under the program, with much more complete benefits than are now generally available to the aging. Under the proposed system, the old-age and survivors insurance beneficiary would have certain other important assurances: There would be no lifetime limits on the total costs that would be covered; there would be no exclusion of preexisting conditions. Each of us who is at all familiar with the problems of older people knows that there is an overwhelming humanitarian basis for this legislation. The need for it can be demonstrated through facts and figures, as well as through personal experience or knowledge. The recent study by the Department of Health, Education, and Welfare, conducted at the request of this committee, gives an objective picture of the plight of the elderly in obtaining and paying for medical services. An examination of the income figures of this age group and the costs of medical care which are needed by them points up the existing dilemma. If we want a healthy and vigorous population, and I trust we do, then I see no alternative than to take proper and adequate measures to make this goal reality. I believe, therefore, that this Congress must give favorable consideration to H.R. 4700. The CHAIRMAN. Thank you, Mr. Carnahan, for coming to us and giving us your views on the subject. Mr. CARNAHAN. Thank you, Mr. Chairman. The CHAIRMAN. We will now hear from our colleague, the Honorable Isidore Dollinger, from the State of New York. We are happy to welcome you, Mr. Dollinger. Mr. DOLLINGER. Thank you, Mr. Chairman. STATEMENT OF REPRESENTATIVE ISIDORE DOLLINGER, OF NEW YORK Mr. DOLLINGER. Mr. Chairman and members of the Committee on Ways and Means, you have before you for consideration the Forand bill to amend the Social Security Act and the internal revenue code so as to provide insurance against the costs of hospital, nursing home, and surgical service for persons eligible for old-age and survivors insurance benefits, and for other purposes. I introduced a similar bill on March 4, 1959, as I wished to emphasize my strong support of this legislation. There is an overwhelming need for the benefits provided by the bill. Such benefits would be allowed as part of our established social security system and would be financed under that system. The contributions to be made by employees and employers would insure the necessary help when illness and disability are suffered in later years by those entitled to old-age and survivors insurance benefits. Today there are more than 14 million persons in the United States who are over 65 years old. As of March 1959 more than 12 million persons were receiving social security payments, the majority of whom are entirely dependent upon such social security benefits for their existence; they have no other income or assets. All living costs are at a new high-including medical, nursing, and hospital care. Many thousands of our older persons are suffering great pain and discomfort, jeopardizing their lives, because they cannot afford doctors' bills, medicines, or hospital or nursing care. Present social security benefits are still grossly inadequate to meet the barest necessities; our older citizens have nothing left with which to pay for the high expenses of illness or medical aid. It is incredible that, in our Nation of plenty, countless older persons are denied the medical aid and attention they so desperately need. I have received many letters describing pitiful circumstances and great hardships being suffered by older people in my district; petitions bearing the names of many thousands have been sent me attesting to their inability to procure necessary medical help and to the great need for the legislation before you. I believe that your committee has before it evidence to show that many outstanding organizations strongly endorse health benefits under the old-age, survivors, and disability insurance program; also evidence that health services for the aged are grossly inadequate throughout the Nation. As a result of the studies of the situation which have been made, it is obvious that such a health program cannot be provided satisfactorily in any way other than that provided by the bill before you; the Federal Government must take the necessary action. It would be unconscionable and cruel of us to continue to ignore the tragic plight of our older persons who find it impossible to provide for themselves the insurance to cover the high cost of illness and care. They should be given this opportunity under our social security program. I know that your committee will show the proper concern for our older persons and that you will take favorable action on the bill before you. The CHAIRMAN. Thank you, Mr. Dollinger, for coming to us and giving us your views on this subject. Mr. DOLLINGER. Thank you, Mr. Chairman. The CHAIRMAN. Our next witness is our colleague