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to you, giving their views as well as my own, and I am pleased to do so.

The majority of the people I represent are conservative in their approach to Government matters. They generally believe that many things can be handled cheaper and more efficiently by State, local, or private institutions or governments than by the Federal Government.

While we all recognize that many aged persons have difficulty meeting the problems of day-to-day living, and especially in meeting the costs of hospitalization and physicians' fees which are more common among older persons, I believe that these problems can, in the large, be handled by State and local governments in Nebraska and by private institutions and individuals.

I am opposed to increased social security taxes on wages earners and employers to pay for the program envisioned under H.R. 4700. I sincerely believe that in Nebraska our State and local hospitals are adequately handling the problem of aged persons needing medical care who do not have the financial resources to pay for this care. In addition, I believe that the physicians in Nebraska recognize the problems older persons have, when so many of them are on pensions or other fixed incomes, and are waiving fees or reducing fees to the point where there is little or no problem of medical care for older indigent persons.

Accordingly, as I indicate above, I cannot support the provisions of H.R. 4700 and do not believe that the majority of the people in Nebraska would support this legislation either. Sincerely yours,

GLENN CUNNINGHAM, Member of Congress.

MONTGOMERY, ALA., July 8, 1959. Hon. WILBUR D. MILLS, Chairman, Committee on Ways and Means, House of Representatives, Washington, D.O.

DEAR CHAIRMAN MILLS : In behalf of the aged citizens of Alabama, we urge a favorable consideration of H.R. 4700, introduced by the Honorable Aime J. Forand, to amend the Social Security Act to provide insurance for the cost of hospital, nursing home, and surgical services for persons eligible for old-age and survivors insurance benefits.

We in Alabama certainly appreciate the committee's keen interest in the proposed legislation, designed to safeguard and protect the lives of our 15.4 million persons aged 65 and over, representing 8.7 percent of the total population of our country.

H.R. 4700 will take a leading part in reducing our yearly mortality rate of about 1 million among persons age 65 and over. Every approach should be explored which might offer a remedy for the present situation, where large numbers of senile patients are sent to hospitals for the mentally ill to die, because of the lack of suitable facilities for treatment of the aged. yet those who do become hospital patients this year and have no adequate in

Many of our aged citizens are beset by boredom and left with few outlets ; yet those who do become hospital patients this year and have no adequate insurance against the soaring costs may find the psychic shock of expense to the pocketbook nerve almost as great as the physical shock of an operation to the body.

The Government's own figures show that living costs in general have gone ap 108.6 percent since 1939, while in that same 20-year period the rise in hospital costs has been around 300 percent. The income of the average aged citizen in Alabama is between $49 and $80. Adequate hospitalization, surgical, nursing home, and rehabilitation programs for the elderly are but examples of some of the requirements which, therefore, must be supplied. If the necessary facilities don't exist, they must be supplied under this program and the Hill-Burton program. Only then can the aged remain in their community. Only then will they not have to be sent away from loved ones and friends. Only then will they not die from loneliness and isolation.

Medical progress has gradually lengthened the life span of our citizens, mainly through saving infants and mothers who die unnecessarily. Is it not equally vital that our aged, in whose ranks are found some of America's greatest spiritual, mental, and skilled assets, should share in these benefits, which H.R. 4700 will provide?

If we reject this bill, we reject the aged, and we allow precious human lives to be tragically and needlessly wasted. Most of our aged don't wear out. They rust out. Thy rust out for lack of adequate medical, nutritional, and health cares, and for want of the simple necessities of life.

This bill, regardless of expenditure, will not be a liability to the country. It will be an investment for the best future interests of our Nation. Nor can those who so oppose a liberal national hospitalization and medical plan seriously argue that this bill is a step in the wrong direction.

