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From Oshkosh, Nebr.

Case History of a Retired Minister "So many higherups in Washington, D.C., think it's such a terrible thing to formulate a medical plan to take care of our senior citizens. My wife and I are among the senior citizens. I am a retired minister because I had to 4 years ago with a bad heart attack. I will be 71 years old in January and my wife is 75.

“We have a little home we built in 1928 and paid for it as we could, a lot 75 by 150, a six-room house we paid $6,000 for. Last year we paid $220 real estate tax on this home.

“My wife got sick sometime ago. Our doctor said, 'Mrs. Sharp, you need to go to the hospital.' She said to him, 'Doctor, I can't afford it.' And she

didn't go.

“If either of us had to have an operation now, we don't have any insurance to have it done. Our Government could make an appropriation for a medical plan as well as appropriating billions of dollars to these countries that don't care anything for us.

God says in His good old Book, the Bible, in 1 Timothy, chapter 5, verse 8,
'But if any provide not for his own and especially for those of his own house, he
hath denied the faith, and is worse than an infidel.
"I hope and pray something will be worked out for the senior citizens.

"R. S. SHARP." From Miami, Fla.

"My husband had a stroke March 1962, was bedridden for 13 months. He died April 1963.

"All that time I had all the doctor, hospital, and medicine bills to pay; it really cleaned me out.

“I'm not a well person myself. I need a checkup. I'm just afraid to go to the doctor on account of the big bill I'm going to get. There are plenty others like me that's why we have so many heart attacks, we have to wait until we are almost dead to see a doctor. "Hoping the best for all of us.

“Mrs. DOTTY SCHLESINGER.” From Illinois

Case History of Man Who Couldn't Get Help

"On Thursday, August 8, 1963, I played a political football game with a man's life. Yes, this is no joke. The man was 69 years old and his eyes were set. He was cold and clammy feeling. He lives on what he receives from his old-age pension, which most of us couldn't start to live on. He had been sick for 3 days and had nothing to eat in that period of time.

"He was so weak, he couldn't walk under his own power. He had stayed in his own room all during this time, for he didn't want anyone to worry about him. When at last he came out, it was for help. But where is a man in this condition supposed to receive help? The old-age pension naturally.

“Oh no! We called them and told them he was sick. They said to send him to the emergency room at the hospital. He was left there, thinking he would get help. He waited in the hall for 45 minutes to an hour.

"The first thing they asked was did he have a doctor or did he have insurance. No, he had neither. What transpired between the hospital and the old-age pension then is beyond me. All I know is they sent this man, too weak, home in a cab, not knowing if someone was there to help him or not. We paid the cab.

“We then decided to call the relief office and see if we could get some assistance there. After telling Zack Monroe the details, he said he would call back if he found a solution. He never called back.

1

"Looking at this old man, I realized he needed medical attention fast or it would be too late. My only solution was the State hospital in Bartonville. This was suggested by the old-age pension. I took him over there, with the assistance of another man since I couldn't handle him myself. We had to support all of his weight. Upon being admitted at the admitting office, I was told they only took mental patients. To this I replied, 'If nothing else, I'll say he's crazy. He needs. a doctor. They asked if I were a relative. “No, I'm just a friend. Many questions kept coming.

"I pleaded for them to take him. I waited in the hall for the doctor to talk to me. When he finally came, he went out to the car with me, took one look at him and said, 'We'll take him.' I'm not a religious person but I stood in that heat and thanked God for finally finding a place for this old man.

“People of Peoria, what are we supposed to do with our old people? We take in babies and we take in puppy dogs, but we kick the old people out. We have a humane society for dogs, but what do we have for old people? Are we supposed to just sit back and let them die without even trying to help?

I'm 26 years old and the mother of six wonderful children. I thank God for this blessing and pray that my children won't have as much trouble getting help if I ever need it as bad as this man. I was over to see my old friend Saturday afternoon and again today. It was his birthday. The only present I had for him was his life. No one else seemed to care about it."

Submitted by Mrs. Thelma Tarbrough, Peoria, Ill. Washington, D.C.