from Wisconsin, Hon. Clement J. Zablocki. Mr. Zablocki, we appreciate very much your being before the committee. STATEMENT OF HON. CLEMENT J. ZABLOCKI, A REPRESENTATIVE IN CONGRESS FROM THE STATE OF WISCONSIN Mr. ZABLOCKI. Thank you, Mr. Chairman. I deeply appreciate this opportunity to appear before your committee, to present my views on legislation proposing to provide health benefits to the aged. Some time ago, on March 17, 1959, to be exact, the Common Council of the City of Milwaukee, Wis., adopted a resolution expressing its position on H.R. 4700. Last week I received a telegram from Mr. Stanley J. Witkowski, city clerk of Milwaukee, asking me the present the common council's position to your committee. I am happy to do so, and I would like to ask for permission to have Mr. Witkowski's telegram, and the text of the common council's resilution, included in the record of the hearings. The CHAIRMAN. Without objection, that will be included. Mr. ZABLOCKI. Very briefly, in summarizing the resolution, the Common Council of the City of Milwaukee is wholeheartedly in support of H.R. 4700. (The telegram and resolution referred to follow :) Hon. CLEMENT J. ZABLOCKI, Washington, D.C.: MILWAUKEE, WIS., July 10, 1959. The Milwaukee Common Council on March 17, 1959, adopted resolution relative to supporting H.R. 4700 amending Social Security Act to provide health and surgical service. You are respectfully requested to appear at hearings of the Committee on Ways and Means in behalf of our constituencies. STANLEY J. WITKOWSKI, City Clerk. CERTIFIED COPY OF RESOLUTION FILE NUMBER 58-4264 Resolution relative to the city of Milwaukee supporting and appearing in behalf of the Forand bill (Federal) (H.R. 4700) Whereas there is presently pending in the House of Representatives a bill known as the Forand bill (H.R. 4700); and Whereas under the terms of this bill medical and surgical benefits would be provided to retired people under the social security system on a funded basis; and Whereas the city of Milwaukee has many retired employees who have attained eligibility in the social security system and are in need of such benefits: Be it hereby Resolved, That the Common Council of the City of Milwaukee actively support such legislation and diligently seek its passage; and be it further Resolved, That the city clerk transmit a certified copy of this resolution to our Representatives and Senators and that city representatives designated by the common council president make appearances on behalf of this bill if necessary; and be it further Resolved, That the executive secretary of the pension system be authorized and directed to send a communication to all retired personnel informing them of the nature of this bill and advising them of its pendency in the Congress of the United States. OFFICE OF THE CITY CLERK, I hereby certify that the foregoing is a copy of a resolution adopted by the Common Council of the City of Milwaukee on March 19, 1959. [SEAL] STANLEY J. WITKOWSKI, City Clerk. Mr. ZABLOCKI. As you know, Mr. Chairman, I have long been interested in legislation affecting our elder citizens, particularly in our social security program. Over the years, I supported fair and constructive amendments intended to strengthen the program, and to improve various benefits. I am proud to have been among the original sponsors of a bill to provide social security benefits to disabled workers, and to lower the retirement age for women. I introduced bills containing these proposals as early as 1953, and I was deeply gratified when the Congress enacted their main features into law in 1956, Today, thanks to that legislation, many thousands of our disabled workers and women are receiving social security benefits without being compelled to wait until they reach age 65. The legislation which is presently being considered by your committee deals with another serious problem facing our elder citizens: the problem of obtaining required health care. I would like to address myself briefly to this grave problem. THE NUMBER OF OUR AGED IS INCREASING I would like to begin by reviewing some general statistics about our aged population, statistics which were presented to another committee recently by a fellow Milwaukean, Prof. Wilbur J. Cohen, of the University of Michigan, who was associated for many years with the administration of our social security program. About 1,230,000 persons became age 65 in 1956, and about 900,000 persons age 65 died during that same year. The net increase in our aged population was about 330,000, nearly 1,000 every day. There are 15.4 million persons age 65 or over and living in our country, and they represent 8.6 percent of the total population. By 1975, according to reliable estimates, there will be 20 million aged persons in the United States. THE AGED LIVE ON LIMITED INCOMES Most of our aged population