extra sales tax that once relieved them of part of their local taxes. 2. My second recommendation concerns uniform Federal standards as to what constitutes a needy person. In California, we have one set of standards. In Nevada there's another, and another in Utah, and so on. Congress should spell out the qualifications, so that an elderly man or woman who can no longer work, or even find a job, can obtain the aid he needs promptly.

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Until our present public assistance program is replaced by one more in keeping with our modern times, Congress should guide the States in providing for the elderly. They are with us in greater numbers than ever before, and their number will keep growing as medical science extends the life span. At the same time, their economic problems are growing, too. Our society makes no provision for family care of the old. An industrial nation simply cannot rely on the young to give homes to the elderly when they near their dotage.

It means that eventually, we must have a true social security program, one that provides for all that one needs when he grows old.

But in the meantime, we could make long strides in the field of public assistance by streamlining its administration and putting policies in the hands of socially conscious, highly trained public servants operating from the State level. Twenty-three States have complete State administration of welfare programs and are well satisfied with the system. Three others have State administration, but the counties contribute some financial support. Here, too, we find efficient operation coupled with widespread recipient satisfaction.

I speak for the entire membership of the California institute and thousands of other needy oldsters in California when I urge you honorable gentlemen to consider my recommendations. I realize they fall far short of true social justice for our Nation's deserving aged. But they represent a practical step. toward that goal, one that the oldsters of America hope that you will take. I thank you.

COST OF OAA ADMINISTRATION

Mr. McLAIN. In touching on Mrs. Williams' statement, I would like, if I may be so permitted, to point out that these public assistance programs have developed into giant bureaucratic setups, particularly here in California. We have the State administration with its thousands of employees; we have the counties with their thousands of employees, 58 counties; in other words, it is duplication all the way down the line to where it is costly. It takes $40 million a year just to administer the program. It costs to administer a pension of between $70 and $80 a month 10 bucks that goes into redtape and processing. God knows that these elderly people could use that extra $10.

HOUSING

Regarding housing for the elderly, in Congress you gentlemen voted to put in a housing for the elderly program with the idea it would help the elderly people of this country. Our group have become professionals. We have been trying to get a housing project underway since the act was put into effect. I think since 1957 we have been working toward the consummation of the houisng for the elderly project in Fresno, Calif., with a value of $4 million. Our project, FHA project 2105-A, would provide 556 living units in onestory multiple-dwelling structures on a 42-acre tract. There would be accommodation for 4,050 elderly people of limited income, plus a community center. This is quite a setup. We are a nonprofit corporation. These poor people here, these elderly people, are sustaining our organization and looking for this type of houisng. We have been compelled to raise rents three times already by the FHA. We are being asked by the FHA to put up $770,410 to get this thing underway. Just think of it. A nonprofit group, of all people, to put up $770,000 as our part of the equity. Now, all we need now is $150,000 to start plowing the ground, so if we can see someone around here with a checkbook to start that, it would certainly be a happy day. In the statement, very carefully prepared by the director of housing

of our organization, Robert A. Brown, we have got some really good meat in here. I know we have two very, very able Members of Congress, Senator Sparkman of Alabama, on the Housing Committee, and Representative Rains, a very capable gentleman. I have the pleasure of knowing him personally. Now, the new bill that you gentlemen just passed for the third time, I am sorry to say, won't do the job. You still have to make a $50 million appropriation to get it underway, and the thing that makes it difficult to bring low-rent housing is because while the Federal Government will offer 100 percent financing, 50 years to pay back; they want a tremendous profit, and yet they expect a nonprofit organization to build and operate the thing at no profit. Yet the Government wants a profit, and so the result is the tremendous insurance, the amount of the discount, the new interest rate makes it absolutely impossible to even get close around to a low rental for the elderly people who need it so greatly. I think we have made a contribution in this statement, Senator, and I certainly trust you will be kind enough to put it into the record.

Getting back to myself, I am chairman of the California Institute of Social Welfare and president of the National Institute of Social Welfare. Governor Warren was kind enough, or foolish enough, to appoint me on his citizens' committee for old age pensions. That was some years ago, and Governor Brown has been kind enough to appoint me on his committee on aging for the State.

