Page images
PDF
EPUB

which I was asked more questions, and there was no matter in which there appeared to be more general interest, than in the question of amendments to and improvements on the Social Security Act. Most of the interest centers around lowering the age for men from 65 to 62, and providing health insurance for both men and women when they reach retirement age. This is a universal demand shared in by people in all walks of life; they seem to feel that when reaching retirement age many of them are either sick of body or weak of limb and that the social security check which they receive monthly and which is intended to pay their grocery bills and other living expenses, is of necessity drained off for medical and hospital care, so that they are left with no money on which to live, or as an alternative they find it necessary to become recipients of public aid. This means that for them there is no such thing as retirement and the social security retirement becomes a mess. These conditions apply to a large percentage of the cases and there is deep concern among those who are either reaching retirement age and those who are already there over the possibility of retirement being denied them because of illness. There is also deep concern on this point by dependents, that is children, who have their own families and obligations, but find it necessary to pay the medical bills for parents. They naturally do their best but sometimes an impossible situation is caused and the result again is public relief.

There is, as you know, a great difference between receiving a retirement pension under social security and in receiving welfare from the community. The dignity of the individual is involved and especially so with our senior citizens for it is important that we help them maintain their self-respect and prevent them from becoming objects of charity either to their children or to their own community. This possibility can be insured against by the individual's paying slightly more during his productive years so that when he reaches retirement age there will be enough in the social security fund to pay his doctor and hospital bills. This is an insurance plan; it is the American way of doing things. There is no difference between this plan and a Blue Cross or Blue Shield plan except that the premium is collected weekly and is held by the Government; it is deducted from wages rather than paid to a private company. The net result is the same and I believe that the addition of this provision to the Social Security Act comes under the general welfare clause of the Constitution, and under this clause it is the duty and burden of Congress to do that which is for the general welfare of the citizens. Certainly, no one can be heard to say that it is not for the general welfare of our senior citizens that they be permitted to insure themselves against the possibility of undue sickness in their old age or the possibility of being denied adequate income in retirement because of the necessity of using the retirement funds for the payment of doctor and hospital bills.

This is a social bill; it takes into consideration the needs of human beings, citizens of this country, wage earners, sincere people who desire to look ahead and insure against this possibility in their old age. I sincerely and firmly request of this committee that they give favorable consideration to H.R. 4700, and that they pass the Forand bill

or rather recommend it for passage. I believe it is in the best interests of both this country and the people of this country.

Thank you very much.

The CHAIRMAN. Thank you, Mr. Flynn, for coming to us and giving us the benefit of your views on this subject.

Mr. FLYNN. Thank you, Mr. Chairman.

The CHAIRMAN. We will now hear from our colleague, Hon. Joseph E. Karth from the State of Minnesota. We are happy to welcome you, Mr. Karth.

Mr. KARTH. Thank you, Mr. Chairman.

STATEMENT OF REPRESENTATIVE JOSEPH E. KARTH, OF

MINNESOTA

I appreciate the opportunity to make a statement in support of H.R. 4700 and H.R. 6248 an identical bill which I introduced to indicate my strong feeling regarding the need for a national insurance plan to care for sick and ailing old-age, survivors, and disability insurance beneficiaries.

There has been increasing recognition in recent times that the period which has euphemistically been described as "the golden years," "the autumn of life" and the like, have, in our highly sophisticated society, been really years of insecurity and even of grim terror to our older population.

The three areas where this insecurity centers, I believe, is (1) economic, lack of assured income for basic human needs of shelter, clothing, food, and so forth; (2) emotional, especially the bewildering shock experienced by men and women who, after a long life of selfsufficiency and independence, upon retirement are treated as burdens to society and their families; at best, to be tolerated, at worst, to be rejected; and, (3) health, fear of sickness, of debility, of immobility; and especially of the lack of available, adequate health care within the means of the retired.

These areas are listed in order of the general awareness about them as problems. The economic factor was first recognized and answered by social security and by private pension plans to supplement the basic social insurance plan. The emotional area has increasingly come under the attention and study of a whole host of social scientists. It is only fairly recently though that the problem of providing health care for the aging and the aged has become as important as it is.

