covered enough to return to her home in the remote area of Hornell, New York. Mary could not manage alone and was forced to rely on others to care for her. But, she had what she wanted, she was home. Home health aids were made available but the expenses were ruled ineligible by Medicare as there is no participating agency supplying the services and billing Medicare in Stuben County. Mary's care did not, therefore, meet all the criteria for benefits. Appeals were filed. Again, denials. Letters to her Congressman were written with only an oral negative response. All efforts to obtain reimbursement were fruitless. Mary was forced to draw upon her life savings. She wanted to maintain her independence. As she watched her money disappear she tried to do without the home health aids and do more on her own as much as possible. In February of 1982 Mary, alone, fell and fractured her hip. Hospitalized for some time, Mary was eventually allowed to return to her farm home. She again hired home health aids to assist her. She was adamant she would not die poor and again refused the help she needed as long as she could. As her money dwindled, so did her will to live. Mary was buried two weeks ago. Mr. and Mrs. David B. Gordon had their story published in the September 27, 1982, issue of "Newsweek". Mr. Gordon, a retired police officer, and his wife have a total annual retirement income of $41,100.00, including Social Security, Pension and Dividends and Interest. They have no debt. Mrs. Gordon suffers from Parkinson's disease and its com-plications and remained at home with her husband and paid help until a few months ago when she suffered a stroke. She then required more skilled care which her husband, who lovingly gave of himself and often was unable to sleep more than an hour at a stretch, could not provide. The nursing home cost is $105.00 daily or $38,325.00 per year more than their entire net income. "Other than Medicaid there is practically no insurance that covers extended care in a nursing home. Medicare will pay most nursing home expenses for up to one hundred days, but only under certain conditions---". "Mr. Gordon must spend all his savings and liquidate all "The odd part of this arrangement is that by making (them) liquidate (their) savings, the government is depriving (them) of the $1,000.00 a month in bank and dividend interest that could go toward (his) wife's upkeep. If that income could be retained, the nursing home cost to Medicaid would be $600.00 or so a month.-------Instead, it will cost the taxpayers, through Medicaid, more than $1,600.00 per month." Are there any alternatives? Yes. Divorce was suggested as a logical alternative. But why should people who love each other be forced to divorce? Mrs. Gordon's greatest fear has been that that she might end her life in a charity ward as did her grandmother during the Depression. She is in a good nursing home and is well cared for thanks to Mr. Gordon. Now, what about Mr. Gordon? Mary and the Gordon's are not isolated cases. Hlas Medicare been insuring too much or too little? Are not Medicare recipients currently paying more than their "fair share"? I thank you for the opportunity to testify and for your kind attention. This Way to the Poorhouse MY TURN/DAVID B. GORDON I am 67 years of age and have a $20,000 pension. The social-security payments my wife and I receive total $9,400. Our income from interest on savings and dividends amounts to approximately $12,000 a year. We have no debts. Yet in a year or so I could be virtually penniless, living on an allowance similar to that given to welfare recipients. My wife is in a nursing home. About 15 years ago I learned that my wife had Parkinson's disease. This condition triggered other problems, and four years ago a massive internal infection necessitated the removal of most of her small intestines. A chronic bladder problem and unusually low blood pressure required that she take extremely large doses of medication. Because of her weakened condition she required constant assistance with even ordinary chores, such as going to the bathroom or dressing. Then, three months ago, she suffered a stroke. Her speech is still unintelligible and the state of her health is such that she can no longer be cared for at home. Paid Help: We have been married 35 years and in all that time have never been separated. Even after her intestinal operation she had refused to go to a convalescent home and insisted on coming home to me. For my part, I was more than willing to have her. We were forced to take in paid help costing close to $400 a week but, still, I was on my own nights and weekends, doing laundry, shopping, preparing meals, cleaning our small apartment, seeing that she took all her medicine, attending to her every need. I was seldom able to sleep more than an hour at a stretch. Since the stroke, however, my wife requires even more skilled and timeconsuming care, which can best be provided in a nursing home. The cost is $105 daily, roughly $3,200 a month or $38,325 a year, which is more than our entire net income. These charges for the kind of care my wife receives are more or less