Of the 64 countries listed as having some statutory old age benefit or pensions system, 13 have noncontributory medical care programs for pensioners, which are extensions of employee programs, 10 have contributory medical care programs for pensioners, which are extensions of employee programs, 8 have medical care programs for all residents, 4 have voluntary coverage programs for pensioners, 3 have medical programs for the needy, 26 exclude pensioners from coverage. Apparently not one single country has a health program exclusively for pensioners, separate and apart from a health program for employees and their dependents. After reviewing the summary given by the U.S. Department of Health, Education, and Welfare's publication, Louisiana Business finds that not one of the programs established in the 38 countries, which have medical care plans for pensioners, is equal to, but less superior to, what is available to the aged in the State of Louisiana. Louisiana Business is confident that the voters of this Nation would not voluntarily choose any of the plans of those nations. It is quite difficult, then, for Louisiana Business to believe that any elected representative of the people of these United States could advocate and vote that the Congress enact any such plan. Members of the Committee on Ways and Means are aware that of the 180 million people in this Nation, more than 120 million are presently voluntarily covered by private and commercial hospitalization plans. According to the July 1963 report of "Health Insurance of America," there are 17.2 million persons 65 years of age and over and more than 60 percent of these, or some 10.3 million persons 65 years of age and over, presently voluntarily pay for private hospitalization coverage. Approximately 6.9 million such persons, then, do not have hospitalization insurance, some of whom have never been gainfully employed and some, although financially able, never cared for, and do not want, coverage. Perhaps the insurance companies have taken a very long time in making available health-care insurance policies for the aged at some reasonable cost. Be that as it may, the general concern of coverage for the senior group during the past several years has apparently greatly accelerated research into and the sale of medical care policies. Increased and extended private coverage is evident almost daily. Louisiana business is fully aware that there are senior persons who are not able to pay for single or group coverage, although that cost has been greatly reduced and is being currently further reduced actuarially by insured larger numbers. In those cases where there is no coverage, nor personal funds available for medical care, no one in Louisiana will be denied such care. This was very evident many years prior to the enactment of Federal Public Law 86-778, the Kerr-Mills law. It is even more so now since that measure was adopted several years ago. Matching Federal and State funds out of general revenues are available to any State that has a recognized need for such a plan for its citizens who, for some reason, do not receive sufficient income maintenance to be able to pay all of their medical expenses or to purchase adequate private coverage. Current fiscal year operating budget for Louisiana State hospitals, medical institutions, vendor payments and other medical care is $64,786,000. This is a sizable current medical care budget for a State with a population of 3,257,000. If the Congress of the United States, at some unfortunate later date, determines that senior citizens of this Nation must compulsorily be medically insured, it would appear that funds could be made available through an extension of Public Law 86-778 to senior citizens to pay the premiums actuarially established by private insurance carriers, if they desire. VI. Conclusion The issue is not "Should the aged have medical care?" Louisiana business, after reviewing the medical care now available to all Louisiana citizens, is of the studied and definite conviction that, under freedom, there is no better system of available medical care anywhere else than now exists in Louisiana. Louisiana business holds that the astoundingly increasing record of workers voluntarily and fully covering themselves and their families for hospitalization and medical care at their own expense, sometimes with employers assistance, has assured considerably greater health care of the citizens of this Nation. Moreover, on a voluntary basis, the extension of such employee coverage, beyond 27-166-64-pt. 5-26 attachment to the labor market, is increasing at even a more tremendous pace. Accordingly, Louisiana business urges the Committee on Ways and Means to consider the gross inequity of imposing an additional tax burden on that worker, and the business that employs him, to compulsorily provide medical care for those senior citizens who have not provided or who cannot now pay for all of their medical expense. Louisiana historically has adequately and most effectively taken care of its sick at every age and in every emergency. In raising necessary funds it directly taxed the population and did not place the burden on free enterprise, its lifeblood. Many