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STATEMENT BY JOHN SKIFFINGTON, RHODE ISLAND STATE REPRESENTATIVE

Representative SKIFFINGTON. Thank you, Senator, Mayor Lussier, and many old and good friends in the city of Woonsocket. I am glad to see so many of you, here, concerned with the problems of the elderly. It is really heartwarming to see this wonderful turnout this morning, to be here and to express your views to Senator Pell. Senator Pell, of course, is one of our favorites and has been in Woonsocket many, many times for different things during political campaigns and other events—but I think this is the most important visit that Senator Pell has ever made to the city of Woonsocket. I want to congratulate him on having the first senatorial hearing or congressional hearing that ever was held, to our knowledge, in the city of Woonsocket.

Thank you, Senator.

Senator PELL. Thank you very much, Representative Skiffington. I would also like to acknowledge the presence of the State official with the most responsibility in the area of aging. She has been very kind to come here because this is really, in a sense, a trial run in this hearing to develop what the problems are in a local community; and, then in a period of weeks or maybe months we will have another hearing in Providence to determine what the problems are, more or less, at the statewide level and what can be done to resolve them. I would like to welcome her, and ask her if she has anything to say. Let's have a warm welcome, and ask her to stand up, and say helloEleanor Slater, an old friend.

STATEMENT OF ELEANOR SLATER, DIVISION ON AGING, DEPARTMENT OF COMMUNITY AFFAIRS, PROVIDENCE, R.I.

Mrs. SLATER. Thank you, Senator Pell; Mayor Lussier, and my former colleague in the House of Representatives, John Skiffington, it is just great to see all you people here. I know that this is going to be very meaningful because of the White House Conference on Aging that is going to be held in November. There is a meeting of the steering committee of that committee tomorrow at my office, and with all of this buildup and other hearings on a statewide basis coming this fall, sometime; and with the enthusiasm for the older people and their needs—particularly in the area of health-it is going to be most meaningful in the State. The message is certainly going to be carried by Senator Pell to the congressional delegation and the Senate.

Thank you very much, Senator.

Senator PELL. Thank you very much, Mrs. Slater.

I would also add that my colleagues in the Congress, Senator Pastore and Congressman St Germain have received invitations to come here. They would be here today except that they have other responsibilities and were glad to be invited and perhaps may be able to come yet. I would like to thank the Elks particularly for letting us have the use of this fine hall. They declined to take any rent for this hearing at all and turned it over to us for the day. I think we should have a round of applause to go to the Elks for letting us all be here. [Applause.]

I think as we move along I would be remiss if I did not thank my Senate staff and particularly Mr. McKenna, Bill Oriol, and the staff of the subcommittee who came up here and worked all weekend on this hearing.

OPENING STATEMENT OF SENATOR PELL, PRESIDING

Now, as we move into the morning I want to put really in the back of your mind some thoughts, because it was nearly 6 years ago that Congress established the Medicare and Medicaid programs. These programs were designed to relieve the health costs of our senior citizens. Experts in Washington told Congress these health programs should be improved.

Some say that Medicare and Medicaid need to be expanded, and my own views are in that direction.

There are others at this time who are saying that the benefits of these programs should be reduced.

Today the Senate Special Committee on Aging is here in Woonsocket to hear from these panels, and the people, as to what your own views are about the Medicare program.

The Senate Special Committee on Aging has asked me, as a member of the health subcommittee, to take testimony from senior citizens of Woonsocket and those who serve them regarding changes they believe should be made in Federal health programs for the aged. Woonsocket was chosen as a hearing site, the first of this sort in our State, because of its high percentage of senior citizens-nearly 23 percent of the residents are over the age of 55.

The committee believes that there are no persons better able to tell us about workings of the Medicare program than the persons who are served by it. The senior citizens themselves know the problems, they know what we are trying to do and here I would add in a more personal vein I am particularly concerned with the problems of the aging.

I remember going through some of the nursing homes and the habitations of our older citizens. I think, those who are in public life, no matter in what they are interested, are surely interested in the plight of people. Social workers, clergymen or politicians are probably more aware of the plight of older citizens, and the poor, and the sick, than the average citizen. Because the old, the sick and the feeble do not get a chance to be as visible as do the rest of our citizens their misery is often tucked under the rug. One is not aware of it and I think, for those reasons, we have a special responsibility in this regard.