"DEAR SIR: I am 65 and receiving social security. I certainly hope Congress will pass a health insurance plan for the aged. Personally, I cannot pay for medical care and hospital much longer. Until this year, no insurance company wanted to sell me hospitalization insurance, none. I am now paying $188.80 yearly for a policy. "Cordially yours,

“EMILIE L. GLASS, Washington, D.C." Colorado

"DEAR AIME FORAND: I am interested in medicare aid to the aged geared to social security. We are getting $60 per month from social security. At our age we have no health insurance and can't get any. "Best of luck,

"RAY DUGAN, Colorado Springs, Colo." New Jersey

"I have received a bill for $523 for the first 5 days in the hospital. My insurance company will only pay half. Lucky I have a brother who will loan me money. I have to stay in the hospital 10 days. It will take me years to pay my brother back a little at a time. Do you know of any part-time job for a houseworker?

“Mrs. L. ANDERSON, Jersey City, N.J."

J. MEDICAL ASSISTANCE FOR THE AGED

1. Number of people helped

According to the latest report (October 1963) released by the Department of Health, Education, and Welfare in January 1964, only 28 States and 4 jurisdictions (Washington, D.C., Guam, Puerto Rico, and the Virgin Islands) have a working Kerr-Mills program. Those 65 and over residing in these 28 States total about 91/2 million. The remaining 842 million elder citizens in this age group living in the other 22 States have derived no benefits whatsoever under the Kerr-Mills medical aid to the aged program because no Kerr-Mills program exists in these States.

Alabama: With over a quarter of a million oldsters 65 and over, only 254 réceived MAA benefits. This can only mean that 1 person out of every 1,027 received benefits. Must we conclude, therefore, that only 1 out of every 1,027

is medically indigent and in need of medicare? Or that only 1 out of every 1,027 was sufficiently destitute to pass the means test? Or that the remaining 1,026 out of every 1,027 were either on old-age assistance or sufficiently well off financially to pay for their own medical and health care costs?

The January 1964 HEW report shows that in October 1963 there were 108,098 recipients of OAA in Alabama. Subtracting this figure from 261,000 (the total 65 and over in Alabama) we have left 151,000 who are not on OAA. Subtracting again, the 254 MAA recipients from this 151,000 we come up with the figure of 150,746 who are not on OAA or MAA. Are we now to conclude that these 150,746 senior citizens are all well enough fixed financially or covered by adequate health insurance to take care of their medical needs? Obviously, this is not so. The simple truth of the matter is quite the opposite. Alabama is one of the poorest States in the country per capita income. It ranks fourth highest in the Nation in the number of low-income old people. Yet only 254 were deemed eligible for MAA benefits.

Arkansas : In Arkansas there are 2,382 MAA recipients out of a total population of 194,000 aged 65 and over. Of this number 57,612 are receiving OAA monthly benefits averaging $62.02 per person. Imagine trying to put food on the table, clothes on the back, and keep a roof overhead for one aged person on $15 a week. And then pay for medical care out of this amount.

How does an MAA recipient fare in Arkansas? The figures reveal the appallingly meager sum of $56.02 average monthly cost per recipient. At today's prices, $56.02 will purchase 1 day's stay in the hospital, a visit to the doctor's office, and a few prescriptions filled at the neighborhood drugstore.

Kentucky: Kentucky has 5,360 MAA recipients out of a total of 292.000 persons 65 and over. The number of those on OAA for the month of October 1963 was 55,339 with the recipients receiving an average of $59.67 a month. This amount includes allowance for medical care. In looking at the average monthly costs per MAA recipient, we find the low figure of $27.09, scarcely enough to pay for 1 day in the hospital.

Illinois : In contrast, in Illinois there are 487 MAA recipients out of a total of 975,000 age 65 and over, for an average monthly benefit of $382.43. Here we note a sharp change in the philosophy of those responsible for setting up the Illinois MAA program. They preferred to have fewer recipients so those on the program could receive better medical care. In Kentucky, the MAA thinking was to spread a minimum scale of benefits among a much larger number of recipients. In either case, the fallacy is glaring when champions of Kerr-Jills extol its virtues.

Vermont: Vermont is another State which subscribes to the philosophy of more benefits for a fewer number. Only 81 received MAA benefits out of a total 65 and over population of 44,000, amounting to an average of $393.96 per recipient. This amount, incidentally, was the highest benefit paid in any of the 28 KerrMills States. 2. Limitation of benefits

Under the Federal Kerr-Mills law of 1960, comprehensive medical services are theoretically available. These services exist on paper only. While a few States such as New York, North Dakota, Hawaii, and Massachusetts offer fairly comprehensive benefits, the rer aining 24 States offer benefits of varying degrees both as to types of services and duration. For example, let us consider hospital benefits:

Kentucky.Offers up to 10 days hospital care per admission for acute emergency and life-endangering conditions only.

