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Act are increased with respect to wages by section 201(c) of the Act which amended the Social Security Act by adding title XVI, the rates of tax imposed by this section shall be increased, with respect only to compensation paid for services rendered before January 1, 1965, by the number of percentage points (including fractional points) that the rates of taxes imposed by such section 3111 are so increased with respect to wages".

TITLE IV-MISCELLANEOUS PROVISIONS

MEANING OF TERM "SECRETARY"

SEC. 401. As used in the provisions of the Social Security Act amended by this Act, the term "Secretary", unless the context otherwise requires, means the Secretary of Health, Education, and Welfare.

STUDIES AND RECOMMENDATIONS

SEC. 402. The Secretary of Health, Education, and Welfare shall carry on studies and develop recommendations to be submitted from time to time to the Congress relating to (1) the adequacy of existing facilities for health care for purposes of the program established by this Act; (2) methods for encouraging the further development of efficient and economical forms of health care which are a constructive alternative to inpatient hospital care; (3) the feasibility of providing additional types of health insurance benefits within the financial resources provided by this Act; and (4) the effects of the deductibles upon beneficiaries, hospitals, and the financing of the program.

[For the press-For immediate release, Friday, May 5, 1961]

CHAIRMAN WILBUR D. MILLS (DEMOCRAT, ARKANSAS), COMMITTEE ON WAYS AND MEANS, ANNOUNCES PUBLIC HEARINGS ON PRESIDENT'S HEALTH INSURANCE PROGRAM FOR AGED AS NEXT MAJOR BUSINESS AFTER COMPLETION OF CONSIDERATION OF PRESIDENT'S TAX RECOMMENDATIONS

The Honorable Wilbur D. Mills (Democrat, Arkansas), chairman, Committee on Ways and Means, House of Representatives, today announced that the next public hearing of the Committee on Ways and Means would be on the subject of the Preisdent's recommendations for a program of health insurance for the aged under title II of the Social Security Act. The President's proposal is embodied in H.R. 4222, introduced by the Honorable Cecil R. King, of California. Identical proposals by several other members of the committee are also pending. The chairman stated that this public hearing would be held immediately after the committee disposes of the subject matter included in the tax message of the President, on which the Committee on Ways and Means is presently conducting public hearings.

The chairman stated:

"In view of the interest which has been expressed with regard to whether the Committee on Ways and Means intends to give consideration to the recommendations of the President for a health insurance program for the aged under title II of the Social Security Act during this session of the 87th Congress, it is our intention, as soon as we complete consideration of the subject matter included in the tax message of the President, on which hearings are now being conducted, to hold full and complete public hearings on the President's health insurance program. The exact date will be announced in due course."

Chairman Mills further pointed out that it had been the intention of the committee to conduct this hearing as soon as the schedule permitted, but that the committee has been engaged from the very beginning of this session of the Congress, continuously, in programs of an urgent and emergency nature recommended by the President and that to date there has not been time for the committee to take up this additional subject.

[For the press-For immediate release, July 11, 1961]

CHAIRMAN WILBUR D. MILLS (Democrat, Arkansas), CoMMITTEE ON WAYS AND MEANS, HOUSE OF REPRESENTATIVES, ANNOUNCES TENTATIVE DATE FOR PUBLIC HEARINGS ON THE PRESIDENT'S HEALTH INSURANCE PROPOSAL, H.R. 4222, THE HEALTH INSURANCE BENEFITS ACT OF 1961

The Honorable Wilbur D. Mills (Democrat, Arkansas), chairman, Committee on Ways and Means, House of Representatives, today announced that the Committee on Ways and Means hopes to begin public hearings on Monday, July 24, 1961, for the purpose of receiving testimony on the subject of medical care for the aged and in particular, on the President's health insurance proposal which is contained in H.R. 4222, the Health Insurance Benefits Act of 1961, which was introduced by the Honorable Cecil R. King, of California. In addition to H.R. 4222, a number of related bills are also pending before the Committee on Ways and Means on the subject of medical care for the aged.

The chairman stressed that whether or not the hearings begin on July 24 depends on the committee concluding policy decisions on the tax program recommended by the President by that time. The purpose of this announcement is to alert the interested public so that final preparation can be made for the hearings. It will be recalled that on May 5 the chairman announced that hearings on the President's health insurance program for the aged would be the next major business of the committee after consideration of the President's tax recommendations. A firm date for the beginning of the hearings will be announced at a later date.

The chairman stated that officials of the administration will be leadoff witnesses at the beginning of the hearings to be followed by public witnesses.

Chairman Mills emphasized that, while the hearings will be concentrated principally on receiving testimony on the President's proposal, the committee will also be pleased to receive comments and recommendations on alternative proposals on this same subject.

