they receive this care, but we do not, and many only get a few dollars, and if they should be taken to a hospital, 1 week will clear their problems up. And I find that many are afraid to go for any medical treatment.

On Social Security, we also find that the percentage allowed on this, they take out already for Medicare, and you will find many will be in the high expense area, and we feel that the raise in Social Security will not take care of them, because you give with one hand and take away with the other. If you take them out of that percentage for Medicare and go up on rent, what are you going to have on food they are supposed to get the raises for?

Now, transportation also we find is inadequate. Recreation for the institutionalized elderly is far from what it should be. Now, these patients in the medical center, they cannot get out and be in the groups that have good times; so, therefore, we should take recreation to them. Some have no relatives come on a visiting day, and I feel that these are the forgotten few that recreation should be taken to.

I'd like to add something on crime, if I may. I'd like to say that 2 years ago I lost my home because of vandalism. They broke into my home four times in 1 year and for 4 years, while I lived in that housing, I had to go to bed and stay ready to get up and run if something should happen because my life was threatened. And this past year I have been very happy because I have been living in a project where they have adequate guards and so forth.

But I lost my home that I worked hard to get figuring that when I retired I would have my own home, which I don't have.

Senator PELL. Thank you, Mrs. Dean. Our next witness is Mr. Anthony Vittorio, who is a member of the Senior Citizens of Rhode Island Action Group, and first spoke with me right here in this auditorium last April.

STATEMENT OF ANTHONY VITTORIO, MEMBER, SENIOR CITIZENS OF RHODE ISLAND ACTION GROUP

Mr. VITTORIO. Thank you, Senator. I am Anthony Vittorio. I represent the Senior Citizens of Rhode Island Action Group. This is my case. I would like, Senator Pell, to relate the case of a friend of mine who cannot be here today because he passed away last Saturday. This man was speaking with me complaining of a pain in the chest. He was 80 years old.

I suggested to him that he should see a doctor. He said, "A doctor won't take me because I am on Medicare," because a lot of doctors do not accept Medicare. "I already have paid over $100 for glasses. "This man was almost blind. He tried to care for himself as cheap as possible because he couldn't afford anything else. So he gave a dollar to someone to buy him an enema, thinking that he could be relieved from constipation, he would be OK.

So a couple of days later I went to see him to find out how he was feeling. He was no better. Against his wishes, I called his daughter, who contacted her doctor. As soon as the doctor saw him, my friend was immediately brought to the hospital. Seven days later my friend was dead. Senator Pell, this is one case that I have time to speak of.

How many more cases and more tragic ones are still taking place because of Medicare and Medicaid? They are a great problem to senior citizens.

I would ask that all those healthy children be eliminated and full health benefits be given to senior citizens under a national health program. Thank you very much. [Applause.]

Senator PELL. Thank you, Mr. Vittorio. Now, if Mrs. McGrath would care to give her testimony, also a member of the Senior Citizens Action Group, a very active group indeed, and a group with whom we usually find ourselves in agreement. Mrs. McGrath.

STATEMENT OF ALICE MCGRATH, MEMBER, SENIOR CITIZENS OF RHODE ISLAND ACTION GROUP

Mrs. McGRATH. I am Mrs. Alice McGrath and I represent the Senior Citizens of Rhode Island Action Group. There are many services. available for the sick and elderly in our State of Rhode Island. Medicare and Medicaid are good programs; however, I know several persons who do not benefit from the services granted by our Government.

COMMUNICATION GAP

In our times when TV and radio do such a good job of communicating information of all kinds, there is for the elderly people of Rhode Island a serious communication gap. We have over 30,000 senior citizens who are below the poverty level. Many of them have neither radio nor television. There are several groups of seniors who cannot read English. Some have spoken French or Polish or Portuguese all their life. Because of this problem and because of this language barrier, Senator Pell, here in the city of Providence there are elderly people who do not get proper health service.

A very dear friend of mine, Senator Pell, I met her coming from the doctor's office one day with a prescription for the druggist. She said, "I don't know how I am going to get through the month." I said, "Why?" She said, "With the high cost of the office visit and the high cost of drugs, I don't know whether I will be able to make it to the end of the month." So I said to her, "Don't you have Medicaid?" She said, "What is Medicaid? I have never heard of it." So I explained it to her, I helped her fill out an application, and now she is receiving Medicaid and she has been very grateful for the help I have given to her.

