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entirely on the farmer, we therefore feel that we are very closely allied to your No. 1 problem. Although I have only been in business here 21 years, I now find I am the oldest retail implement dealer in this county and may be the longest term implement dealer in many of the counties of Kansas.
Perhaps we, as retailers, are to blame for our present condition in not having done a better job of selling in the past. Some of us feel, however, that we certainly do not merit the punishment and competition that most of the major companies are giving us in the operation of company-owned stores. This one factor, Floyd, has worked a terrific hardship on the independent retail implement dealers.
Of course, today's high cost of doing business which is comprised of high wages for help, high taxes, and high insurance rates have placed a burden upon the independent operators that have taken their toll. You and I have both seen hundreds of good, independent retail houses close and look to more lucrative fields to make a living. Deep down, Floyd, I feel this is a real tragedy. I'm old fashioned enough to still believe that the very backbone of this Nation is nurtured and fed by the independent farmers and small businessmen, and the thought of losing so many of our numbers is an alarming situation.
Having talked to you previously along these lines, I can only say that I, for one, appreciate your attitude on this, as I know you are as greatly concerned over this problem as I am. I know and I feel that you know that any future legislation passed by Congress that in any way will affect the cost of doing business by the small independent business operator only hastens the day of his demise. It is, therefore, unnecessary for me to tell you that sincerely hope that H.R. 4700, known as the Forand bill, will not be approved by Congress. I can readily understand that elderly people should be taken care of, but when the cost of doing this is placed in whole or in part upon a segment of the business economy of this country that is today literally fighting with its back to the wall for its continued existence, then I believe the independent retailers are well within their rights in pleading with you and every other elected representative of the people to use your influence and strength in defeating this bill.
I trust, Floyd, that you will overlook the length of this epistle. Frankly, I am a poor letter writer, and I could have a much better time visiting straight across the board with you, as we have done in the past.
Trusting this finds you in the best of health and with kindest personal regards to yourself and your good wife, I remain Yours very truly,
P.S.—With your kind permission, I would like to send a copy of this letter to Representative Mills, chairman of the House Ways and Means Committee. I will not forward it to him, Floyd, until I hear from you.
THE FIRST NATIONAL BANK OF MISHAWAKA,
Misharoaka, Ind., July 13, 1959. Hon. WILBUR MILLS, Chairman, House Ways and Means Committee, House Office Building, Washington, D.C.
SIR: I wish to register my opposition to the passage of H.R. 4700 introduced by Congressman Aime J. Forand and upon which your committee is holding hearings commencing today.
I do not intend or desire that elderly persons in need of medical attention should be deprived this service. However, the high cost of the gross inefficiency demonstrated by the Federal Government in administering programs for the benefit of individuals and of local communities is both alarming and constitutes gross injustice as well as an unnecessary burden to the American taxpayer. The benefits intended by this bill would best be administered through local welfare departments with local financing and local control. Under such circumstances aid would be furnished when and where needed, as is now the case in most communities, and there would not be the great need felt to "convalesce” unnecessarily, which need I am sure would be felt by a flood of elderly people if the proposed bill became law. It is requested that this letter be made a part of your hearing. Very truly yours,
JOHN M. DI GANN.
MEDICAL AND CHIRURGICAL FACULTY OF THE STATE OF MARYLAND,
Baltimore, July 15, 1959. Hon. WILBUR MILLS, Chairman, Committee on Ways and Means, House of Representatives, Washington, D.C.
DEAR MR. MILLS: I am writing to you as chairman of the Medical and Chirurgical Faculty of the State of Maryland's Legislative Committee. The Medical and Chirurgical Faculty, as you may know, is one of the oldest State medical societies in the country. Not only is it one of the oldest State medical societies, but in the State of Maryland we have two of the most outstanding medical schools in the country. As a consequence, the views of the medical profession in the State of Maryland are not ones that are taken rashly or hurriedly, for the records that have been established by the medical profession in Maryland are the result of considerable work, thought, and consideration for the health of the public.