The chairman recalled that the Committee on Ways and Means and other committees of the Congress have, within the past several years, received considerable testimony in public hearings on the subject of medical problems of the aged. The chairman further recalled that the Department of Health, Education, and Welfare submitted a report on this subject to the Committee on Ways and Means at its direction on April 3, 1959, which was made public.

Chairman Mills emphasized that the committee was interested in receiving, in addition to whatever general views individuals and organizations may have, specific factual information which would be of assistance to the committee in evaluating the various aspects of the President's proposal and other alternatives which have been or may be suggested. In this connection, the chairman expressed the hope that all witnesses would direct their attention to the points on the attached sheet and comment thereon to the extent feasible and possible.

IMPORTANT

Due to the very limited time available for the hearing, it will be necessary for all organizations, groups, and individuals with a similiar interest and position to designate one spokesman to speak for the group or groups concerned so as to conserve the time of the committee and witnesses and at the same time avoid needless repetitious testimony. This will enable the committee to make a more adequate time allocation available to witnesses expressing differing points of view.

In the past it has been the experience of the committee that there have been numerous requests to be heard by many persons and groups representing the same interests wherein it appears that there would have been an undue amount of needlessly repetitious testimony since, in general, the position of many of these groups is the same on this subject-either supporting or opposing this type of legislation. These groups have cooperated with the committee in the past in avoiding time-consuming, needless repetition which does not necessarily add to the knowledge or understanding of the committee or the interested public. It is again urged that these groups cooperate with the committee.

In cases where there are differences within an organization or group, this fact should be pointed out in the request to be heard and the committee will undertake to schedule spokesmen representing the different points of view. It is emphasized that all persons who desire to do so will be permitted to file written statements for the consideration of the committee and for inclusion in the printed record of the hearings in lieu of presenting testimony in a personal appearance. In this connection, where persons or organizations desire that their written statements be included in the printed record in lieu of an appearance, the statement should include the specific request that it be made a part of the printed record.

Persons desiring to appear and testify before the committee should submit their requests to Leo H. Irwin, chief counsel, Committee on Ways and Means, room 1102, New House Office Building, Washington, D.C., not later than the close of business Thursday, July 20, 1961. To properly schedule witnesses, it will be necessary for the request to specify

IMPORTANT

(1) The name, address, and capacity in which the witness will appear; (2) The time the witness desires in which to present his oral testimony; (3) Whether the witness, in general, supports or opposes the President's proposal; and

(4) The subject and the basic points on which he wishes to comment. Witnesses who are scheduled to appear will be notified as soon as possible after the termination date for receipt of requests to be heard-July 20, 1961.

IMPORTANT

In the event that a witness or group has already indicated to the committee an interest in appearing before the committee on this subject, it is necessary that a reconfirmation be made of the request to be heard setting forth the information requested above. A copy of this press release is being mailed to all persons who have indicated an interest in these hearings for this purpose.

All persons who desire to do so may submit a written statement in lieu of giving testimony in a personal appearance. Such statements will be considered by the committee and will also be printed at the proper place in the record of the hearing. It is requested that persons who submit such statements in lieu of an appearance make the statements available not later than August 4, 1961, or the last day of the hearing, if this later occurs. A minimum of three copies of such statements for inclusion in the printed record of the hearings should be submitted.

Witnesses who are scheduled to appear in person before the committee should, where possible, submit a minimum of 60 copies of their statement for the use of the committee members and staff at least 24 hours in advance of their scheduled appearance. If a witness also desires that his statement be made available to the press and the interested public, it is suggested that at least 60 additional copies be submitted for this purpose to the staff office, room 1102, New House Office Building, on the witness' date of appearance.

Persons submitting statements in lieu of an appearance may submit the number noted above if they desire the same distribution.

It will be most helpful to the members and staff if written statements contain subject headings on the subjects and points covered and a summary of comments and recommendations.

POINTS ON WHICH IT IS HOPED THE WITNESSES WILL COMMENT, AMONG OTHERS I. EXTENT OF NEED FOR LEGISLATION ON THIS SUBJECT

Witnesses are invited to present their views, including supporting evidence and/or statistics, to indicate the extent of the need for this, or other, legislation in the area of medical care for the aged, including information as to

(a) The character and nature of the basic medical-care requirements of persons aged 65 and over and whether or not these are in any respect unique;

(b) Whether and to what degree such medical-care requirements are now being met through existing governmental, nongovernmental, and individual programs;

(c) The extent to which individuals age 65 and over can now finance their medical care requirements, directly, through insurance, etc.;

(d) The extent to which this proposal, or other proposals, will meet the basic medical-care requirements of the aged if legislation is deemed necessary.

