5. The State of South Carolina has a fund to pay for hospital services for those on the welfare rolls of the State 34,000 people over 65 fall in this category. 6. Most counties of the State have emergency welfare funds to pay for hospitalization of those persons not on relief but who find themselves financially embarrassed by reason of sudden or unexpected illness. 7. Other funds already in existence such as those provided by the State cancer fund, the heart fund, veterans hospital facilities, etc., help materially in these specific fields. Recapitulating, we find that those over 65 who have adequate means can pay for medical care or buy insurance as they choose. Those with limited income can budget for hospital and medical care at a cost of $2 per week. Those in this group who find themselves unable to budget can call on the county emergency funds. Those on the welfare rolls have adequate funds available for hospitalization and no physician would think of charging these bona fide unfortunates. This leaves only 14 percent to be cared for by the Forand bill, and it seems to us that rightfully they should be allowed to avail themselves of the insurance which has been offered by American free enterprise. Committees of Most of this has been accomplished during the past year. the South Carolina Medical Association, Dental Association, Hospital and Nursing Home Associations continue to study ways and means of solving these and other problems connected with the care of the aged of which medical and hospital care is only a small part. The State of South Carolina has a special legislative committee set up to study the various aspects of geriatrics and make recommendations to be considered by next year's legislature. Also, the South Carolina State Council on Care of the Aging has been organized and brings together the best thinking of all interested groups. Surely, free enterprise, with the cooperation of the local government, can solve this problem. Let's give them a chance. The Forand bill is not the answer. HOUSE OF REPRESENTATIVES, Hon. WILBUR D. MILLS, Chairman, Ways and Means Committee, House of Representatives, Washington, D.C. DEAR MR. CHAIRMAN: The enclosed statement was sent to me by Mr. John C. Foster, executive secretary of the South Dakota State Medical Association, with the request that it be included in the record of hearings by the House Ways and Means Committee on H.R. 4700. May I ask you as chairman of the committee to request the committee's consent for including this statement in the record? Very sincerely yours, GEORGE MCGOVERN. STATEMENT OF THE SOUTH DAKOTA STATE MEDICAL ASSOCIATION ON H.R. 4700 FOR INCLUSION IN THE PROCEEDINGS OF COMMITTEE ON WAYS AND MEANS, HOUSE OF REPRESENTATIVES Gentlemen, the South Dakota State Medical Association, through its committees on aging and on legislation has considered the provisions of H.R. 4700 and finds it must record strenuous objections to the proposal. 1. It is our feeling that H.R. 4700 attempts to solve a problem the dimensions of which are presently unknown. It would appear that the sponsors of H.R. 4700 are assuming that a large segment of the population is without care. This assumption is the basis for the proposal but has not as yet been proved nor studied adequately to produce intelligent and logical answers. A step in the right direction has been taken in the promulgation of State and National committees to study problems of aging which will culminate in the President's Conference on Aging in 1961. To date, these committees have not been able to do more than organize and scan the areas to be researched. In South Dakota no Governor's committee has yet been named, but two research persons are preparing the way for appoint ment of a committee. Nothing of concrete value concerning the aging problem, care, treatment, recreation, and housing can be arrived at in less than a year to 18 months of continuous study. It would be hazardous to even guess at the number of aged in South Dakota, let alone to attempt to figure how many might need the provisions of an H.R. 4700 (you will note the use of the word "need" rather than "desire"). It would appear ill advised to attempt to solve a problem when there are as many unknowns involved. It is our considered judgment that much more time should be allotted to the judicious scanning of facts before any attempt is made to solve alleged problems at the Federal Government level. 2. Care of the aged should not be considered in the light of political expediency or attractiveness. While social problems brought about by increased longevity did not appear overnight, they are reasonably new. Provisions for housing the aged were not difficult when the aged were few in number; the same was true of medical and hospital care. Geriatrics as a field of medicine is totally new and merely in the explorative stage. To attempt to solve problems of medical care by legislation is erroneous judgment. 3. The solution to the problem lies with survey, research, and action, not by Government but by every citizen and every agency concerned with problems of the aging. One of the problems already recognized is the securing of adequate housing, not for those needing hospital care but for those whose needs include some nursing care. When the problems of housing and financing such housing are met, only a few problems of medical and hospital care will exist. 