The established insurance plans such as Blue Cross and Blue Shield and the private medical expense reimbursement programs have attempted, largely unsuccessfully it is generally conceded, to supply a great need for health attention. There is considerable corroboration of this sad fact in the numerous surveys and studies (including the latest Department of Health, Education, and Welfare work, "Hospitalization Insurance for OASDI Beneficiaries"). Social workers and Government officials have long considered health care for the aged as a major problem for those levels of Government least able to provide help-State and local governments struggling desperately to provide services for the population explosion which has occurred, and to catch up on deferred construction as a consequence of the depression, World War II, and the Korean conflict. The need for com

munity services has become increasingly acute as revenue sources reach the optimum of exploitation and the strait jacket of tax and debt limitation, and political considerations have severely restricted the ability of State and local government to expand services.

In Ramsey County, Minn., in which the city of St. Paul is situated there were, in each of the first 3 months of this year 1,059 OASI beneficiaries needing old age assistance supplementation because social security payments were not sufficient to cover basic maintenance and/or medical needs. Of this number, 369 recipients received OAA payments for medical care totaling $77,723.18, or an average of $73.39 per case per month. Ramsey County officials expect this cost for medical care to total $310,892 by the end of the year.

As evidenced by the statistics, caseloads and payments for old age assistance medical and maintenance cases increase as the total OAA caseload decreases. In Ramsey County OAA total case months decreased by 4,505 from 1954 to 1959 while medical and maintenance cases increased by 5,474. Significantly, maintenance costs increased from 1954 through 1958 by $188,346 while medical costs went up during the same period by $245,429. This is money that has to be obtained at the sacrifice of funds which would otherwise be used for urgently needed projects.

In the 1930's it was determined that the general welfare required a program of national insurance to provide workers with an income after they retired from the labor force. To my mind this is a conservative approach and not a radical one. The idea of social recognition of the need for income maintenance after retirement and human conservation was new but the mechanics of insurance was quite traditional.

Today we are belatedly realizing that the measure of income security for our aged which might have covered the essentials of living, including health care, when the social security system began is now grossly inadequate when illness strikes.

Private health insurance plans for retirees cannot economically provide adequate health care in view of the expanding aged population and skyrocketing medical and hospital costs. Costs which are due to the development and use of the sulfas, antibiotics, and steroids which work miracles in reducing deaths and improving rates of recovery. New techniques of all sorts have revolutionized health care but have made being sick considerably more expensive.

Yet we would have it no other way than when a doctor undertakes to treat a patient he does so by using the most up-to-date procedures and materials generally available.

This is as it should be but this is costly.

H.R. 4700 is a bill that reflects the social conscience of America. It is legislation which guarantees that OASDI beneficiaries will have at least a "floor" under their health care needs. But why shouldn't this group, which is predominantly made up of retired workers, deserve this help? They have, in their day built the greatness of America.

H.R. 4700 is a modest, constructive approach to an increasingly serious social and economic problem. H.R. 4700 is, in the best tradition of the social security system, conservative legislation based on human values and sound financial principles.

The CHAIRMAN. Thank you, Mr. Karth, for coming to us and giving us your views on the subject.

Mr. KARTH. Thank you, Mr. Chairman.

The CHAIRMAN. We will now hear from our colleague, the Honorable Frank Kowalski from the State of Connecticut. We are happy to welcome you, Mr. Kowalski.

Mr. KOWALSKI. Thank you, Mr. Chairman.

STATEMENT OF REPRESENTATIVE FRANK KOWALSKI, OF

CONNECTICUT

Mr. KOWALSKI. Mr. Chairman, may I express my appreciation to you and to your committee for giving me this opportunity to appear before you in support of H.R. 4700. I also want to commend our distinguished colleague, Congressman Aime J. Forand, for introducing this progressive legislation.

am no expert in health insurance. I appear before you essentially as a man who is concerned with the vital need for medical care and hospitalization for our elder citizens.