(A translation, in French, of Senator Pell's opening statement follows:)

L'ÉNONCÉ DU SÉNATEUR DES ÉTATS-UNIS CLAIBORNE PELL

Il y a presque six ans le Congrès a établi les programmes de Medicare et Medicaid. Ces programmes ont creés pour servir en aidé aux citoyens agès.

Les éxperts de Washington nous ont dis que ces programmes doivent être improvés.

On dit que ces programmes Medicare et Medicaid doivent être augmentés. Les autries nous dit que ces programmes doivent être rédui.

Aujourd'hui la Commission du Sénat pour les vieillards y est à Woonsocket pour écouter ce que le monde pense de ces programmes de Medicare et de Medicaid.

La Commission du Sénat m'a demandé, comme un membre du SousCommission pour la santé, de prendre de la deposition des citoyens de Woonsocket et de ceux qui les serve à l'égard de problems Medicare. Nous avons choisi la ville de Woonsocket pour une audition parceque les citoyens agés y sont si nombreux. Presque 23 pour cent sont à l'age de cinquante et cinq ans au plus.

La Commission croit qu'il n'y a personne que les citoyens agés qu'ils nous pouvent dire de la mannière que ces programmes ont condui. Cette audition, à présent, vient en ordre.

Senator PELL. I would like to ask the first panel on Medicare Coverage—Mr. Albert Peters, of Woonsocket; Mr. Alfred Farley, of Woonsocket, a former representative; and Mrs. Irene Chauvin of Woonsocket- come forward and sit at that table there.

I believe it is fairly appropriate that Mr. Farley lead off, as he was a representative acting in Government long before I was and perhaps he is a good leadoff witness because he is wise to the ways of Government.

STATEMENT OF ALFRED FARLEY, WOONSOCKET

Mr. FARLEY. Well, Senator Pell, distinguished guests and Mayor Lussier, my name is Alfred Farley of Woonsocket, Rhode Island. Senator Pell, I want to tell you about an experience that my wife had under the Medicare program. My wife and I are covered by Medicare and Blue Cross and Blue Shield which is plan 65. It was my understanding that I had complete health coverage but a recent experience with my wife's illness has demonstrated that my health coverage was not complete. This past winter my wife was ill and was sent to the hospital. Medicare covered all the hospital costs except $71.50, and Medicare and Blue Cross covered $570.65. My physician cost was $105; Medicare and Blue Shield paid that cost. After my wife was in the hospital for about a week and a half, the director recommended that my wife would get stronger if I placed her in the Grandview Nursing Home. I thought that Medicare would cover 100 days stay but this was not true. Five days after my wife was in the nursing home, the Social Security Administration informed me through the nursing home administrator that Medicare would no longer cover the cost of my wife's stay. My wife stayed another 7 days and it cost me $140. This is a cost that I thought Medicare would cover and I was disappointed with this action. I think it is unfair.

Senator PELL. Well, I have to ask that we have all three statements and then go on to the questioning afterwards. I would like to ask Mr. Peters if he would make his statement.

STATEMENT OF ALBERT J. PETERS, WOONSOCKET

Mr. PETERS. Senator Pell, my name is Albert J. Peters, Woonsocket, R.I. Senator Pell, I want to tell you about an experience my wife had on Medicare. My wife and I are covered by Medicare, Blue Cross, and Blue Shield. We started when it was $13 and it has gone

to $16 and now it has gone up to $21 plus. We can't afford to pay that. I brought her to the hospital for open heart surgery and could not afford the cost of a nursing home. I understood that Medicare would pay 80 percent of the cost of the nurse visiting every day and Medicare did pay 80 percent of this care; but, I could not afford the cost of the nurse visiting every day so I dropped the visits from every day to 4 days a week. Now, it is 1 day a week. I have been taking care of my wife myself. My request is that Medicare should pay 100 percent of the cost for a visiting nurse. I am required to pay for all of her medication and it is impossible to do this and pay 20 percent of the cost of the visiting nurse.

Senator PELL. Thank you very much. We will come back to the questions in a moment but I would like to get all the evidence and the examples of the problems that I am sure that everybody in this room has been exposed to and knows about. I want to get them in the record and then we will talk about them. Mrs. Chauvin, would you give us your statement.