4. The proposed provisions of H.R. 4700 will serve to place a greater burden of taxation on people already overburdened. Much of this type of legislation is "sold" to the public on the basis that it is "free" care. Obviously, this cannot be. We do not wish to belabor any weaknesses in the social security program, but we feel that those weaknesses should not be compounded. If 10 percent of the aged need care as provided in H.R. 4700, 30 percent would avail themselves of it. Similarly, if all of the aged would presently need care once or twice a year under a Government program, they would demand care three to five times as often. Additionally, Government programs tend to lengthen hospital stays. This is proved by Veterans' Administration figures that the average acutely ill person stays twice as long in a VA hospital as the average in private general hospitals. These tendencies are normal reactions to a prevailing attitude that "as long as the Government pays, we might as well get ours." Government has no resources but its people; if this type of program gets started and is enlarged to encompass all age groups, the people may well feel it is easier to live off Government largess than it is to work. Proposed taxes of 91⁄2 percent for the total social security program proposed by 1969 would be inadequate due to overutilization from the start to support an H.R. 4700. It is the considered opinion of the South Dakota State Medical Association that H.R. 4700 should not receive favorable action of the committee because of (1) the high cost, (2) the political approach to a medical problem, and (3) inadequate background studies to determine the scope of the problem. Hon. WILBUR D. MILLS, HOUSE OF REPRESENTATIVES, Chairman, House Committee on Ways and Means. DEAR COLLEAGUE: I have been requested by the executive secretary of the Vermont State Medical Society to see that their letter of July 7, 1959, concerning H.R. 4700, the Forand bill, is entered in the record, and I'm therefore enclosing a copy of this letter. I will appreciate its being made part of the record on H.R. 4700, even though I have already made my own personal position in favor of H.R. 4700 clear in my earlier letter of July 2. With best personal regards. Sincerely yours, WILLIAM H. MEYER. VERMONT STATE MEDICAL SOCIETY, Hon. WILBUR D. MILLS, Chairman, House Ways and Means Committee, DEAR SIR: It is our understanding that H.R. 4700, the Forand bill, is up for hearings beginning July 13, 1959. Our Blue Cross-Blue Shield program here in Vermont and New Hampshire has always (for some 15 years now) allowed people to enroll in it without regard to age or physical condition. They enrolled a lady of 99 living in a nursing home a few months ago. We already have about 45 percent of our people over 65 enrolled in Blue CrossBlue Shield. We would estimate that another 5 percent have some other kind of health insurance. The costs of our BC-BS are not great-Blue Shield costs less than $2 per month for an individual. Our Blue Shield provides for payments to doctors for office, hospital, and home calls as well as for surgery, X-ray, etc. We sincerely believe that the people in Vermont (and New Hampshire) have a better plan of health insurance available to them now on a private basis than they would have under the Forand bill (as we understand it), making that type of legislation unnecessary. Half our people are already taking advantage of it and more and more people are being enrolled every month. We will never cover everyone, neither would the Forand bill. There will always be those who don't believe in insurance; those who have sufficient funds to make insurance unnecessary; those on relief; etc. It is sincerely hoped that your committee will give thorough consideration to all aspects of this situation, including those plans already in effect on a voluntary, private, and nonprofit basis, before rushing into a governmental do-good program which may not do as much good as hoped and with the usual (necessary, but usual) redtape and administrative expense. Very sincerely yours, GETTY PAGE. WASHINGTON STATE MEDICAL ASSOCIATION, Hon. W. D. MILLS, Chairman, House Ways and Means Committee, DEAR REPRESENTATIVE MILLS: Because the Forand bill, H.R. 4700, is a farreaching step toward total socialization of medical care, the Washington State Medical Association respectfully recommends against passage of the measure. Free choice of hospital and physician would be definitely restricted if the bill should become law; the Federal Government would inject itself into the principle of fixing physician fees and hospital charges, which would result in a regimented economy. The Forand plan would mean higher taxes and reduced take-home pay, and the entire social security program would be jeopardized. The Federal Government would be placed in competition with private health insurance plans, which are well on the way toward solving the problem of health care for the aged. Eventually, these plans would be destroyed, and free enterprise would be badly handicapped. Other segments of the population would insist upon similar treatment, leading us definitely toward total socialization of medical care. The bill would result in Government control of hospitals, thus discouraging their support and control by the communities. Inasmuch as free enterprise is making progress in taking care of the aged, the Federal Government should offer encouragement and its blessings to the effort, instead of lending discouragement by passage of the Forand bill. Therefore, Congress is urged to defeat the measure. Sincerely yours, E. L. CALHOUN, M.D., President. Mr. LEO H. ERWIN, THE WYOMING STATE MEDICAL SOCIETY, Chief Counsel, Committee on Ways and Means, House of Representatives, Washington, D.C. DEAR MR. IRWIN: This is a statement for the Wyoming State Medical Society regarding H.R. 4700, by Hon. Aime J. Forand. In Wyoming nearly all of the aged are receiving excellent medical and hospital care paid for by themselves, by Blue Cross-Blue