II. EFFECT OF PROPOSAL

Witnesses are invited to comment on and present evidence relative to the impact which this proposal, or alternative proposals, might have upon

(a) Utilization of hospitals by aged persons, including the rate and duration of hospital use, as well as other pertinent factors, and including general, chronic disease, and other hospitals;

(b) Quality and availability of hospital care;

(c) Utilization of nursing homes;

(d) Quality and availability of nursing home care;

(e) Utilization of hospital, diagnostic, outpatient facilities;

(f) Quality and availability of diagnostic outpatient service.

III. COST OF THE PROPOSAL

Witnesses are requested to comment upon the probable cost (both short and long-range) of this proposal, or alternative proposals, as well as on any alternative methods of financing.

IV. AMENDMENTS

If the witness approves the general approach embodied in H.R. 4222, but considers that the language is not adequate, or that modifications should be made, it would be helpful if alternative language is furnished. If the witness does not necessarily approve of the bill, the committee would still appreciate any comments or suggestions to perfect it, if the witness desires to make them.

[For the press-For immediate release, Tuesday, July 18, 1961]

CHAIRMAN WILBUR D. MILLS (DEMOCRAT, ARKANSAS), COMMITTEE ON WAYS AND MEANS, CONFIRMS DATE FOR COMMENCEMENT OF HEARINGS ON PRESIDENT'S PROPOSAL FOR HOSPITALIZATION INSURANCE FOR AGED UNDER SOCIAL SECURITY Hon. Wilbur D. Mills, (Democrat, of Arkansas), chairman, Committee on Ways and Means, House of Representatives, today stated that it is now definite the Committee on Ways and Means will begin public hearings on the President's proposal for hospitalization insurance for the aged under social security (H.R. 4222) on Monday, July 24, 1961, at 10 a.m. The chairman in a detailed announcement on July 11, 1961, stated that the committee would begin these hearings on July 24, 1961, if it had completed major decisions on the President's tax program by that time.

Chairman Mills confirmed that the committee probably would complete these decisions this week, and that in any event the medical care hearings will begin next Monday, July 24, 1961, at 10 a.m.

The CHAIRMAN. The Chair wishes to observe that over 400 requests to be heard were received. The Chair wishes to thank the witnesses for their cooperation in coordinating testimony so as to avoid repetitious oral statements.

Our first witness today will be the Honorable Abraham Ribicoff, Secretary of Health, Education, and Welfare.

Mr. Ribicoff, you appeared before the committee in your present capacity on other occasions. We welcome you back to the committee, sir, and you are recognized.

STATEMENT OF HON. ABRAHAM RIBICOFF, SECRETARY OF HEALTH, EDUCATION, AND WELFARE; ACCOMPANIED BY WILBUR J. COHEN, ASSISTANT SECRETARY (FOR LEGISLATION); WILLIAM L. MITCHELL, COMMISSIONER, SOCIAL SECURITY ADMINISTRATION; DR. LUTHER L. TERRY, SURGEON GENERAL, PUBLIC HEALTH SERVICE; AND ROBERT J. MYERS, CHIEF ACTUARY, SOCIAL SECURITY ADMINISTRATION

Secretary RIBICOFF. Thank you very much, Mr. Chairman.

First may I say that I am accompanied by Wilbur J. Cohen, Assistant Secretary; William L. Mitchell, Commissioner of Social Security; Dr. Luther Terry, Surgeon General; and Robert J. Myers, Chief Actuary of the Social Security Administration.

I appreciate the opportunity to appear before this committee in support of health insurance for the aged under the social security program, H.R. 4222, introduced by Representative Cecil R. King.

It is my firm belief that this bill, if enacted, is destined to become as significant as any piece of domestic legislation produced by the 87th Congress.

This committee has the opportunity to equal the landmark action. taken by the 74th Congress, which passed the Social Security Act in 1935. They sought to promote freedom from fear-the fear of economic insecurity. To a large extent, Congress, under your leadership, has succeeded.

Today the later years of millions of Americans are plagued anew by fear. With lifespan lengthened, with medical science breaking into undreamed realms of discovery, the Nation's aged now face another aspect of insecurity-how to meet the mounting costs of medical care.

Gentlemen, let me set forth my position clearly:

1. The high costs of medical care for the aged are going to be paid for in this country. The issue is not whether to pay these costs. The only issue is how to pay them.

2. The alternatives to health insurance that have been suggested are not adequate, not fair to the elderly who need the care, and not fair to the public which pays for it.

Private insurance plus public assistance cannot do the complete job. If the medical assistance for the aged program, enacted by Congress last year, is expanded to cover a major share of the costs, the drain on State treasuries will be fantastic. If the issue is left to collective

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