1 Formerly designated "Hospital Room Rates." Includes charge to full-pay adult inpatients for routine nursing care, room and board, and minor medical and surgical supplies. 2 Formerly designated "Group Hospitalization." 3 December 1958=100. 4 Limited to prescriptions (an APC or aspirin, phenacetin, caffeine citrate compound; elixir terpin hydrate with codeine; and buffered penicillin) and over-the-counter drugs (aspirin tablets, milk of magnesia, and multiple vitamin concentrate) prior to March 1960, this prescriptions and drugs index was expanded by linking into the index prescriptions appropriate to each of 7 end-use classes (anti-infectives, sedatives, and hypnotics, ataractics, antispasmodics, antiarthritics, cough preparations, cardiovasculars, and antihypertensives). Source: U.S. Department of Labor, Bureau of Labor Statistics, "Price Indexes for Selected Items and Groups," annual averages and quarterly indexes. See "Medical Care in the Consumer Price Index, 1936-56," Monthly Labor Review, September 1957. The consumer price index was converted as of January 1962 from the 1947-49-100 reference base to the new base 1957-59=100. Composite chart from Health, Education, and Welfare, January 1964. C. WHAT ARE THE HEALTH CARE PROBLEMS OF OLDER PEOPLE? The National Health Survey and the American Hospital Association agree that people 65 and over are hospitalized nearly twice as often as younger people. The population under the age 65 has an average of 75 admissions per thousand persons per year (excluding maternity cases). Persons age 65 and over had 121 admissions per a thousand persons per year. The aged stay nearly three times as many days in the hospital as do younger people. Persons under 65 years of age average 833 days of hospital care per thousand persons per year-those over 65 average 2,333 days per thousand persons per year. During 1959, 12 percent of the aged were hospitalized as compared with only 72 percent in the younger groups. When they go to the hospital, the National Health Survey shows older people stay about twice as long. Most of the hospitalized aged (82 percent) stay less than 1 month, 6 percent stay more than 2 months, and only 21⁄2 percent stay more than 3 months. The average duration of hospitalization per aged person is 21.2 days. Older people are twice as likely to have chronic conditions as younger people. The average aged person is incapacitated for 5 weeks a year and must spend 2 of these weeks in bed because of these conditions. Percentage of aging with one or more chronic conditions: two-fifths of the people under age 65, four-fifths of the people over age 65, 84 percent of the people over age 75. The proportion of the aged with one or more chronic conditions that limits activities, one-fifth of the people under age 65, one-half of the people over age 65. Older people have 5 times as much chronic illness as younger people. One-third of the persons in mental hospitals are over 65. One-fourth of all first admissions in mental hospitals are persons over age 65. Many of these elderly people who are in mental hospitals should not be there at all, but are sent to these institutions as the only places they can get free care. One out of four persons over age 65 has an accident every year. Twice as many as younger people. Persons over 65 had 6.8 physician's visits per year as compared with 4.8 visits for younger people. Nine out of ten people over 65 can expect to be hospitalized once during their retirement, two out of three aged persons at least twice, and one-third at least three or more times. D. WHAT ARE THE HEALTH CARE COSTS FOR THE AGED? When an older person goes to the hospital he must expect to spend at least $700. For the 300,000 aged who must be in the hospital more than 30 days each year, the average individual bill runs well over $1,000. The aged spend $42 a year for drugs compared to $18 for younger people. These figures from the National Health Survey are conservative and would be increased by at least one-fourth if the survey had included the aged who died during the year. Twenty percent of all expenditures made for personal health services in 1961 were for the care of the aged who constitute 9 percent of the population in the United States. Twenty-eight percent of the $5.4 billion spent on the care of the aged came from public sources. Only 20 percent of the money for the care of people under age 65 came from public sources. Under our present system, one-third of the people who are forced to accept old-age assistance do so because of inability to otherwise handle medical care costs. Nine out of ten of these people never leave welfare. Several checks of bankruptcies of individuals indicate unpaid hospital bills as a major factor. While over 90 percent of the aged on social security who went to the hospital paid some