Shield or insurance coverage, or by the welfare departments. If the Congress feels that for political reasons some kind of health legislation should be passed to appeal to the increasing numbers of aged in the United States, the Forand bill is not the answer. It will make the situation worse in Wyoming and not better. There are other ways Federal money could be spent which might be helpful to the aged, such as they suggested in the letter date June 25, 1959 to Senator Pat McNamara, chairman, Subcommittee on Problems of the Aged and Aging, expressing the views of most of the doctors of Wyoming. However, the Wyoming State Medical Society is opposed to the Forand bill because it is unnecessary, it costs too much, and it will not do the job. There is no health problem or social problem or economic problem in Wyoming which this bill would solve and we think that the Forand bill makes a purely political issue. The reasons for opposition have been well stated by Secretary of Health, Education, and Welfare Arthur S. Flemming, and representatives of the American Medical Association. Yours truly, BYRON HIRST. JEFFERSON COUNTY MEDICAL SOCIETY, Hon. WILBUR MILLS, Chairman, Ways and Means Committee, DEAR REPRESENTATIVE MILLS: The Jefferson County Medical Society, comprised of 648 physicians, has gone on record in opposition to the Forand bill (H.R. 4700) which we understand will be the subject of hearings before the House Ways and Means Committee this month. We feel this legislation is not in the best interests of democratic government nor of our citizens it purports to serve. As you well know, most of our sick-poor are not covered by the social security system and, therefore, would not be benefited under the Forand proposal. The physicians of this State traditionally provide free service to the indigent and will continue to do so. In our judgment, this measure would be a dangerous step toward a socialistic form of government which we feel certain no thinking member of your committee would favor. This measure undoubtedly would undermine, if not destroy, our voluntary health insurance programs which now protect 75 percent of our older population. We see in this measure a political approach to a health problem controlled and administered by persons not specifically trained in the health fields and, therefore, liable to political abuses and administrative wastes such as now are glaringly evident in certain other programs. We strongly urge that this committee report adversely on this measure, and further, will take positive action to end foolish Government spending and waste which someday will wreck our Nation. Respectfully yours, S. JOSEPH CAMPBELL, M.D., President. SALEM, N.J., July 16, 1959. Hon. WILBUR MILLS, Chairman, Ways and Means Committee, The Salem County Medical Society wishes that it be recorded in strenuous opposition to the Forand bill, H.R. 4700. We believe that Federal financing of hospital, surgical, and nursing home treatment of the aged will inevitably lead to Federal control and regulation of such treatment to which we are firmly opposed. SALEM COUNTY MEDICAL SOCIETY, RESOLUTION Whereas the Congress of the United States is now considering H.R. 4700, popularly known as the Forand bill, proposed legislation which would provide for the purchase of health care services by the Federal Government for those persons entitled to social security benefits; and Whereas in the absence of an authoritative survey, the need for this program has not been clearly established; and Whereas this program would result in the Federal Government assuming a function of private health insurance industry, a function now being competently handled with increasing scope and efficiency; and Whereas the financing of this proposed program would result in prohibitive public taxation additional to present high levies; and Whereas the program as proposed denies the patient the basic right to select his own physician, limiting him to those doctors under contract to the Federal Government; and Whereas such a program would result in a staggering overutilization of hospital and clinical facilities, resulting in lowered standards of medical and hospital care to those actually ill; and Whereas the program does not provide for a large segment of the destitute aged who are ineligible for such benefits; and Whereas the proposed legislation is a political approach to a health problem which will unquestionably result in an extension of bureaucratic practices, inhibition of private initiation and industry, and political abuses and administrative waste: Now, therefore, be it Resolved, That the Tulsa County Medical Society hereby opposes the enactment of H.R. 4700 introduced in the 86th Congress by Representative A. J. Forand, of Rhode Island; and be it further Resolved, That this expression of opinion be communicated to the Members of the Congress for their careful examination and consideration. JAMES W. KELLEY, M.D., President, Tulsa (Okla.) Medical Society. Approved this 1st day of July, 1959. DAUPHIN COUNTY MEDICAL SOCIETY, Hon. WILBUR D. MILLS, Chairman, Committee on Ways and Means, DEAR SIR: The executive committee of the Dauphin County Medical Society, a nonprofit organization consisting of approximately 350 physicians licensed to practice medicine in Pennsylvania, recently adopted the attached resolution pertaining to H.R. 4700, the Forand bill. As president of the county medical society, I am directing a copy of it to you as well as copies to the Honorable Messrs. Richard M. Simpson, William J. Green, and Walter M. Mumma. I know that you and members of your committee will give it every consideration. Respectifully yours, FRED B. HOOPER, M.D., President. |