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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.

Subject: Statement for record.

CENTRAL TRADES AND LABOR COUNCIL

OF ROCHESTER, N. Y., AND VICINITY,
Rochester, N.Y., July 13, 1959.

CHAIRMAN OF WAYS AND MEANS COMMITTEE,
Hearings on H.R. 4700, Forand bill,
Washington, D.C.

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,

JAMES L. BURKE,
President.

[P. 140-Official proceedings of the 94th Annual Convention of the New York State Federation 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.

STATEMENT IN SUPPORT OF THE FORAND BILL (H.R. 4700)

(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 individual 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 services which would permit early diagnosis and treatment. This delay causes unnecessary pain and suffering. It may also result in complications or the development 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.

STATEMENT OF WILLIAM POLLOCK, GENERAL PRESIDENT, TEXTILE WORKERS UNION OF AMERICA, AFL-CIO, IN SUPPORT OF THE FORAND MEDICAL AID TO THE AGED BILL, H.R. 4700

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 have 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 systems. 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 their own financial resources and social security benefits. Consequently they get no medical care as independent 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 com44432-59-41

munity, which often has inadequate resources for this purpose, particularly in textile areas. The retirees are, therefore, pauperized and inadequately cared

for.

Our Nation boasts of its humanity and its wealth and the great social advances. This boast must remain empty while this great gap in our social security system exists.

We have developed a system of providing hospital care which is easily administered. We urge that the Forand bill be adopted to remove this injustice from the present system of care for the aged and to relieve the cost of this care from the local communities unable to carry the burden and which are therefore in many instances not discharging their humane responsibilities. The speedy enactment of the Forand bill is imperative.

Hon. WILBUR D. MILLS,

COMMUNICATIONS WORKERS OF AMERICA,
Washington, D.C., July 13, 1959.

Chairman, House Ways and Means Committee,
Washington, D.C.

DEAR CONGRESSMAN MILLS: On June 22, 1959, the 1,200 rank-and-file delegates to the 21st Annual Convention of the Communications Workers of America adopted a resolution pledging their support of Congressman Forand's bill (H.R. 4700) which provides for the addition of health benefits to the existing old-age and survivors insurance program. The purpose of this letter is to inform you of some of the reasons for CWA's wholehearted support of the Forand bill.

In the communications industry the number of persons drawing company service pensions, as distinguished from disability pensions, has more than doubled over the past 10 years. At the end of 1958 there were a total of 49,006 retired men and women, including both management and nonmanagement employees, in the Bell Telephone System alone. At the end of 1947 there were only 18,730 people on pension. Of course, the overwhelming majority of these pensioners also are eligible for benefits under the Social Security Act.

The average monthly company pension payment amounted to approximately $105 during 1958. However, the average pension received by nonmanagement employees would be less since their wages were a great deal less than the salaries paid to management personnel.

Under the Bell System pension plan, as is true in the communications industry generally, the pension payment is reduced by one-half the amount of social security benefits received by the retired employee, and there are no survivor benefits provided. Thus, even with the combination of social security and pension benefit payments, a retired employee in the communications industry receives only enough to maintain and provide himself and any dependents he may have with the bare necessities of life.

In the vast majority of cases retired employees cannot continue their group hospitalization and surgical insurance at group rates, but must pay considerably higher, almost prohibitive rates, if they choose to continue this necessary protection subsequent to their retirement. Thus, for the most part, they are unable to afford any type of hospital and surgical benefit protection.

Under Congressman Forand's proposal the type of insurance most needed by our elder citizens would be provided, such as the costs for hospital, home nursing and surgical services. The manner of administration of the program is clearly defined and adequate safeguards are provided for the internal management of participating institutions, the practice of medicine and the manner in which medical services are rendered. Moreover, H.R. 4700 provides a means of adequately financing these additional benefits by increasing the present contribution rates of employers and employees by one-quarter percent each.

The Communications Workers of America urges you to consider most favorably the proposals contained in H.R. 4700 and to recommend the passage of this bill during this session of the Congress. It is respectfully requested that this letter be made a part of the verbatim record of the hearings on this matter which your committee is commencing this date.

Sincerely,

J. A. BEIRNE, President.

STATEMENT ON THE FORAND BILL (H.R. 4700) TO PROVIDE HEALTH CARE FOR SOCIAL SECURITY BENEFICIARIES

(By the International Longshoremen's and Warehousemen's Union)

The International Longshoremen's and Warehousemen's Union represents 60,000 members who work in the longshore, warehouse, sugar, and allied industries on the west coast and in Alaska, Canada, and Hawaii. We appear representing the membership and on behalf of pensioned and retired members of the union.

We wish to state at the outset that we support passage of H.R. 4700, the Forand bill, with but one technical amendment which we believe is imperative, and which we will describe later.

The Forand bill includes some of the improvements called for by the 13th biennial convention of our union, and it has been specifically endorsed by resolution and by petition by ILWU members and pensioners. Petitions signed by more than 5,000 ILWU pensioners and retired members were placed in the hands of Congressman Cecil King of this committee in June of last year in connection with the hearings on H.R. 9467.

STATUS OF HEALTH CARE FOR RETIRED ILWU MEMBERS

While the vast majority of ILWU members are covered by various pension plans, only in our longshore division do our contracts provide reasonably adequate health care for the pensioner, his wife, and his children.1

Longshore pensioners receive the same health coverage as do working members. Even though this coverage is the best on the west coast under available prepaid plans, we have found that they are inadequate for the needs of our retired members. A perennial problem, one which emerges persistently and chronically, is that of the pensioner who exhausts his hospitalization benefits. Under our plan the limit is 100 days per year per disability in the hospital under most of our service plans, and 70 days per year per disability under our insured plans. We find that the great need of this group is for nursing home care which is not provided under our plans. Such care generally costs much more than the total money income of our retired longshoremen, including both their ILWU-PMA pension of $100 a month and their social security pension. It will, therefore, be of great importance to our longshore pensioners to secure the nursing home services provided by H.R. 4700.

Longshoremen in Hawaii have similar health coverage for pensioners as in west coast locals. Of the remaining parts of our union, only the pineapple and sugar divisions of our Hawaii local 142 provide such care, but it is limited coverage only.

THE NEED FOR AMENDMENT OF SECTION H

Unfortunately section h of H.R. 4700, as written, clearly envisages reimbursement of fee for service systems only and does not clearly provide a mechanism for reimbursement of service plans under which most retired longshoremen, for example, secure health care at the present time. We do not believe this was intended and we urge adoption of an amendment which would, in some fashion, convert fee-for-service dollars into a per capita amount so that service plans will be treated on a basis of equality with fee-for-service plans. Otherwise, groups that utilize service plans will be penalized.

THE SOCIAL CHARACTER OF THE PROBLEM

The general shape of the problem clearly emerges from the report by the Secretary of Health, Education, and Welfare to this committee.

Fifteen and one-third millions are now aged 65 and over, and the proportion of the aged in the population is steadily increasing.

The median total money income of retired couples on social security in 1957 was $183 a month. Single retired workers and aged widows had considerably less money income. Three-fifths of the aged have yearly incomes of less than $1,000. The aged cannot possibly be expected to pay for medical care from this meager income.

1 In most ports pensioners' children are covered up to age 19 (except in Aberdeen, Wash. (age 18), and the Seattle Service Plan (age 21)). All longshore pensioners' children up to age 15 are also covered for dental care.

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