We most seriously urge more medical help for the aged, through passage of this bill, and would to that end again call to your attention not only the humanitarian aspect, but the needs of our Nation today for every available ounce of its energy and resource, not just to preserve our society, but that freedom and a better life might flourish for all in our society. Respectfully submitted.

RUBIN MORRIS HANAN, Vice Chairman, Committee on the Aging of the State of Alabama.


Newark, N.J., July 9, 1959. Hon. WILBUR MILLS, House Office Building, Washington, D.O.

MY DEAR MR. MILLS: I understand the House Ways and Means Committee will hold 5 days of hearings on the Forand bill beginning July 13.

The Consumers' League of New Jersey has endorsed H.R. 4700 and prepared a statement in favor of the bill.

I am submitting a copy of the statement which I hope you will place in the records of the hearing. Sincerely,

Mrs. MARION C. REED, President, Consumers' League of New Jersey.



Medical insurance for the aging must be considered in relation to our changing economic structure and medical achievements. Society must meet the obligation for the medical needs of the aging.

A large percentage of our citizens over 65 are medically indigent. The income in many cases does not even cover a low standard of living. Chronic illness is prevalent in this age group when the need to meet such a financial burden can wipe out a family's savings. The span of life has lengthened, fear of financial burdens too great to be borne by the "senior citizen” himself often aggravate a medical condition.

The normal pattern of living is changing. Many retired people no longer remain in the same locality after retirement, in fact, many go to another State. Moving from one State to another jeopardizes the possibility of receiving State aid for medical emergencies until resident requirements have been fulfilled. This is one of the reasons we believe medical insurance under the social security program is necessary to solve such a problem.

Insurance to provide medical security on a private basis is seldom satisfactory once a person has reached 65 because of cost and limited coverage. The increasing number of people in this age group and the prevalence of infirmities has encouraged unscrupulous salesmen to trade upon the fears of the aging by marketing unsatisfactory programs.

Many States are faced with a tremendous problem of providing for the medical care of our older people. In New Jersey 75 percent of the aged are now covered by old-age and survivors insurance. If social security included health insurance the State would be financially better able to provide care for those who are not covered.

There are 465,000 people in New Jersey aged 65 or over. Approximately 351,000 receive monthly social security benefits that average $62.23 per month.

Statistics recently released would indicate that approximately $162 a month would be required to meet all the needs of an aged woman living in a family, and about $206 per month if living alone in a furnished room and eating meals in a restaurant. About $10 a month is allowed for medical care. Obviously any extensive medical care must be met out of savings or in some other manner.

We believe medical care should be guaranteed the same as old age assistance by an insurance program paid for by both the employer and employee during the productive years.

We would appreciate your support of the Forand bill, H.R. 4700.


Rochester, N.Y., July 13, 1959.
Subject: Statement for record.
Hearings on H.R. 4700, Forand bill,
Washington, D.O.

GENTLEMEN : The Rochester Central Trades and Labor Council wish to emphasize their support of the Forand bill, H.R. 4700. Our interest in this bill stems from the many cases of hardship, repeatedly brought to our attention by members of various affiliated locals, our friends, and numerous news releases, that Rochester, N.Y., is the "oldster" capital of the United States. Therefore, we realize the tremendous need for legislation to relieve the plight of aged and retired people living on a fixed income, with no provision for medical care.

Our interest dates back to July 15, 1957. We felt that as an organized body it was our civic duty to insititute positive action. At a meeting held that day we passed the enclosed resolution, carried it to the New York State Federation of Labor convention held July 22–25, 1957, where it was overwhelmingly approved, and the same year adopted by the American Federation of Labor, passed and approved at its convention. The need is urgent, our duty is clear, old age can be a good. The Forand bill is the answer. Sincerely,



(P. 140_Official proceedings of the 94th Annual Convention of the New York State Federa

tion of Labor, held in Buffalo, N.Y., July 22-25, 1957)

To: The committee on resolutions.
From: Rochester Central Trades and Labor Council.