lives on limited incomes. In 1958, three-fifths of all people age 65 and over had less than $1,000 in money income. Another one-fifth received $1,000 to $2,000. The remaining one-fifth had more than $2,000. Further, of the 15.4 million aged persons, only about 1 in every 5 had a paying job in December 1958. It is estimated that over 11 million aged persons are dependent upon income or support from sources other than employment. About 6 out of every 10 aged persons in June 1958 were receiving insurance benefits under the social security system. Another 1 out of 10 received some other social insurance or pension benefit. AGED USE MORE HOSPITAL CARE We know, then, that our aged population numbers 15.4 million persons; that it is increasing at the rate of 1,000 per day; and that most of our elder citizens have to try to make ends meet on limited incomes. In the light of these facts, let us take a look at the medical problem facing our aged. Statistics cited recently by Dr. Wilbur Cohen indicate that days of hospital care used by persons 65 and over, are about 2 to 21⁄2 times as much as those used by persons under age 65. Further, about 90 percent of all the aged hospitalized in 1956 and 1957 were in hospitals for 60 days or less in the year. Since 1947-49, the overall Consumer Price Index has increased about 24 percent. During that time, surgeon's fees have risen about the same. But medical care costs in general have risen twice as fast49 percent-and hospital room charges have risen 105 percent, and are continuing to increase. We find, therefore, that our elder citizens use more days of hospital care than younger people, and that the cost of such care has risen greatly during the past decade, and continues to go up. MOST OF THE AGED LACK ADEQUATE HOSPITAL INSURANCE This, of course, creates a serious problem for our aged. Their medical needs and expenses are high, while their incomes are limited. How can they, therefore, attend to those needs? Once again we must seek our answer in statistics. Statistics reveal that 65 percent of the aged do not have any type of hospital insurance, as compared with 34 percent of those under age 65 who do not have such insurance. Further, for the aged couples drawing social security benefits, 80 percent of those with incomes of under $1,000 did not have any hospital insurance, compared with 35 percent for those with income of $5,000 and over who did not have such insurance. It would appear, therefore, that most of our aged do not have any insurance protection against the high cost of medical care. Further, such insurance as some of our aged have is very inadequate. It is expensive, too expensive considering the small resources of most of our elder citizens. It can be canceled in most cases at the discretion of the carrier, and it may run out completely when lifetime ceilings have exhausted the benefits stated in the policy. Even when in effect, much of this insurance is of very limited amount. THE PROBLEM DEMANDS ATTENTION There is, on balance, serious evidence that a grave problem exists in this field. Many aged persons find it increasingly difficult to meet their health problems. The high cost of medical services is appar ently barring many older persons and widows from required health care. I am certain, Mr. Chairman, that your committee is interested in obtaining as much information and evidence on this subject as possible. I have asked the proper authorities in Milwaukee to prepare information about the situation in our city, the number of our elder citizens, their medical care needs, and their ability to meet them. As soon as I receive this information, I shall convey it to your committee, for your consideration and inclusion in the record of these hearings. (The following information was received by the committee:) Hon. CLEMENT J. ZABLOCKI, House of Representatives, Washington, D.C. MUNICIPAL REFERENCE LIBRARY, DEAR CONGRESSMAN ZABLOCKI: Thank you for your support of H.R. 4700 before the Ways and Means Committee. In reply to your wire of July 14, we are able to supply the following data: In a study made in 1958 for our housing authority, workers in the Marquette University School of Business Administration interviewed 2,500 families, numbering 8,752 individuals. The purpose of the survey was twofold. One, to discover the number of families in the city of Milwaukee having one person or more 65 years of age or older. These families are hereafter referred to as elderly families. The second purpose of the survey was to study certain characteristics of the elderly segment of the population in order to determine the number of persons who might qualify for public housing support. The university found that there were in these families 800 individuals 65 or over. They also interviewed the directors of homes for the aged where they found an additional 908 individuals |