doubt that Public Law 86-778, the Kerr-Mills Act, was necessary in Louisiana. There is no doubt, however, that in full cooperation, and with Louisiana matching funds, aid under Kerr-Mills is now meeting and will continue to meet medical needs of its citizens when those citizens are unable to provide from income and resources. If, despite this, National Government feels constrained, for the welfare and security of that Government, to assume responsibility for medical care needs of its citizens, it should do so from general revenues obtained from direct levies on the population. Louisiana Business fully anticipates that if H.R. 3920 is ever adopted, it will very quickly be confronted with another question: "Why is the United States of America so far behind, when many foreign countries are paying doctors, dentists, and nursing bills for all of its citizens?" As the demands increase, as they inevitably must, the funds required from business would further reduce the amounts otherwise available to invest, to improve, to expand and to create jobs in free enterprise and even to remain in business. Again, Louisiana Business commends the members of the committee who stalwartly weigh proposals on their merit without regard to political expediency. Coordinated, endorsed and respectfully submitted by— Automotive Wholesalers Association of Louisiana. Baton Rouge Chamber of Commerce. Chamber of Commerce of the New Orleans Area. Louisiana Building Material Dealers Association. Louisiana Laundry & Dry Cleaners Association. Louisiana Motor Transport Association. Louisiana Oil Marketers Association. Louisiana Restaurant Association. Louisiana Retailers Association. Louisiana State Chamber of Commerce. Louisiana Wholesale Grocers Association. Louisiana Wine & Spirits Foundation. Shreveport Wholesale Credit Men's Association. Southern Pine Industry Committee (Louisiana Division). I hereby certify that the position of Louisiana Business, as outlined in the foregoing, has been endorsed by the associations named above. JULES L. LAMOTHE, Coordinator. STATEMENT OF THE OKLAHOMA PUBLIC EXPENDITURES COUNCIL Mr. Chairman and members of the committee, I am Steve Stahl, executive vice president of the Oklahoma Public Expenditures Council. The Executive Committee of the Oklahoma Public Expenditures Council has authorized me to submit the following statement with the respectful request that it be included in the record of the House Ways and Means Committee hearings on H.R. 3920. STATEMENT On August 1, 1961, it was my privilege to appear before the House Ways and Means Committee to oppose legislation seeking to commit the Federal Government to a program of providing medical care for the aged under social security. Since that time I have attempted to keep informed on this issue by carefully reading much of the voluminous material which has been published by both opponents and proponents, including the Senate subcommittee report on the health of the elderly. It is still my conviction that: (1) The medical care program under social security, as proposed in H.R. 3920, is not needed and (2) despite an all-out selling effort by the administration, there is no popular demand for the enactment of this legislation. Mr. Chairman, although the Kerr-Mills program, for which you deserve much of the credit, was severely and unjustly criticized in the majority report of the Senate Subcommittee on Health of the Elderly, there was no recommendation that it be repealed. Therefore, it is assumed that proponents of H.R. 3920 are seeking to establish a third program to provide medical assistance for the aged. This duplication of effort-medical aid for old-age assistance recipients; medical assistance for the aged under the Kerr-Mills Act; and, medical aid for the aged under social security-would be costly to taxpayers and confusing to senior citizens. Certainly, cost is one of the major factors which must be considered by members of the House Ways and Means Committee in arriving at a final decision on H.R. 3920. Without the added tax burden of the program under consideration, the cost of health and social welfare programs has been going up faster and climbing higher than a Cape Canaveral missile. According to the Department of Health, Education, and Welfare, total Government expenditures for these two items have increased from $16 billion in 1953 to $44 billion in 1963. This tremendous increase during a period of prosperity is a matter of major concern to all Americans and particularly to younger generations who must bear the brunt of the burden, and who may well find the cupboard bare when it comes their turn to collect. Many of these young citizens are already paying more in social security taxes than they are in Federal income taxes. It is regrettable, Mr. Chairman, that during the time the House Ways and Means Committee was considering H.R. 8363-the tax reduction bill—you were compelled to introduce H.R. 6688, seeking to raise the social security salary base from $4,800 to $5,400, in order to raise sufficient revenue to halt recurring deficits in the social security program. The fact that this program, without the added burden of medical care for the aged, has operated in the