The medical profession in Maryland is very concerned over the provisions of H.R. 4700, which would provide surgical care, hospital, and nursing home care for all those eligible to receive social security, and we are desirous of going on record as being in opposition to this bill.
The Department of Health, Education, and Welfare has estimated that this will cost over $1 billion in the first year of its operation, with further increases as the program proceeds.
Now, I would like to provide your committee with some information as to what is being done and what has been done in the State of Maryland in connection with the provision of health care to those older persons in our population.
In the State of Maryland it is estimated that only 9 percent of the total population is aged 65 or over. In other words, roughly 9 percent of the total population could become eligible for these benefits it is proposed to add under the terms of H.R. 4700. Figures provided by the Blue Cross and Blue Shield organization show that about one-quarter of these individuals are presently covered under programs now in force under Blue Cross and Blue Shield. Those who are unable to obtain coverage because of their age at the present time will soon be eligible to receive coverage because the Blue Cross organization is presently requesting permission from the State insurance commissioner to enable it to sell policies to those over 65 years of age without restriction as to age.
This, then, leaves about three-quarters of the over-65 population to be accounted for. Of this percentage there is bound to be a number who fall within the category of being financially able to pay for all medical and hospital expenses they incur. And many of these people also have insurance with commercial insurance companies. It is estimated that about 15 or 20 percent of these people would fall within these two categories.
This, then leaves only about 5.4 percent of the population over age 65 who are without coverage of some sort. A large number of these people, specifically 17,438, or 0.9 percent are now being adequately and properly provided for under the various medical care programs operated by local and State departments, both on an inpatient and outpatient basis. Many of these individuals would not be eligible to receive benefits under the proposed provisions of H.R. 4700 because they are not eligible for social security but are recipients of oldage assistance or recipients of local welfare grants.
In addition, there have been great inroads made on the provision of health insurance to over-65's. Many commercial organizations are actively promoting the sale of health insurance to these over-65's and many more will be adequately provided for through this means.
The passing of a law such as this will not wipe out the problems of the aging with the stroke of a pen. Many efforts are being made on local and State levels to investigate the needs of the aging and to develop solutions to these problems.
In the State of Maryland there has recently been authorized by the State legislature the formation of a commission on the aging. This commission became effective on July 1 and is now planning to undertake a comprehensive study of all facets of this problem.
The State medical society for many years has had a geriatrics committee and this group is now actively engaged in seeking solutions to this problem and is hoping to work closely with the State commission on the aging to seek a solution to any medical or health problems that may exist and with which the commission is not familiar.
I will not go into the details of what is being done on a national level in this regard. Suffice it to say that a regional conference on problems of the aging is being scheduled for Baltimore in early 1960. This regional conference is similar to other regional conferences that have been held throughout the country in the past several months.
In brief, then, the problem of provision of health care for those over-65'ers is not as acute as some of the proponents of H.R. 4700 would have us believe. There is progress being made on a local level; and, as more information is gathered, solutions to additional problems that may be uncovered will be found. A positive, optimistic approach has been adopted on a State level.
In closing, I would like to point out some things which have probably already been brought to your attention dealing with the actuarial soundness of the whole social security program. We are in agreement with these points, but I would like to emphasize them once again :
1. Such a program would lead to poorer medical care for those people over
2. This would eventually lead to a completely socialized medical program for the entire country.
3. You would find that as more hospital and nursing home beds became available the tendency would be to admit patients and provide them with custodial care rather than care for acute or chronic illness.
4. There is the inherent danger of complete collapse of the social security system because of the financial drain placed upon it for this type of program.
It is the sincere wish of the Medical and Chirurgical Faculty of the State of Maryland that H.R. 4700, 85th Congress, should not be favorably considered by the House Ways and Means Committee. Sincerely,
KARL F. MECH, Chairman, Legislative Committee.