portion of their hospital bill out of their own resources, only 60 percent of the couples and 40 percent of the single people indicated that they paid all of their hospital bills from their own resources including income, savings, and hospital insurance. One-fifth of the aged couples with one member hospitalized and 12 percent of single persons hospitalized each year have a long-term debt resulting from their hospitalization. Eighteen percent of the couples and 35 percent of the single persons hospitalized had been aided with their hospital bills by relatives. The amount of the bills average $230 with 9 percent of the cases amounting to over $1,000. Since the aged have less income they are likely to have more untreated symptoms. A Michigan study shows that 45 percent of the persons of all ages with less than $1,000 income had untreated symptoms, while only 10 percent of the people with over $5,000 income had untreated symptoms. In Boston among people 65 and over there were twice as many untreated symptoms in the lower economic groups as the upper economic group. The National Health Survey and the social security studies show that 14 percent of the persons on social security who had hospital insurance were hospitalized, while only between 8 and 9 percent on social security without hospital insurance were hospitalized. Excerpts fom a White House Conferenc on Aging Regional Report The following is from a White House Conference on Aging Regional Report. This report is a summary of similar scientific surveys made by the universities of Minnesota, Iowa, Missouri, North Dakota, and South Dakota, concerning the aged person. These surveys were made in the States of each university and prepared by a joint university committee. It is unfortunate that these important State studies have not previously been made available to Congress. "Concern for health increases with advancing age. Older persons express worry and concern for their health more often than for any other single matter. Though this is more true for those in ill health, it also holds for others. "In addition to the immediate impact of health upon the ability of the individual to care for his physical needs, it has many other ramifications. It affects his earning capacity, his general morale, and his degree of dependence upon others as well as the contribution which he can make to the activities and happiness of his friends and family. Several of the studies also observed a high correlation between person adjustment and good health. In turn good health appears to be, at least in part, a function of education, income, and urban rather than rural residence. A "A wide range of responses was received in answer to the series of inquiries regarding how a person felt physically. Thus in Minnesota 110 of 1,400 respondents stated that if they could not feel better soon they would just as soon die. similar proportion of Iowa senior citizens declared themselves in 'very poor' or 'poor health'. The proportion reporting poor health was slightly higher for North Dakota (13 percent). On the other hand, somewhat over half of Iowa and almost as high proportions in Minnesota and North Dakota considered themselves to be in excellent or in good health. The rest thought of themselves as in fair health. “Despite the high proportion which expressed favorable attitudes toward the state of their health, significant numbers reported major medical problems, 10 to 15 percent had had no contact with medical personnel or facilities during the previous year. A fourth of all respondents indicate no contact with health service personnel (doctors, dentists, or nurses) during the preceding year. The reasons given most often for not seeking medical attention when presumably needed was the cost. Medical diagnosis might have indicated either higher or lower incidence of both cared for and uncared for health conditions. The data presented reflect the senior citizen's own reaction to his state of health. "Less than 1 in 10 reported no medical costs during the previous year. Apparently some had paid for medical services obtained at a prior time. Medical costs of over $500 were indicated by 15 percent in Minnesota and by 12 percent in North Dakota. Expenditures in excess of $250 were reported by 23 percent in Missouri. Approximately half of all respondents spent between $100 to $150 or more on health care during the preceding year. "Close to half of the respondents carried hospitalization insurance, far lower percentages had medical and surgical insurance. Although many of the aged persons believed themselves to be able to meet the foreseeable medical costs, a third did not believe they had the resources for expenditures beyond $1,000. "Those who were covered by some form of health insurance had largely purchased it fairly late in life. This probably