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7.5. Congress. Senate, Special Commellie. on Aging, Subcommittee on Health CUTBACKS IN MEDICARE AND 77

MEDICAID COVERAGE

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SPECIAL COMMITTEE ON AGING

UNITED STATES SENATE

NINETY-SECOND CONGRESS

FIRST SESSION

PART 3-PROVIDENCE, R.I.

SEPTEMBER 20, 1971

Printed for the use of the Special Committee on Aging

U.S. GOVERNMENT PRINTING OFFICE

WASHINGTON: 1972

For sale by the Superintendent of Documents, U.S. Government Printing Office
Washington, D.C. 20402 - Price 60 cents

SPECIAL COMMITTEE ON AGING

FRANK CHURCH, Idaho, Chairman

HARRISON A. WILLIAMS, JR., New Jersey HIRAM L. FONG, Hawaii

ALAN BIBLE, Nevada

JENNINGS RANDOLPH, West Virginia EDMUND S. MUSKIE, Maine

FRANK E. MOSS, Utah

EDWARD M. KENNEDY, Massachusetts WALTER F. MONDALE, Minnesota

VANCE HARTKE, Indiana

CLAIBORNE PELL, Rhode Island
THOMAS F. EAGLETON, Missouri

JACH MILLER, Iowa

CLIFFORD P. HANSEN, Wyoming

PAUL J. FANNIN, Arizona

EDWARD J. GURNEY, Florida
WILLIAM B. SAXBE, Ohio

EDWARD W. BROOKE, Massachusetts
CHARLES H. PERCY, Illinois

ROBERT T. STAFFORD, Vermont1

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1 Senator Winston Prouty, Vermont, served as ranking minority member of the committee from September 1969 until his death, September 10, 1971. Senator Robert T. Stafford, Vermont, was appointed to fill the vacancy on September 17, 1971.

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CONTENTS

Opening statement of Senator Claiborne Pell____.

CHRONOLOGICAL LIST OF WITNESSES

Doorley, Joseph, mayor, Providence, R.I.

Hill, Ann, director of the St. Martin de Porres Center for Senior Citizens

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Marshall, Hannah, Providence, R.I...

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Lamoreux, Ruth, director, Providence Senior Citizens Center

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McQueeny, Walter A., chief of Providence Police Department..
Dean, Mildred A., president, Rhode Island Association of Senior Citizens
and Senior Citizens Clubs.

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Vittorio, Anthony, member, Senior Citizens of Rhode Island Action Group-
McGrath, Alice, member, Senior Citizens of Rhode Island Action Group..
LaPlante, Eleanor, member, Senior Citizens of Rhode Island Action
Group.

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Curley, Betty, senior vice-president, Rhode Island State Council of Senior
Citizens..

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Person, Ruth M., field aide for Project SECAP.
Newsome, Elizabeth, director, Project SECAP-

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Mulvey, Dr. Mary, vice-president, National Council of Senior Citizens--
Kraemer, Dr. Richard J., chairman, Committee on Aging, Rhode Island
Medical Society..

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Johnson, Wade, executive director, Hospital Association of Rhode Island__
Buonaiuto, Gustin L., president, Rhode Island Nursing Home Association.
Lees, Albert V., president, Rhode Island Association of Facilities for the
Aged..

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Whitcomb, Shirley, member, Association of Home Health Agencies..
Hanley, Arthur F., chief executive officer, Rhode Island Blue Cross and
Blue Shield.

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272

Burgess, Alex M. Jr., chief, Division of Planning and Standards, Rhode
Island Department of Health..

274

Pesare, Dr. P. Joseph, Medical Care Program Director, Rhode Island
Medical Assistance Program..

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Brown, Edwin, secretary-treasurer, Rhode Island AFL-CIO.

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Tierney, Joseph, president, Rhode Island Congress of Senior Citizens__

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Murray, Veronica, vice-chairman, Rhode Island Senior Citizens Action

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APPENDIXES

Appendix 1.-Prepaired statements:

Item 1. Prepared statement of Arthur F. Hanley, president, Rhode
Island Blue Cross and Blue Shield___.

Item 2. Prepared statement of Dr. Richard J. Kraemer, chairman,
Committee on Aging, Rhode Island Medical Society--

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303

Item 3. Prepared statement of Edwin C. Brown, secretary-treasurer,
Rhode Island AFL-CIO.

306

Item 4. Prepared statement of Eleanor F. Slater, coordinator, Division on Aging-.

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Item 5. Prepared statement of Dr. Mary Mulvey, vice-president, National Council of Senior Citizens-

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Item 6. Prepared statement of Wade Johnson, executive director,
Hospital Association of Rhode Island_.