Tennessee.—Offers up to 15 days of hospital care per year for acute illness or injury only. Patient pays for the first $25 in any year.

New Hampshire.-Up to 12 days hospital care per admission.

West Virginia.-Up to 12 days of hospital care per year for emergency cases only.

Oregon.-Up to 14 days of hospital care per year. Patient pays $7.50 per day for the first 10 days.

Idaho.—Up to 14 days per admission for acute conditions and emergency cases only.

California.-Provides hospital care starting with the 31st day. For the first 30 days the patient is strictly on his own.

What happens if the MAA patient in Kentucky has to stay in the hospital longer than 10 days?

1. Number of people helped

State

Cumulative Cumulative

number of number applications transferred

approved from other through Sep- programs tember 1962, through Sepexcluding tember 1962 transfers

Cumulative

number of applications denied or otherwise disposed of

Total..

265, 424

81,423

81, 454

1,254 7,209 5, 551 1,002

61

555 1, 585 5,997 1, 181

0

646

269

Alabama.
Arkansas.
California.
Connecticut
Guam.
Hawaii.
Idaho
Illinois
Kentucky
Louisiana.
Maine
Maryland.
Massachusetts.
Michigan
New Hampshire
New York.
North Dakota.
Oklahoma
Oregon
Pennsylvania.
Puerto Rico
South Carolina.
Tennessee
Utah.
Vermont.
Virgin Islands.
Washington.
West Virginia.

1

0 17,972 4, 346

0 222 1,350

0 195

0 0

0 22,553 3,934

0 28, 677

1,714 4, 508 10, 114 2,065 2,841 14, 698 18, 296 20, 398

318 70,821

644 5, 243 5, 182 20, 761 10, 729 6, 700 7, 235

746
155

593
6, 476
39, 464

384 3,049 1,007 1, 327

371 4,261 8, 631 6,490

89 23, 537

226 1,236 2,324 10,257

44 2,834 2,217 327 58

24 2,536

638

1,053

0 460 88 0 0

0 508

2

61 0

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Average administrative

costs per

case, total

applications

$52.60

17.32 13.46 84.01 120.34 21.58 52.77 71.20 10.96 20.63

52.86 4530 3.59

:"10.06 " 113.28

28. 26

3.68 94.75 175. 18

8.01 30.33 2.66

.75 33.95 28.04 28.02 31.38 69. 67 12, 25 60.37

Number of

different recipients during year

265 4, 638 18, 557

13, 585

120 69, 900 1,237 2,363 12, 915 8, 732 3,217

1, 921

956 3,723 26, 568

Source: Senate Committee on Aging on MAA and U.S. Department of Health, Education, and Welfare, September 1963.

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1 Excludes $26,000 for the Virgin Islands; distribution by type of service not available.
: MAA program in operation less than 1 year.
8 Less than 0.05 percent.
Source: Senate Committee on Aging Report "Medical Assistance for the Aged,” October 1963.

Can anyone who reviews the table above honestly say the Kerr-Mills program is unlimited ?

Kentucky.Kentucky's commissioner of economic security at the fifth annual medical services conference of the American Medical Association on November 25, 1962, stated :

“We pay only for 6 days.” (This was the allowable maximum number of days at that time.) “If the patient is in the hospital longer, the care may be paid for by a relative or a charity, or the hospital may discharge him. We do not know what happens after our responsibility is met."

West Virginia.-Under the West Virginia MAA rules a person could not get hospital care who required this care but whose condition is not diagnosed as acute, nor is not the victim of an injury.

Oregon-Utah.-A senior who applies for MAA but doesn't have the $7.50 per day or the $75 for 10 days receives no help. In Utah, the same applies if the senior does not have the $50 upon admission.

Kerr-Mills advocates often condemn the use of deductibles in the King-Anderson bill yet remain silent when deductibles are used in Kerr-Mills State MAA programs.

California.-MAA recipients of hospital care in California who are without resources are consigned to OAA rolls and city- or county-owned and operated hospitals. Services are rendered by staff physicians and not by the patients' private or family doctors.

This is socialized medicine and a loss of the patients' precious rights to select their own doctor and hospital. Kerr-Mills apologists profess to believe that this very situation will come to pass if the King-Anderson bill becomes law, yet they condone this in California.

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