In the rural area such problems are just as numerous, but less known to the authorities on aging. If not less known, there are less opportunities to solve these problems than there are in the city. Communication is a severe problem throughout the State, Senator Pell. This communication problem is very much related to our health problems, Medicaid and Medicare.

Again, I speak for all the elderly who are poor, who receive insufficient amounts of money, and moreover, I speak for those who do not even know about the facilities that are offered to them. What we need is someone to contact us on a human level. We often do not have ridesor phones to get in touch with organizers. We are afraid to burden others. We need someone to help us know what is available to us, some-one who is sensitive to the needs of low-income people.

Senator Pell, do you think people should be informed properly about what is available in the lines of health services, and don't you think we should have organizers to have us know what our rights are on Medicaid and medicare? Could you give us someone to care, really care, about our problems of health, pay some organizers to help us? We believe that a very great need would be served if in the allotment of funds for the older Americans provisions were made for the hiring of fulltime workers to contact and inform senior citizens not now being helped by the Medicare and Medicaid agencies.

Thank you, Senator. (Applause.)

*

Senator PELL. Thank you, Mrs. McGrath. Actually, one of the purposes of this hearing today is somewhat along the lines of what you are saying, to try to get across to the community as a whole and the older people particularly, not only what the problems are, but what the present programs are. And I think in general you will find that the question of carrying the message of what the programs are to the citizens is one that is not handled as well as it should be, but it is usually not a question of ill will, but a question of omission.

I think groups like yours can do a great job of it and on a volunteer basis as well.

Mrs. McGRATH. But, Senator Pell, we cannot always reach the isolated cases, people that are living in one room and no one to come to speak to them on the level of their own language. They don't understand some of the things that are said because they don't understand the language.

Senator PELL. That is very true. As you have pointed out, many citizens have Portuguese or French or Italian heritage, older citizens who don't speak English. And this is one of the areas where we have a particular need in Rhode Island.

Now Mrs. La Plante is a witness who also has a message for us from the Senior Citizens Action Group.

STATEMENT OF ELEANOR LaPLANTE, MEMBER, SENIOR CITIZENS OF RHODE ISLAND ACTION GROUP

Mrs. LAPLANTE. I am Eleanor LaPlante. I believe we have met before and we did discuss some of the problems concerning Social Security increases, Medicare and Medicaid. We still encounter several problems and they are big problems. We are meeting with you today as we need action now, not in 1973 or 1972, but now, in 1971.

Action, Senator Pell, means, as you know, willingness, choices, and doings. We feel you are willing to help, but we would like to tell you that action is most urgent now. Right now, we senior citizens are paying out of our Social Security checks $5.60 a month, which adds up to $67.20 a year. Do you realize that more than 30,000 of us in the State of Rhode Island are unable to pay for this service?

As a representative of the Senior Citizens of Rhode Island Action Group, I am asking you if you could find a way of getting free Medicare for so many deserving people. I would like to remind you that Canada provides free care for her people. Why can't the United States provide free care for their people?

Several people have already asked us why wouldn't Medicare benefits go back to the original cost. I go further, Senator Pell, knowing

that you are willing to take action for the benefit of the elderly and ask for free Medicare. Senator Pell, I have three more points to make clear with you: No. 1, many doctors will not take care of Medicare patients. Why shouldn't all doctors be obliged to take care of people on Medicare? I believe that if Medicare were better organized, with less paperwork, doctors would not hesitate to care for us.

No. 2, Medicaid takes care of many things that Medicare does not cover, but many people are not eligible for Medicaid. No. 3, the pension for all senior citizens should be lowered to 60 years of age with full benefits.

TIRED OF SURVEYS

Senator Pell, we are very tired of surveys and studies on old age, as we know what is best for us. Why waste money on surveys, let's use that money for free medical services for the elderly of the Ocean State. Let's have a pilot program. Senator Pell, please be our action man. We're banking on you. Thank you, Senator Pell. [Applause.]

Senator PELL. I think you will be glad to hear that I have already cosponsored an amendment that would make part B free. But it takes a majority of the Members of Congress to pass a law, not just one or two or three or four or 20 or 30. So your message will be delivered to my colleagues from all over the United States as well as right here in Rhode Island.