Item 7. Summary of prepared statement of Dr. P. Joseph Pesare,
Medical Care program director, Rhode Island medical assistance
program----

Item 8. Prepared statement of Dr. P. Joseph Pesare...
Appendix 2.-Additional information requested from witnesses by Senator
Pell:

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Item 1. Supplementary materials in response to specific questions
raised by Senator Pell: submitted by Dr. P. Joseph Pesare--
Item 2. Letter from Wade C. Johnson, executive director, Hospital
Association of Rhode Island, in response to specific questions.
raised by Senator Pell..

Item 3. Letter from Albert V. Lees, president, Rhode Island Associa-
tion of facilities for the Aged, in response to specific questions raised
by Senator Pell..

Item 4. Letter from Richard J. Kraemer, M.D., vice-president, Rhode Island Medical Society, in response to specific questions raised by Senator Pell__

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Item 5. Letter from Gustin Buonaiuto, president, Rhode Island State Nursing Home Association, Inc., in response to specific questions raised by Senator Pell...

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Item 6. Reply from Arthur F. Hanley, chief executive officer, Rhode Island Blue Cross and Blue Shield, in response to specific questions raised by Senator Pell..

357

Item 7. Letter from Shirley A. Whitcomb, R.N., director, Cranston District Nursing Association, in response to specific questions raised by Senator Pell_

359

Item 8. Letter from Alex M. Burgess, Jr., M.D., chief, Division of
Planning and Standards, in response to specific questions raised by
Senator Pell__

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Appendix 3. Additional material submitted by witnesses:

Item 1. Letter to Senator Pell from Veronica Murray, Providence, R.I
Item 2. Letter to Senator Pell from Mildren A. Dean, Providence, R.I.

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Appendix 4.-Letters from individuals and organizations:

Item 1. Letter to Senator Pell from Doris E. Johnson, Providence, R.I.
Item 2. Letter from Aristide B. Morsilli, Johnstown, R.I..

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Item 3. Letter to Senator Pell from Anthony J. Agostinelli, executive director, The Urban Coalition of Rhode Island__

366

Davis, William E., Providence, R.I

Appendix 5.-Statements submitted by the hearing audience:

Heltzen, Ms. Louise, Providence, R.I..

Terrier, Eugene, Woonsocket, R.I__

McCullough, Daniel J., Providence, R.I

Cullen, Miss Ellen, Providence, R.I..
Goode, James A., Providence, R.I..
Hood, Marshall L., Providence, R.I
Coffey, Paul, Providence, R.I.

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CUTBACKS IN MEDICARE AND MEDICAID COVERAGE

MONDAY, SEPTEMBER 20, 1971

U.S. SENATE,

SUBCOMMITTEE ON HEALTH OF THE ELDERLY,

SPECIAL COMMITTEE ON AGING,

Providence, R.I.

The subcommittee met at 10 a.m., pursuant to call, in the Diocesan Auditorium, Saints Peter and Paul Cathedral, Cathedral Square, Providence, R.I., Senator Claiborne Pell, presiding.

Present: Senator Pell.

Also present: Keven McKenna, legislative aide to Senator Pell; Kenneth Dameron, Jr., professional staff member; Carol Ann De Vaudreuil, secretary; and Janet Neigh, assistant chief clerk.

OPENING STATEMENT OF SENATOR CLAIBORNE PELL, PRESIDING

Senator PELL. This hearing of the Subcommittee of the Special Committee on Aging of the U.S. Senate will come to order.

I am very pleased to say I am grateful to the Catholic Diocese for the use of this auditorium. I thought we would start punctually because we have quite a long list of witnesses.

Nearly 7 years ago the Congress acted to pass a law to care for the health needs of our senior citizens. Today we are here to review the operation of the Medicare and the Medicaid programs over the past years in Rhode Island. The Senate is presently considering a bill, Ĥ.R. 1, to change the scope of the Medicare and Medicaid programs. Today we are here to examine the ramifications of that bill on the senior citizens of Rhode Island. Today we are also here to take a comprehensive overview of the Medicare and Medicaid programs in Rhode Island.

Following our discussion of the problems of access to health care, we will hear senior citizen consumer representatives as to the adequacy of the Medicare and Medicaid programs in Rhode Island. Following our discussion of consumer viewpoints, we will hear directly from those persons who have the responsibility for providing health care services to senior citizens, the doctors, the hospitals, the nursing homes, and the visiting nurses.

The Department of Health, Education, and Welfare recently predicted, in a cost study required by an amendment of mine enacted into law last year, that health costs will rise by 50 percent in the next 2 years. One question I plan to pose for the providers of health care services in Rhode Island is how they plan to control this expected 50 percent rise in health costs. If this rise cannot be controlled, the senior citizens will unfortunately have to pay the bill.

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