Some who oppose this legislation say it is socialistic for the Government to be concerned with health assistance for our citizens. If this is so, then I am a most grateful beneficiary of our socialistic system which, in my case, provides me as a retired Army officer with medical care at the expense of the Government. Believe me, gentlemen, it is a wonderful feeling to know that as I grow older this great democracy has provided for the day when I may need medical and hospital care.

Some will say, well you've earned_this-you served in the Army 30 years. This is true and I hope I have earned these wonderful benefits. But who can really say which one of our citizens has made the greater contribution to his country-the professional man, the manager, the worker, or the serviceman. In any case, I am grateful that a previous Congress provided these progressive social benefits to me and to our military personnel and their families.

In the light of my own background, my own experience and my own benefits, I could do no less than to co-sponsor and support the Forand bill. If this legislation is incorporated into our social security program, then the workers of this Nation will in their later years enjoy a small part of the benefits that our military personnel and their families have enjoyed so much more completely for many years. And I might say that the Forand bill does not provide these benefits for nothing. The workers covered by social security will, of course, contribute from their pay envelopes to pay an essential part of the costs of their health insurance.

Nothing is so devastating to a person or family as a serious illness. The cost of medical care has become so expensive that only the wellto-do can afford a sickness. The President, deeply concerned about this cost has urged the medical profession to do something about the continuously climbing doctor's bills. This is fine, but records show that thousands of our citizens have put off badly needed operations because they simply cannot pay for the care.

Our older citizens living on fixed or declining incomes are the main victims of this economic squeeze on their health. It is reported that only 40 percent of the people over 65 years of age are covered by any health insurance programs. Thousands of our oldsters must depend on their children for care, or they are forced to seek medical assist

ance from charitable institutions, or just can't and so don't pay the doctor's bill.

We know that the incidence and severity of illness increases with age. A study conducted by the Department of Health, Education. and Welfare over a 12-month period in 1957-58 of two groups of 100 persons each showed that those 65 and over had 1,630 disability days, as against 697 for those under 65. The same study showed that people 65 and over required 178 days of hospitalization as against 76 for the younger group. The aged group had almost four times as many days of "restricted activity" 4,730 as against 1,743 for the younger group.

The committee is familiar with the provisions of this legislation, so I shall not belabor details. I would like to, however, emphasize the elements of this legislation which I favor.

I favor a program which will become a part of our social security system. Under this program, I would like to see all those retired under social security eligible for hospitalization which would be completely paid for up to a period of 60 days. This would include payment for a semiprivate room, board, drugs, and care together with payment for convalescent care up to another 60 days. It would also include the cost of dental and all other surgery.

In conclusion to this brief statement, I should like to say that if the medical scientists in our great American democracy have discovered wonder drugs and medical techniques which will prolong the lives of our citizens then, in my opinion, our Christian society and Government should provide the means for our elder citizens to enjoy the right and opportunity to live out this greater span which has been won for them.

Therefore, I urge this committee to give the Forand bill a favorable report so that Congress may have an opportunity to implement its progressive human program.

The CHAIRMAN. Thank you, Mr. Kowalski for coming to us and giving us your views on this subject.

Mr. KOWALSKI. Thank you, Mr. Chairman.

The CHAIRMAN. Our next witness is Dr. Larson and Dr. Swartz. Mr. Simpson.

Mr. SIMPSON. Mr. Chairman, I note these gentlemen are accompanied by our colleague, Mr. Short.

Mr. Short, did you want to present one of your constituents?

STATEMENT OF HON. DON SHORT, A REPRESENTATIVE IN

CONGRESS FROM THE STATE OF NORTH DAKOTA

Mr. SHORT. Yes, Mr. Chairman. If I could impose for just a moment or two, I am very happy and very proud to have this opportunity to present to this committee and to you, Mr. Chairman, one of North Dakota's most distinguished citizens.

I might add that all North Dakota citizens are distinguished, but this is one of the more distinguished ones. Dr. Larson is the past president of our State Medical Association. He is the present chairman of the board of trustees of the American Medical Association. He has just returned from the World Health Organization Conference in Geneva, Switzerland.

« PreviousContinue »