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Mr. FORAND. Of course, "short" is very indefinite.

Dr. HUNTER. Well, I would say as things go from the present time, we will be doubled in 5 years and probably covered up to about 80 percent in 10 years.

I think, from my way of looking at it, that is a very reasonable period of time.

Mr. FORAND. I am going to tell you for the benefit of you and all others concerned that I am going to keep fuel on that fire. I want a solution to that problem.

Dr. HUNTER. More power to you, sir. I am in favor of a solution,


Mr. FORAND. Mr. King.

Mr. KING. Dr. Hunter, I was not following your written statement. I wish you would elaborate a bit in connection with your reference to the submission to Canada of some findings that they were too busy to look at or deal with. Would you elaborate there?

Dr. HUNTER. I was referring to the Papanicolau procedure with which you may be acquainted. We had published a large number of pamphlets indicating how the procedure should be carried out and the details of just how it should be done. This is a proven procedure at the present time. It has been proven to be able to diagnose the presence of the early stages of a malignancy in the uterus and thereby the patient can be treated before the disease has gotten a head start.

This literature was distributed throughout the country and at the present time it is widely used and I think well used. We have some colleagues in Canada who are members of our association. We distributed it to them, and wrongly or rightly—I do not understand completely their ideas on this they felt that if they distributed this, this would increase their work excessively for them and they are not particularly interested in it.

This we believed to be the result of the fact that most of these men are federally controlled by the Canadian Medical Service, and, although they are interested in taking care of patients, they are not interested in the same degree that their American colleagues are in the sense that they are anxious to forge ahead and make improvements in medical care.

This we believe is a byproduct of Federal medical care. Mr. KING. I dislike to believe, Doctor, that anything as important as this can be handled in such a way regardless of what form medicine would take in any country.

Do you not believe that conscientious doctors there, regardless of what impediment they might be suffering under, would cry out against their workload and say that an important finding like this would be made available to them and they are too busy to handle it? Is it true that it is your feeling that because of Government interfering with medicine in Canada they are not able to have disseminated valuable information such as you describe?

Dr. HUNTER. This information, Mr. King, is available to the doctors there perfectly freely but this is more a matter of publicity and the spread of the publicity has been an effective means of improving the control of cancer of the uterus in this country.

I believe that with the facilities that the Canadian doctors have that it is their belief that they will not be given the facilities, the per

sonnel. This requires many, many technologists and much equipment to carry out. I believe that they do not believe that they will be given the necessary facilities to have this carried out the way they would like to have it done.

Mr. King. I see. Thank you, Doctor.
Mr. BETTS. Are you a member of the AMA?
Dr. HUNTER. Yes, sir; I am.
Mr. Berts. What do you say about the freedom of expression?

Dr. HUNTER. Well, I am a member of the house of delegates of the AMA and I assure you that the AMA is a forum where every one has a perfectly free right to express himself and if you are a member of the AMA, you can express yourself any way you want just like you can here.

Mr. BETTS. Without fear of reprisal?
Dr. HUNTER. Without fear of reprisal.
Mr. FORAND. Mr. Alger.

Mr. Alger. Dr. Hunter, the factor of timing is certainly an interesting one. There was an earlier statement here today that holding hearings focuses attention on this problem and maybe there is a salutary effect no matter what happens.

Dr. HUNTER. I think you are absolutely right.

Mr. Alger. From your knowledge, have you any idea of what the personnel requirements would be in the Federal Government to put this program into effect and how much time that might take?

Dr. HUNTER. Well, anything I would have to say in this regard would be a guess and I do not think it would be accurate except that, if you would say that a program like this would be similar to medicare, it took about a year to put medicare into effect and after it got into effect, it was a very jumbled up mess for about 8 months. Then when the budget was cut and disrupted the organization of the setup, at that time it was further distorted or upset, so that a matter of 2 years would be a minimum to get a thing like this into effect, and I think the growing pains associated would be very, very severe for another 2 years.

Mr. ALGER. I do not know whether the gentleman from Rhode Island has a time limit on you, but you had better hurry. If we were too quickly to go to a compulsory Federal plan, would it cause the breakoff of voluntary programs which are just getting started ?