As far as the other point you mentioned, the question of the doctors giving the treatment, this will be discussed later on in another panel and we'll see what their reaction is to the point you made. As far as pensions at 60 goes, that is a nice idea, it would be nice to have pensions at 55, too. But it would be the question, really, of the amount of money that it would cost the taxpayers and the government as a whole, and how much more that would add to the tax burden of our citizens.

As to the question of Medicaid coverage: It certainly should be more inclusive. My own view is that dentures and eyeglasses and hearing aids should be included. But this again takes a certain amount of discussion around the country. One of the purposes of these hearings is to have these issues ventilated not only in Rhode Island, but, as I pointed out earlier, in other points of the United States.

Thank you, Mrs. LaPlante, for very specific suggestions. Our next witness is Mrs. Betty Curley, senior vice president of the Rhode Island State Council of Senior Citizens, and a senior aide in Dr. Mary Mulvey's agency.

STATEMENT OF BETTY CURLEY, SENIOR VICE PRESIDENT, RHODE ISLAND STATE COUNCIL OF SENIOR CITIZENS

Mrs. CURLEY. Senator Pell, members of the panel, ladies and gentlemen, may I say that I heartily agree with Colonel McQueeny. I personally know of three instances of our senior citizens being sent to the hospital after being robbed and assaulted, and two others had their homes burglarized of substantial sums of money and articles impossible to replace.

This leaves us in such a state of apprehension that we are being deprived of the right to live out our lives as free senior citizens, afraid to leave our homes for meetings and classes we wish to attend even

though we are always furnished transportation to and from such meetings. It is about time for us to recognize that the protection of the law is for the innocent and not the guilty. Therefore, there must be some sort of a plan of protection devised to allay our growing fears of assault and robbery on the streets, even in the daylight hours.

IMPROVEMENTS ON MEDICARE AND MEDICAID

Now, I have several suggestions for improvements on Medicare and Medicaid. (1): Enactment of national health insurance, health security bill. Our immediate goal is early improvement in Medicare and Medicaid. (2) Eliminate the premium charged for Part B, combine parts A and B, and finance through taxes on payrolls and through Federal general internal revenues. (3) Fill prescription drugs. Medicare does not pay the full cost of Medicare drugs prescribed for us on an outpatient basis. It now pays only during hospitalization.

(4) Eyeglasses, dentures, and foot care are three leading ailments of our senior citizens and these definitely should be included in our Medicare program. (5) Limitations on hospital care should be abolished. The benefit period should cover the entire period of the illness or disability, including the first day payment of $60, additional payments beyond 90 days, and limit of 100 visits under Medicare home health services. (6): Eligibility, immediate determination for extended care. Many people enter nursing homes believing they have coverage, only to learn after weeks or months that Medicare officials have ruled against their reimbursement. This is a frightening experience. The U.S. Department of Health, Education, and Welfare should promptly devise some method to insure early decision of eligibility.

I personally know of a terminal cancer case, a very dear friend of mine, she had been hospitalized for about 2 months and the supervisor walked in one day and said, "You have to go down into a different room, $100-a-day." And she panicked and said, "I can't afford that." They said, "The only alternative is to go to a nursing home this afternoon." And they packed up her things and sent her to a nursing home. I saw her a week later, she was very pitiful, and she was a well-educated and intelligent woman, didn't know where she was, didn't know how much she was going to have to pay for the room. And they then found out she wasn't eligible, after she had been in and out of the hospital and nursing homes, and she died 3 weeks later.

(7) Nursing homes. I would recommend sweeping changes in nursing homes nationwide. David Pryor testified in Washington at our Senior Citizens National Conference. At a time when the Nation's attention has been on the young, David Pryor has been concerned with older Americans. He worked as a volunteer janitor and nurse's aide. He gave some shocking testimony on brutality existing in Washington homes right in the shadow of our National Capital. This is a gross miscarriage of justice when we realize that they are being paid by our Government with Federal funds.

ACTION NEEDED NOW

The time to act is now-this year. We can no longer postpone action in the hope that all problems associated with old age are transitional problems, that given time they will solve themselves. To the contrary,