Whereas to help alleviate the ever-increasing economic pinch of our aged and retired persons; and

Whereas our social security payments being farcical and totally inadequate in respect to present day living costs and a consequent lowering of our living standards, not to mention total lack of coverage for any hospitalization of beneficiaries under social security over 65; and

Whereas in order to keep pace with Canada, our neighbor to the north, on advances in social legislation and to establish a bulwark against communism in this country: Be it

Resolved, That the New York State Federation of Labor approve and carry forward this plan that the top social security payments be increased from the present $108.50 per month to $151.80 for an individual worker, the raise to be financed by an increase of 0.0025, one-quarter of 1 percent, on both employer and employee, this increase to be levied on income up to $6,000 per annum instead of the present $4,200; this increase to cover cost of hospitalization as well.


(By Dr. Morris Brand, medical director, Sidney Hillman Health Center, New

York, N.Y.; Dr. William S. Hoffman, medical director, Sidney Hillman Health Center of Chicago; Dr. Joseph A. Langbord, medical director, Sidney Hillman Medical Center of the Male Apparel Industry of Philadelphia; Dr. Julius Schwimmer, medical director, Amalgamated Laundry Workers Health Center of New York)

The undersigned, medical directors of the four health centers affiliated with the Amalgamated Clothing Workers of America and serving 110,000 members and spouses, strongly recommend passage of the Forand bill which will provide for hospitalization, surgical benefits, and nursing home care to those men and women of this Nation who are old enough to be beneficiaries under the Federal social security system.

It is sad indeed that millions of men and women, who by their labors in the prime of their lives have helped build, sustain, and maintain our high standard of living, in their old age are unable to enjoy medical security in a country that considers itself to be in the forefront of medical knowledge and skills. It has been shown by many students of this subject that when workers retire, with the usual accompanying loss of income and health insurance benefits, the need for all medical services, including hospitalization increases. Conversion to indi. vidual coverage, when permitted, by private and quasi-public nonprofit insurance plans, are far too costly for retired persons to purchase and too often have limitations which make the policies of little value in time of medical catastrophy.

The deprivation of income and the lack of medical and hospital insurance coverage may, and often does produce a mental hazard which may aggravate existing functional and organic disturbances. The inability to predetermine the costs of medical services stops many individuals from seeking preventive seryices which would permit early diagnosis and treatment. This delay causes unnecessary pain and suffering. It may also result in complications or the develop ment of chronic disabling conditions requiring costly long-term medical care, usually at the community's expense, or even in premature death.

In our daily activities we are frequently confronted with the necessity of hospitalizing retired members and their spouses for surgical and nonsurgical conditions as ward cases in municipal and voluntary hospitals because they have not been able to afford hospital and surgical insurance coverage. We have cases on record to prove that retired members who have been advised to be hospitalized for such serious conditions as impending gangrene of the toes, acute thrombophlebitis of the lower extremities, cancer of the colon and for rehabilitation following a cerebral vascular hemorrhage (stroke) were turned away by the hospitals to which we had referred the members. Such situations would not have occurred if these members had adequate personal funds or insurance coverage.

We know of no adequate remedy for this gap in our medical coverage except an equitable system of national coverage, paid for by the worker during his years of peak earning power. Neither private insurance plans nor the Blue Cross and Blue Shield plans have met the need. Union-sponsored medical insurance programs have done much to help the workers, but when they retire their coverage usually comes to an end. Our union- and management-sponsored health clinics are doing their best to care for the ambulatory retired workers, treating thousands of them every year and keeping many out of hospitals, but they are helpless in providing hospital care for those whose funds and insurance coverage have become exhausted.

The American Medical Association has officially regarded the Forand bill as socialistic and a step toward a national health insurance plan. Actually, of course, the Forand bill represents nothing more than an extension of the socialsecurity program which is acknowledged by all other groups as being of inestimable benefit to millions of persons. The suggestion to have physicians reduce their fees for elderly patients is neither just nor realistic. The community as a whole must meet these medical needs.