I won't go into all our activities I have here of our radio programs, which have been going on for 18 years, sponsored and paid for by the elderly people; our 16-page newspaper, our pamphlets and booklets, and our 200 meetings. Our own welfare department-our own welfare department absolutely has no connection with the State-maintained by the public and membership, has succeeded in getting some $300,000 back for these elderly and blind people that has by error been taken away from these people by the welfare department.

I mentioned in a statement submitted to this committee while you were holding hearings in Washington, D.C., the needs of the elderly fall into three classes-economic, medical, and housing. In my earlier statement, I dealt with these needs in some detail as they are affected by public assistance programs, so I won't pursue that subject further at this time. Suffice it to say that America's treatment of its aged under public assistance is woefully inadequate, and in some cases downright shameful. As you can see, and as you have learned during previous hearings, there is bitter discontent among the elderly of this great Nation, and unless some steps are taken immediately to alleviate the suffering and hardship the aged must accept under our present programs, we can expect a major social upheaval. There are now 14 million voters of 65 years or older in the United States. There are 20 million men and women of 60 or older. The ranks of these senior voters are growing with explosive speed as science prolongs life. Gentlemen, how long do you think these older voters are going to stand for virtual economic slavery? Not indefinitely. That is for sure. History shows us that when a sizable bloc of a Nation's people suffer the same injustices and face the same problems and find no sympathy or understanding in their leaders, they revolt. I don't mean that America's older folks are going to storm the Capitol with pitchforks and scythes, but they will rebel at the polling place unless they see con

crete proof that America is at long last going to establish a realistic program to insure their security in the later years of their lives.

Why is it that the United States is so fearful of offering Government aid to its own needy elderly, and yet encourages foreign lands to use our handouts for this very purpose? It doesn't make sense.

HEALTH INSURANCE

Year after year, we find sensible proposals in behalf of the elderly running head on into ironclad opposition in Congress. The Forand bill is a case in point. This measure, authored by Representative Aime Forand, a Rhode Island Democrat, would offer free medical care and hospitalization to all persons receiving social security. Everyone knows that medical costs are one of the most serious problems of advanced years. Old folks visit their doctors much more often than the young. The time they spend in hospitals is many times longer than it is for younger people. At today's skyrocketing prices of medical and hospital care, illness is often a financial catastrophe for the retiree. He has less income, and the unavoidable costs of care are higher than ever.

The Forand bill, which would protect the sacred right of the patient to choose his own doctor, would solve this problem for millions receiving small social security payments. It would do this through a small payroll tax, and set up a system for payment of physicians through the social security fund.

Think of what an advance this would me. Millions of old people, now desperately worried over the prospect of illness or accident, could face the uncertainties of the future with confidence. Not only would it protect the physical health of these senior citizens, but it would ease one of the greatest single causes of mental deterioration-worry. I, for one, am confident the Forand bill would be a tremendous step forward in America's treatment of her aged.

But the Forand bill is now bogged down in Congress, hobbled by high-powered opposition from the American Medical Association, some insurance groups, and others. Apparently, these interests would rather see the elderly perish for lack of medical care than surrender one iota of their dictatorial control in the medical and hospital fields. In lieu of the Forand bill, the elderly are offered so-called protection by private insurance companies. Inspired by the AMA in its panicky fear that the Forand bill might be approved, these "over 65" insurance policies offer the scantiest of health protection for the aged. Payments under the plans cover barely half of ordinary hospital costs, and medical indemnities are correspondingly low. This, of course, is in line with the AMA's hyprocritical policy of "protecting the patient's responsibility to pay part of his medical bills." This protection is hardly welcome to an old man or old lady who receives an income of, say, $80 or $90 a month. I daresay most would cheerfully take a chance on a plan that lets the social security fund pay the whole bill, regardless of the cost.

The United States is fortunate in having its Social Security Act. It is broad enough to encompass the Forand bill, and offer decent. health protection to our elderly, without a major legislative overhaul,