STATEMENT OF THE ASSOCIATION OF AMERICAN PHYSICIANS AND SURGEONS, INC.,
BY DR. Louis S. WEGRYN, PRESIDENT
The Association of American Physicians and Surgeons is opposed to H.R. 4700, known as the Forand bill, for many sound and logical reasons which will be given later in this statement. The association's position of opposition to socialistic medical care for the beneficiaries of social security was first established when the delegates (elected by the members in each State) and the assembly (representing the membership at large), meeting in Miami Beach, Fla. on April 27, 1957, unanimous adopted a resolution "in opposition to free hospitalization for social security beneficiaries.” AAPS reaffirmed its opposition to this type of legislation when the delegates, meeting in Chicago, Ill. on October 19, 1957, unanimously approved a resolution opposing the original Forand bill (H.R. 9467) of the 85th Congress.
Once again, the AAPS delegates and assembly stated their opposition to this socialistic legislation at their meeting on April 4, 1959 at Fort Worth, Tex., when they unanimously adopted a resolution of opposition specifically aimed at the Forand bill, H.R. 4700 (86th Cong.). The resolution follows:
"RESOLUTION ON THE FORAND BILL (H.R. 4700) "Whereas, the Forand bill (H.R. 4700) proposes to furnish hospitalization, surgery, and nursing home care for the beneficiaries of social security (about 13 million persons); and
“Whereas the Forand bill would constitute the initiation of compulsory national health insurance for one segment of the American public at the expense of working citizens; and
"Whereas compulsory health insurance (socialized medicine) historically has led to the deterioration of medical care to the detriment of patients; and
"Whereas unlimited financing of the services would increase social security taxes by raising both the ceiling of the taxable income and the tax rate; and
"Whereas these increased expenses would further strain an already unbalanced social security financial structure; and
"Whereas care of the aged, medical or otherwise, is and should be morally a responsibility of families and localities: Therefore be it
“Resolved, That the assembly and house of delegates of the Association of American Physicians and Surgeons, Inc., in regular session assembled in Fort Worth, Tex., this 4th day of April 1959, oppose H.R. 4700 and urge the members of the Senate and House to vote against its enactment." The members of AAPS oppose H.R. 4700 because
1. In most instances it denies the vitally important right of free choice of physicians.
2. It imposes a third party into the physician-patient relationship which will inevitably place the Federal interventionist in the position of making medical decisions affecting the health and welfare of the patient.
3. It is unquestionably socialized medicine for the recipients of social security paid for by the working population who, eventually, would want to get their share of the social security socialistic medical and hospital doles. This would lead to a demand for similar socialized medical and hospital care for the entire population—with resultant inferior care.
4. It shifts the responsibiilty for care of the aged and sick from the family and local agencies (where they rightfully belong) to the Federal Government.
5. This welfare state approach would contribute to the destruction of the individual's self-reliance and initiative and encourage his dependence on an all-powerful central government for his health and welfare needs.
6. Since the medical and hospital care costs of this plan are entirely unpredictable, there is utterly no way of knowing how much H.R. 4700 would cost the American taxpayers. Social security is already paying out more money than it is taking in by way of compulsory taxation. The social security trust fund is short in cash of more than $200 billion to meet its committed doles to the constantly increasing number of beneficiaries. H.R. 4700 would compound the insolvency and irresponsible financing of social security.
7. It would mean higher taxes with less take-home pay for employed citizens who are already bending under the yoke of excessive compulsory taxation.
8. The Federal Government would be given the right to fix fees and charges, and the establishment of this principle would lead to its extension to other segments of the economy and inevitably to inferior medical care, as it has done in every country where socialized medicine is practiced.
9. "Something for nothing" hospital and medical care would encourage patient abuses of the system and would create a dangerous crowding of hospital space.