Dr. HUNTER. I believe somebody made the point earlier that individuals would not be interested in taking up two insurance plans and this would kill it.

Mr. Alger. Would you go so far as to say that, if compulsory insurance came in, it would kill off the development of new voluntary efforts ?

Dr. HUNTER. It would kill off voluntary efforts to improve the care of the aged and this would kill off the terrific amount of work that is already given by doctors on a quasi-free basis. They do the work and just do not send the bill for it in many cases where the person is indigent or their income is low.

Mr. ALGERS. This seems like a real concern for us to certainly bear in mind, Doctor.

Thank you, Mr. Chairman.
Mr. Forand. If there are no further questions, we thank you, Doctor.

Dr. HUNTER. Thank you very much.

Mr. FORAND. The next witness on the calendar is Mr. Gordon E. Brewer.

The Chair is advised that Mr. Brewer has consented to change places with Mr. Adolph Held. Is that correct?

Mr. BREWER. That is correct.

Mr. FORAND. Our next witnesses are Mr. Held and the delegation of the Council of Golden Ring Clubs.

Mr. Held, for the purpose of the record, will you identify yourself and those with you?

Your council has been allotted 15 minutes.



Mr. HELD. I will not take that much time. Mr. FORAND. Before you start your statement, Mr. Keogh has a statement.

Mr. KEOGH. I wanted to be here when Mr. Held and his group were presented and I was momentarily called out.

I am sure, Mr. Chairman, you will recall that you had the pleasure of appearing before a meeting of this fine organization in New York as I have on occasions, and I am delighted to pay my respects to Mr. Held and to his associates for the great work they are doing in connection with the Golden Ring Clubs and, personally, I am delighted to see you all here in Washington.

Mr. FORAND. I may add right there that it was my pleasure last year or 2 years ago to speak before this group in Carnegie Hall where the place was packed to the rafters. There is real interest by this group in this proposal.

Mr. Mason. May I ask, Mr. Chairman, what are the qualifications for belonging to this Senior Golden Club? Is it just age? Mr. HELD. It is age. Mr. Mason. What is the age limit? Mr. HELD. Sixty-five and over. Mr. MASON. Well, I have been eligible for nearly 15 years. Mr. HELD. We are very glad to meet you. You are very welcome. Mr. FORAND. You may proceed, Mr. Held. Mr. HELD. My name is Adolph Held. I am president of the Council of the Golden Ring Clubs of Senior Citizens. This is a voluntary position. Professionally, I am director of the health and welfare department of the International Ladies' Garment Workers' Union. I was formerly president of the Amalgamated Bank of New York.

I am accompanied to these hearings by Mr. Arthur Adams of the Big Six Pensioners Club, Typographical Union; Mr. Oscar Anderson of the Senior Citizens Community Center, St. Luke's Lutheran Church, Queens; Mr. Abraham Beder of the Washington Heights and Inwood Social Action Committee; Mr. Peter Gallegos, membership president, Sirovich Day Center (named after the late Representative William E. Sirovich); Mr. Louis Guss of the Golden Ring Club of Senior Citizens;

Mrs. Fanny Kriegsfeld of the Golden Age Club, YM & YWHA; Mr. Zalman J. Lichtenstein, program director, Golden Ring Clubs; Mrs. Ann Mulrooney, president, Golden Age Drop-In Center, Pater

son, N.J.; Mr. Sam Resnick of the Golden Ring Clubs of Senior Citizens; and Mr. Antony Sassa of the Italian-American Golden Ring Club.

You were kind enough to permit us to make a statement before your committee last year for the improved social security benefits which you embodied in the final bill, for which accept our sincerest thanks.

We consider it a privilege to testify before you on the pending Forand bill. Its provisions are of vital importance to millions of senior citizens.

Older citizens face a major threat to their security when they become ill. Their meager income and limited savings are quickly wiped out when catastrophe strikes. The burden placed on their children is frequently unbearable.

Members of my delegations, if time permitted, could give you many cases of relatives and friends who were brought to destitution as a result of such illnesses.

The Forand bill, now being considered by you is, in our opinion, designed to help older people achieve a measure of security against the most dreaded disaster of later life—serious and expensive illness.