In spite of the American Medical Association's official attitude, many physicians like ourselves support the principles of the Forand bill and want it passed. The Group Health Association of America, a recently formed organization combining the Group Health Federation of America and the American Labor Health Association, has endorsed the Forand bill. As physicians and as administrators of clinics we realize the urgent need for the benefits in the Forand bill. We urge Congress to pass it without further delay.



Immediate approval of the Forand bill is imperative if this country is to discharge its responsibilities to the aged and relieve the hospitals and communities of the heavy load which they must currently cover. No system of voluntary insurance will be adequate to provide for the aged since the low-wage

workers in American industry as well as the large majority of older persons in the United States are completely without insurance coverage when they become unemployed or are retired.

In the textile industry, the proportion of employees who are covered by employer insurance programs providing for hospital benefits is approximately 85 percent. The proportion of the employees whose dependents are covered is less than 40 percent. In both types the employee generally pays a substantial part of the cost of these benefits.

While there is some semblance of adequacy in hospitalization coverage for textile employees, the provisions for private pensions are quite limited. The available evidence indicates that less than 20 percent of the employees work in plants in which there is some system of pension benefits. In most cases, these are inadequate programs which result in monthly payments of less than $15. But the overwhelming proportion of the employees are in plants in which there is no such program. They are completely dependent upon social security benefits after age 65 or 62 in the case of women who retire at that age. In the textile industry we unfortunately observe a concerted effort on the part of the employers to squeeze out employees long before that age and certainly when they have attained the retirement age of 65 years. Moreover, there are many persons who bave been displaced from the textile industry through mill closings and technological changes which have reduced the employment requirements in this industry.

Employment of production workers has dropped by 400,000 or 32 percent since February 1951. These displaced people have found it difficult to get new jobs. Moreover, the retiring problems are aggravated in the case of older workers. The older they are the poorer are the opportunities and the smaller the proportion of those who are actually reemployed. As a result, chronic unemployment is particularly heavy in the New England, Middle Atlantic, and Southern States among the older workers.

These displaced persons are supported by unemployment insurance until their benefits run out. Moreover, because the unemployment is concentrated in textile communities where alternative jobs are not available, the problem causes economic distress for the community as a whole, particularly bearing down on the older people, who are unable to migrate to secure employment in distant places.

The plight of the older worker and the retired worker is considerably relieved by the Federal social security benefits. But the amounts of these benefits are hardly adequate to finance the barest necessities. Many have to have their OASI benefits supplemented by old-age assistance payments. Unlike workers in other industries, few textile workers receive payments under the company pension plans. We have already noted how rare they are. This great deficiency increases the burden placed upon the local community and compels it to finance hospital and medical care, and in some instances to provide custodial care because the individual cannot take care of himself on the benefits which he has been receiving.

However inadequate the hospital and medical benefits are in the textile industry for employees and dependents, they are practically nonexistent for the retired worker and his dependents. It is the rare and isolated company which provides for continued hospitalization and medical care benefits for retired workers. Probably less than 3 percent of the retired employees are covered by such programs.

The consequence of the deficiencies of these systems of coverage for the employees in the textile industry and their dependents is that they are completely dependent upon the public systeins. Their earnings have generally been meager through their working life so that they have not been able to build up any reserves or savings. For some part of these responsibilities they have to turn to their family but for most of their medical and hospitalization needs they must turn to the local communities to supplement th own financial resources and social security benefits. Consequently they get no medical care as inde pendent persons and become charges on the local community. This happens in a great number of cases in the textile communities.

The low-wage workers in this country as typified by the textile worker are not benefiting from private pension systems or private programs of medical and hospital care for the retirees and their dependents. They are dependent upon social security benefits, which prove inadequate to cover even their basic living needs. The present systems thrust the medical costs upon the local com


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