STATEMENT OF IRENE CHAUVIN, WOONSOCKET

Mrs. CHAUVIN. My name is Mrs. Irene Chauvin, Woonsocket, R.I. Senator Pell, I want to tell you about an experience my mother had under the Medicare program.

My mother was taken from Fogerty Hospital to Grandview Nursing Home, April 20, 1971. This was to be covered under Medicare. On May 19, 1971, I received a letter from the board at the nursing home that she was off Medicare. On May 19, my doctor told me when I phoned him that she was covered by Medicare. The nursing home still maintained that she was not covered. Then, in the meantime, I was told that she was back on Medicare. I also received a call on June 3 that she was not covered; and was then informed on June 4 that she was again covered. I still don't know who is going to pay the bill for the period from the 20th of May until the 3d of June. I have been unable to determine why these changes keep on occurring and Mrs. McDermott at the nursing home said she was unable to understand or explain the problem herself.

Senator PELL. Thank you very much.

Now, Mr. Peters, returning to your testimony and the illness of your wife, what was the total cost would you say of your wife's sickness? Mr. PETERS. Well, you mean the cost of the operation?

Senator PELL. The operation, the medical costs and so forth?
Mr. PETERS. For the operation, $1,000.

Senator PELL. How much?

Mr. PETERS. One thousand dollars, and almost another $1,000 for the hospital.

Senator PELL. About $2,000 in all?

Mr. PETERS. Right.

Senator PELL. Am I correct in saying that Medicare the way it is presently written and Blue Cross covered most of these costs?

Mr. PETERS. Yes, Senator.

Senator PELL. What would you say, about 90 percent of the cost? Mr. PETERS. They covered everything.

Senator PELL. So far?

64-350 0-71—pt. 2- -2

Mr. PETERS. Yes.

Senator PELL. What you are really saying is that despite this coverage you are now faced with an economic burden in the future? Mr. PETERS. It is the medicine, it costs a lot of money.

Senator PELL. And the visits for the nursing care?

Mr. PETERS. That is right. The nurse was coming to the house for 100 days and that was paid; but after 90 days I have to pay $3 a day— she was coming four times a week-and I couldn't afford it. Now she is coming only once a week and I have to do the work myself.

Senator PELL. What you are saying then would be that the cost of the visiting nurse and the medicines should be covered by Medicare? Mr. PETERS. Yes.

PRESENT PROPOSALS AN IMPOSSIBLE HARDSHIP

Senator PELL. It is not one of the problems that we face here. We always put the emphasis on looking after the person who is sick in the hospital and not enough on follow-through afterwards. Now, in this regard, the present proposals out in the Ways and Means Committee of the House of Representatives could reduce and narrow the benefits that people will be getting in your case and that would be an impossible hardship I think.

Mr. PETERS. A box of pills cost almost $19 and I get 200 pills in a box, and I think she has to take about eight of those pills a day. Senator PELL. And there is no help from Medicare for that?

Mr. PETERS. No help whatsoever.

Senator PELL. Not five cents?

Mr. PETERS. No.

Senator PELL. How much does it cost you for the visiting nurse to come?

Mr. PETERS. Well, $3.

Senator PELL. Is that out of your pocket or does Medicare take that?

Mr. PETERS. No, it is out of my pocket. Medicare pays for the rest, 80 percent.

Senator PELL. Right. Thank you very much for these facts. I think it is amazing that the community as a whole is not aware of this. I am very glad that you have been willing to share your experience. Mr. PETERS. My wife is a sick woman, Senator.

Senator PELL. I fully realize that.

Mr. PETERS. Very sick.

Senator PELL. I apologize for probing into your personal life but it is only by personal examples

Mr. PETERS. It is all right.

Senator PELL (continuing). That we can get at the problems.

Now, as I understand it, Mr. Farley, let me put it this way. How many days was your wife in the hospital when she was sick?

Mr. FARLEY. I couldn't say exactly the date. I would say about a

week.

Senator PELL. About 2 weeks or a week?

Mr. FARLEY. Over a week and then the doctor advised me that she would get stronger if we transferred out to the nursing home in Lincoln.

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