It is imperative that Congress enact this bill as soon as possible. The very wealthy among our senior citizens are amply protected. The very poor are also more fortunate in this respect. They may turn to the welfare departments of their localities which take care of the indigent. Caught in between are millions of the so-called middle group, who are financially not in a position to take care of their health in the years of retirement.

We are shocked to hear the advice of representatives of organized medicine that those not covered by private insurance, may, in case of need, turn to welfare agencies. This is an affront to the dignity of millions of men and women, who in the course of a lifetime have built a modest nest in which to live out the final stage of their lives. When catastrophic illness exhausts their savings, it is cruel to compound the tragedy by subjecting them to the means test for welfare support.

What strikes us as most illogical is the fear expressed by some doctors that the Forand bill would deprive the patients of freedom of choice of hospital and physician.

Nothing could be further from the facts. The Forand bill clearly states that persons eligible for social security benefits will have the right to choose any hospital, nursing home, or surgeon meeting specific broad standards of professional qualifications.

The bill provides that the cost, up to 60 days a year in a qualified hospital, including complete cost of all normal hospital and surgical services certified by a physician, will be covered. The bill for this care with the doctors' certification or the bill of the surgeon freely chosen by the patient will be submitted to the Social Security Administration.

The medical profession does not object when such bills go to Blue Cross, Blue Shield, or to private insurance companies—but why do they object to the old age and survivors' insurance receiving the bills?

The recent flooding of offers by private insurance companies to furnish health insurance to elderly people is rather interesting. It is not so long ago that insurance companies discontinued such insurance when the insured retired from work. Frequently, the insurance

companies canceled the insurance after the first prolonged illness. We are rather suspicious of the present offers of the insurance companies. It seems to us that this is an attempt to stymie the Forand bill.

The latest offers of the companies is but a caricature of the provisions in the Forand bill. These policies offer $100 per day for hospital care for 31 days and a surgical allowance of $5 to $200. These benefits are far from sufficient to cover actual catastrophic costs.

The proponents of private health insurance for elderly people seem also to overlook the fact that three-fifth of our aging population have incomes of around $1,000 per year. The cost of such 65-plus insurance plans would eat up a substantial part of their already inadequate income.

The Federal insurance plan, such as proposed in the Forand bill would solve this problem on a sensible basis. Some critics say that such insurance would be a heavy tax on our economy. These critics predict that it would cost about $2 billion a year. With the great strides in gross production in our country, such an expenditure is not too great. Our annual gross national income is now well over $400 billion. Surely the health and dignity of our senior citizens are fully deserving of one half of 1 percent of our economy.

We are proud to find that the great labor organization, the American Federation of Labor-Congress of Industrial Organizations hold the same position as we. They have fully endorsed the purposes of this bill and we are happy to join them in their effort.

We owe it to our senior citizens to guarantee the fall and winter years of their lives. The Forand bill proposes to raise social security payments by one-half percent. This would guarantee our veteran citizens high quality care in hospitals and nursing institutions, the preservation of good health and a speedy return to their own homes and an enjoyable life.

The 70 million now employed in business and factories throughout our great country will be happy to contribute to this new feature of health security, just as we were when we laid the foundation for the social security system.

The lawmakers of our country are building a healthier and more abundant America. Gentlemen, by speedy enactment of the proposed Forand bill, you will show vision and will alleviate unnecessary suffering of millions of our senior citizens.

Thank you.

The CHAIRMAN. We thank you, sir, for coming to the committee, and we thank those who have accompanied you to the witness table.

We appreciate your statement representing the views of the Council of Golden Ring Clubs.

Are there any questions of Mr. Held?
We thank all of you for coming.

Mr. FORAND. Mr. Chairman, I ask unanimous consent that correspondence received from the Honorable William H. Meyer, the Congressman from the State of Vermont; Mr. George O. Shecter, administrator of the American Hospital in Los Angeles, Calif.; Mr. Thomas G. Walters with the Government Employees' Council of the AFL-CIO; and Dr. Gustav Loewenstein be inserted in the record at this point.

The CHAIRMAN. Without objection, they will appear at this point.

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