10. H.R. 4700 would tend to destroy community incentive to support and build hospitals and citizens would be encouraged to shift the responsibility to the Federal Government and away from private and local governmental sources, where this responsibility rightfully and morally belongs. The members of this association believe that these are valid reasons for opposing H.R. 4700.
Care of the sick and aged should be the responsibility, first, of the families, and, second, local agencies. The services rendered should be provided under our incomparable system of free enterprise and not be shifted to the Federal Government with services provided under an expanded system of socialism.
This bill, if passed, will be such a strong endorsement of the philosophy of social security, and will fix so firmly upon the American people the shackles of the welfare-state, that most citizens alive today will live to see the total and permanent destruction of individual freedom,
We urge the members of your committee and the Congress to reject H.R. 4700, Social Security Amendments of 1959, and any other type of legislation proposing socialized medical and hospital care-a system that inevitably would lead the deterioration of these services to the detriment of the American people.
LOUIS S. WEGRYN, M.D., President, Association of American Physicians and Surgeons, Inc.
WINSTON-SALEM CHAMBER OF COMMERCE,
Winston-Salem, N.C., July 10, 1959. Hon. WILBUR MILLS, Chairman, House Ways and Means Committee, House Office Building, Washington, D.C.
DEAR CONGRESSMAN MILLS: The Winston-Salem Chamber of Commerce wishes to register its opposition to H.R. 4700, known as the Forand bill.
It may be of interest for you to know how this decision was reached.
A subcommittee of 5 business and professional men from our governmental affairs committee studied this bill and made its recommendation to the full committee, comprised of 21 business and professional men, representing an excellent cross section of all types of business.
The governmental affairs committee, in turn, made its recommendation to the board of directors, which has about 35 members, again representing the various professions and a number of different types of businesses.
Each group gave careful consideration to the bill and arrived at the conclusion that it should not be enacted.
It will be appreciated if you would see that this is made a part of the record of the House Ways and Means Committee which, I understand, will soon have hearings on this bill. Very sincerely yours,
ROYALL R. Brown, President.
CALIFORNIA STATE CHAMBER OF COMMERCE,
San Francisco, July 8, 1959. Hon. WILBUR D. MILLS, House of Representatives, House Office Building, Washington, D.C.
DEAR MR. MILLS: The California State Chamber of Commerce wishes to be on record as opposed to the principles of H.R. 4700 by Congressman Forand, providing for nursing home care, hospitalization, and surgical services as an additional benefit under the Social Security Act.
Voluntary prepaid medical care plans now cover a substantial proportion of the population. In California, as in other parts of the country, various experimental programs are now either in actual operation or in process of formulation to provide adequate medical care at reasonable cost to the elderly members of our society.
The enactment of H.R. 4700 and the creation of statutory medical care benefit rights would, for all practical purposes, destroy voluntary experimentation in the area of expanding prepaid medical care for the elderly and those few others who have not been included in the great expansion of the covered population during the past 15 years.
We believe that voluntary arrangements, inherently flexible enough to accommodate the varying needs and wishes of the beneficiaries, are much to be preferred to a necessarily rigid and cumbersome Federal system with its attendant plethora of rules and regulations.
After adequate experimentation, it will be possible to determine the size of the hard core of individuals who cannot be included in workable voluntary prepaid medical care plans. For such individuals, a governmental plan is proper, but the role of Government should be confined within this limit. Cordially,
JAMES MUSSATTI, General Manager.
STATEMENT WITH RESPECT TO H.R. 4700_86TH CONGRESS, 1st SESSION
BY PAUL P. HENKEL, ISLIP, N.Y. I object to the principle of adopting a Federal program providing hospitalization and nursing home care for OASDI eligibles through the medium of title II of the Social Security Act. I also object to the principle of adopting any new or similar Federal program providing like benefits to all aged persons, whether eligible for OASDI, or not, through any other Federal Government medium or activity.