standard in most major cities. Some institutions are even more expensive. Other than Medicaid (government insurance for the impoverished) there is practically no insurance that covers extended care in a nursing home. Medicare will pay most nursing-home expenses for up to a hundred days, but only under certain conditions: if the patient must be fed and medicated intravenously, suffers from bedsores, is kept on blood-thinning medication or requires throat-suctioning. The catch is that most nursing homes will not admit such a person to their custody. If I were a murderer my pension could not be touched, but having a sick wife carries a special penalty. Once I've spent my savings and disposed of other assets, my wife will be eligible for Medicaid. If there is an alternative to insolvency, I am not aware of it. It is my understanding that I will be allowed to keep $2,600 for myself and $2,600 for my wife, essentially for burial expenses. My pension, earned after 33 years with the New York City Police Department, will be attached. If I were involved in a swindle and owed money, if I were serving time in jail for murder, my pension could not be touched. Having a sick wife carries a special penalty. I will no longer be able to own anything. If I work I won't be able to keep my salary. What I will be allowed is a set amount for rent and food. I will join the ranks of the nonproductive members of society. The odd part of this arrangement is that by making us liquidate our savings, the government is depriving us of the $1,000 a month in bank and dividend interest that could go toward my wife's upkeep. If that income could be retained, the nursing-home cost to Medicaid would be $600 or so a month. Were I permitted to work it would be even less. Instead, it will cost the taxpayers, through Medicaid, more than $1,600 a month. Divorce: The fact is that if I were placing my parent or an incapacitated child in an institution, under the law I would not be financially responsible. A year ago an accountant suggested that since I was neither a millionaire nor a pauper the sensible thing to do was to get a divorce. That way my wife would be entitled to a share of what we own and I would not be left without a cent. Certainly it is logical. But why should we be compelled to do something that is so contrary to the feelings we have for each other? Half of everything a husband has should and does belong to his wife. Why can't the same rule apply for us? Moreover, I believe that half of whatever I might be able to earn should go to her. I would willingly return to work to lighten Medicaid's share of the bill. Why should people who have been together as long as we have, and who feel about each other the way we do, be forced into a divorce? The one bright spot in all this is that I was able to get her placed in a good nursing home where she is well cared for. As long as I've known her, my wife has agonized over the fact that her grandmother, who raised her, ended her life in a charity ward. That was during the Great Depression and thoughts of how things were for her beloved grandmother have always haunted her. I know that whatever happens, even if I am not around, she is in good hands. Now, what about me? David B. Gordon is a retired police officer. He lives in New York City. NEWSWEEK/SEPTEMBER 27, 1982 11 PREPARED STATEMENT OF JACK RAFFERTY, MAYOR, HAMILTON, N.J. CONGRESSMEN RINALDO AND SMITH, I AM JACK RAFFERTY, MAYOR OF HAMILTON, WHICH AS YOU KNOW IS JUST A FEW MILES DOWN THE ROAD. I DON'T PRETEND TO BE AN EXPERT ON HEALTH OR AN AUTHORITY ON MEDICARE BUT RATHER I SPEAK AS A GENUINELY CONCERNED ELECTED OFFICIAL OF THE SEVENTH LARGEST MUNICIPALITY IN THE STATE OF NEW JERSEY WITH A CONSIDERABLE NUMBER OF ELDERLY AMERICANS. THE SUBJECT OF THIS HEARING IS ONE OF VITAL INTEREST TO NOT ONLY ME BUT ALL AMERICANS AND CERTAINLY ONE ON WHICH I WANT TO RECORD MY VIEWS FOR THE RECORD. I THINK YOU ARE TO BE CONGRATULATED FOR TAKING TIME FROM YOUR BUSY SCHEDULE TO COME TO NEW JERSEY AND HEAR THE VIEWS OF YOUR CONSTITUTENTS, LOCAL EXPERTS AND OTHERS CONCERNED WITH THIS VITAL SUBJECT OF HEALTH CARE TO THE ELDERLY AND ITS FINANCING. LIKE ALL AMERICANS, I AM DISTRESSED BY THE EVER INCREASING DIFFICULTY OLDER AMERICANS ARE FACING IN OBTAINING QUALITY HEALTH CARE AT THAT PERIOD IN THEIR LIFE WHEN THEY ARE IN GREATEST NEED. I NEED NOT REITERATE TO YOU, HOWEVER, THE HORROP STORIES OF PEOPLE WHO HAVE SPENT THEIR LIFE SAVINGS ON AN ILLNESS AND THEN WERE FORCED TO JOIN THE RANKS OF THE INDIGENT. THIS, TO ME, IS A POLICY QUESTION THAT MUST BE AT THE FOREFRONT OF THE DELIBERATIONS OF OUR STATESMEN IN WASHINGTON. I AM NOT GOING TO RECITE A LITANY OF TALES OF WOE, BUT RATHER EXPRESS MY VIEWS ON THE PRESIDENT'S BUDGET PROPOSALS FOR HEALTH AND IN PARTICULAR MEDICARE. I AM HEARTENED THAT FOR THE FIRST TIME SINCE THE INCEPTION OF MEDICARE, THIS ADMINISRATION HAS, IN A BIPARTISAN FASHION, HAD THE COURAGE TO CONFRONT THE FINANCING DIFFICULTIES THAT HAVE LONG BENIGNLY PLAGUED THE MEDICARE PROGRAM. I AM ALSO ENCOURAGED TO READ OF THE PASSAGE WITHIN THE LAST FEW DAYS OF THE NEW PAYMENT SYSTEM FOR HOSPITALS THAT WILL PROVIDE THEM WITH |