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Senior Citizens of Manville, Ine.


101 South Main Street Manville, New Jersey 08835


Perhaps, a nominal increase in Payroll taxes, paid by employers. They have already

beon granted generous tax oredits and allowanoes.


Repeal this year's 10% tax credit which really will not greatly benefit the average family. There was really little benefioial economic uplift with the last 5%

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In oonclusion, we plead with your committee to do all in your power to curb the

runaway Health Care Inflation rate,

It certainly is a burden and ourse on the elderly.

We certainly trust that your most important Committee will again serve the interest

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My name is Peter Shields, Director of the Union County Division on Aging for the past ten years, one time County Welfare Personnel Officer and prior to that retired as a Field Representative from the U. S. Social Security Administration with over 30 years federal service,

I'm presently Chairman of the Long Term Care Committee of the New Jersey Association of Area Agencies on Aging, a member of the State Nursing Home Task Force, Immediate Past President of the New Jersey Association of Area Agencies on Aging and former Legislative Chairman of the National Association of Area Agencies on Aging.

I'm also Chairman of an Advocacy Committee representing the state's Area Agencies, Visiting Murses, Home Health Aides, and Medical Social Workers.

I am honored to be invited to express my thoughts on the future financing of

The possibility of increasing the payroll tax for allocation to the Medicare Trust Fund would be unpopular with the working population, but a moderate increase is probably unavoidable,

The recanmendation to increase beneficiary co-payments for hospital stays with "so-called catastrophic" protection after 60 days seems totally unacceptable to senior citizens and a misinterpretation of what "catastrophic" coverage means to most of them. I believe they consider it in-patient hospital days beyond "life-time reserve" and extended nursing home stays. The proposed recanmendation to pay co-insurance through the 60th day is financially unacceptable to senior citizens. Since the average stay is 11.5 days the burden for payment would be on the seven million elderly annually admitted to hospitals for the benefit of about 170,000 patients (a small percentage of the seven million) who stay longer than 60 days. Implementation of this proposal would cause chaos in the MedicareGap insurance with seniors scrambling to protect their interests at presently unestimated but surely prohibitive costs.

Most senior citizens do not have the financial ability now to carry supplemental Medicare insurance and if the proposed co-payments become effective most of those who now have supplemental coverage would have to drop this coverage due to inability to pay for it.

Most of the seniors I talk to are more satisfied with Part A than Part B of Medicare, because even some who can barely afford it have protected themselves for their co-insurance through Medigap Insurance. However, the change in hospital billing to the DRG (Diagnosis Related Group) system must be evaluated carefully. Since this system is in use in New Jersey, it should be possible to obtain detailed information from the New Jersey Department of Health to compare the costs prior to DRG and now for hospitals in a variety of locations. Most people are of the opinion that DRG places the burden of payment for "bad debts which includes patients who can't or won't pay their hospital bills" in one year on patients admitted the next year when the new DRG rate is set. This places an unfair responsibility on those who need to enter a hospital and have provided for this possibility. It would seem the cost of care for non-paying patients should be the responsibility of all people, not just those who become ill. Concerning Part B the seniors are disillusioned with the "reasonable charges" allowed as they are unrealistic and a very small number of doctors accept assignment. Seniors are frequently told to ask their doctor this question before being treated. This is impossible in some instances particularly when the patient needs anesthesia and has to use the group in a particular hospital. Placing a one year freeze on "reasonable charges" would only add to their problems. The only solution for the patient would be if doctors accepted assignment and reasonable charges were realistic. If this could be accomplished, most beneficiaries would not oppose having a 75% 25% ratio used for Part B reimbursement. Social Security and Medicare have helped many people stay out of poverty. TO preserve this protection I would agree to the use of general revenues if at some point the trust funds are threatened. In that case, on a temporary basis use of general funds might be acceptable. I am fearful that use of general revenues could nullify the original goals of Medicare and lead to possible future application of a means test. It could also work adversely against cost-containment in the event a future Congress was tempted to use an increase in Medicare benefits to gain support in an election.

It might be appropriate to transfer Medicare costs to general funds for kidney dialysis patients under 65 and for disability beneficiaries under 65.

"I believe more extensive use of home health services of high quality would be a substantial saving. If a patient felt assured of this type of care they would feel more confident in returning home, A less stringent definition of skilled mrsing care is needed for Medicare patients. Being cared for safely and properly at home would also help the patients avoid or postpone institutionalization.

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reduce the deficit, bring down interest rates, and promote

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Like the past two years, the burden of the Administration's

proposals fall most heavily on our nation's needy, dependent

and vulnerable populations.

For older Americans

particularly the poorest among them

the Administra

tion's FY 84 proposals are as bad if not worse than prior

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a six-month freeze on cost-of-living adjustments

for social security, SSI, food stamps and veterans'


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