reflects a general growth of health insurance programs during the last few decades. Of those who gave reasons for not buying health insurance, one-fourth think themselves capable of handling their medical needs without insurance, while a much larger proportion feel that they cannot afford the costs of such insurance. A substantial majority of respondents in all States favored the extension of OASDI to include hospital and medical care. About one-fourth opposed it." E. CASE HISTORIES OF SENIOR CITIZENS Hospital costs from over the country The following are taken from miscellaneous signed statements sent to the National Council of Senior Citizens from members over the country: "How long do we have to wait for medicare. We old people want it now-not when we are dead. How long and far can this go, it is not human. I was in the hospital 10 days, March 1961. I am 70 years old. "I was operated on and still sick. It cost us $1,800. The $2,000 we saved is all gone. Social security is not enough. Now we do not know what to do or where to turn. We need medicare as soon as possible. "ALBERT MASZIASZ, "Was in hospital in 1962 for 8 days, cost $517. In 1963 in hospital 3 weeks, cost $1,434. I now spend for medicine per month $45 to $50. On social security receive $102 per month, my wife receives $51, a total of $153. No other income and penniless, waiting patiently for medicare. "JOSEPH KRZEMINSKI, Chicago, Ill." "I was in the hospital with an eye operation for 9 days in June 1963. "I receive $117 on social security, my wife receives $58.50, a total of $175.50. "No other income; $30 a month medicine. Praying and waiting for medicare to reduce expenses. Please help. "WALTER KANDYBOWICZ. "Mrs. Marya Babecki operated on in 1963 in hospital, 5 days, cost $236, doctor $125, total $361. Medicine per month $30. "Our only income is social security, a total received of $160. We are struggling not to go on relief so we are waiting for medicare which will reduce our medical cost. "VINCENT BARECKI. "MARYA BARECKI." "In 1962 I was operated on and in hospital 7 weeks; cost $2,000, doctor $850, total $2,850. In 1963 again operated on; in hospital 8 weeks; cost $2,250. All my savings are gone. The social security will not take care of the living. "JULIO MALINOWSKI, Chicago, Ill." "I am 75 years old; my wife is 70. My wife gets $40 a month, I get $74 a month. I have been in the hospital for 21⁄2 months. First it was my heart, then I had three operations on my foot. Now I have developed diabetes. I have to pay about $3,000. We had to move and now living with our son. Please help. "JOSEPH AND VICTORIA CHOLERVA, "Chicago, Ill.” "Michael Sysh was operated on and 13 days in the hospital. Hospital. Doctor- Total--- $500 510 1, 010 "We cannot make ends meet with the little we get from social security. We have no hospital insurance and cannot afford to go to a doctor so we have to suffer and waiting for medicare bill to pass. Won't you please help. "MICHAEL AND SOPHIE SYSH, Chicago." "I am 68 and I am only getting $55 a month. I have been in the hospital for 2 weeks. Doctor bill $350, hospital $450, have no insurance because I can't pay for it. What am I to do? Please help and let the medicare go in effect... "SOPHIE STEFANSKI, Chicago." "I am 73 years old, my wife is 66. I was in hospital for surgery for 3 weeks. Hospital cost.. Doctor cost‒‒‒‒ Doctor cost____. Total_____. $791 $450 150 1, 391 "We are on social security with a total income of $183.50. We have no other income, we are penniless. Praying for medicare to go through. "MICHAEL BEIGERT, "My husband was sick 15 years with cancer. It took much money for doctors. I had to sell my farm. My husband died and I had three little children. I now receive $40 a month social security; no other income. I am penniless. I am praying for medicare to go through. From Florida "ANIELA WALKOWICZ, Haganan, N.Y." ́One of our groups in Florida sent us a number of signed statements concerning hospitalization costs. These statements are listed below as follows: "I have been hospitalized twice at the Miami Heart Institute“May 21, 1963 to May 24, 1963 (4 days). "Surgery. "July 6, 1963 to July 16, 1963 (10 days). "Surgery-. "Total----- $493. 40 400.00 807.35 850.00 2,550, 75 "No insurance; my only income is from social security. "HARRY ROSS, Miami Beach, Fla." "My wife fell and broke her arm and was hospitalized. "Doctor and hospital--. $419.00 "Insurance paid--- 113.00 "Total.. 306.00 "I was hospitalized for heart disease October 6, 1962. "Income is from social security for both $152.70 per month. "I have been hospitalized two times. "July 12, 1959 to Sept. 30, 1959 (11 weeks and 4 days). "Mar. 20, 1961--- "Total----- 263.00 697.00 306.00 1,003. 00 "MORRIS ROHINSKY, Miami, Fla." $864.00 225.00 1,089.00 "Only income is from social security $174 for self and wife. |