red for 5 of the past 6 years provides sufficient reason for the committee to draft an obituary for H.R. 3920. We have no quarrel with the necessity of providing good medical care for all American citizens, regardless of age or income. We do contend this responsibility rests first, with the individual; second, with the family unit; third, with private charity; and, only as a last resort, with government. This final responsibility, insofar as the aged are concerned, is being adequately met in Oklahoma under two programs: Medical assistance to welfare recipients and medical aid to the aged under the Kerr-Mills program. According to the Oklahoma Department of Public Welfare, 112,950 persons over the age of 65 or 44.3 percent of Oklahoma's total over-65 population are protected under these two programs. Under the Oklahoma medical-aid-for-the-aged program, an elderly couple can have assets of $13,500 and an annual income of $2,000 and still be eligible for medical assistance. In fiscal 1963, the Oklahoma Department of Public Welfare spent $26,821,791.08 in medical payments for its needy citizens, and in September 1963, total medical payments by the department amounted to $2,061,175.93 for assistance to 20,300 persons. Since Oklahoma ranks 39th among all the States in per capita personal income, we contend that if Oklahoma can provide adequate medical care for its needy citizens, so can all the other States. The Kerr-Mills program has now been in operation 3 years. It is possible that an objective study of its development during this period may reveal certain defects. If so, let's correct these defects and strengthen this existing program rather than saddle taxpayers with the burden of an entirely new one. Mr. Chairman, in conclusion, I contend the greatest favor we can extend to the people this legislation seeks to help is to preserve the purchasing power of their dollars. In order to do so we must stop fanning the fires of inflation with Federal spending fans. Perhaps the most compelling question which must be considered by this committee and the Congress is the total amount of responsibility the Federal Government can assume in providing for its citizens without impairing its ability to protect our Nation and preserve our freedom in this chaotic world. There will be no security-and very little medical care for any of us in a bankrupt or vanquished America. STATEMENT OF THE NATIONAL LUMBER & BUILDING MATERIAL DEALERS ASSOCIATION ON MEDICAL CARE FOR THE AGED The members of the National Lumber & Building Material Dealers Association are opposed to H.R. 3920 and other bills pending before the Ways and Means Committee which would provide for a program of hospital or medical care under the social security program. Old age and survivors insurance benefits are based upon the wages paid to an employee. The contributions to the program are made by the employer and employee over the years of employment. H.R. 3920 would provide benefits regardless of the contributions made by employer and employee, which is a departure from the original purpose of social security. Furthermore, such a program would, in our opinion, jeopardize the actuarial soundness of the existing program. There has been an important growth of pension plans in the last few years to augment social security benefits received by employees. An ever-increasing number of such employees can afford voluntary health insurance. It is inequitable to tax these employees for a program as provided in H.R. 3920 which the employees will not need. It has been estimated that over 10 million persons 65 years or older now have health insurance. It has also been estimated that by 1969 approximately 68 percent of those over 65 will have health insurance programs. We do not want this committee to think that we are not aware of problems confronting elderly persons in times of serious and prolonged illness. In addition to the increase in voluntary health insurance programs, the Congress has enacted legislation (the Kerr-Mills Act) designed to aid those persons who cannot afford medical care in prolonged illnesses. Here is a Federal-State program which, because it is new, has not been on the statute books a sufficient length of time to determine its effectiveness. If, after some experience gained under the Kerr-Mills law it is found to be deficient, the Congress can then reexamine it and take any steps necessary to provide a workable program of medical and hospital care for our elderly citizens. In conclusion, we urge the committee to consider (1) if there is a need for such a program as provided in H.R. 3920 and (2) the ultimate cost of such a program keeping in mind the effect upon employees and employers who, through payroll taxes, support the old age and survivors insurance program. Consideration of these issues will, we believe, result in the rejection of H.R. 3920 and other similar measures. Respectfully submitted. JOHN H. ELSE, Legislative Counsel. HOUSE OF REPRESENTATIVES OF THE STATE OF MONTANA, Senator LEE METCALF, Washington, D.C. DEAR SENATOR METCALF: hope you seriously oppose H.R. 3920 (King-Anderson bill). In my county, and the environs, there is no need for such legislation. There is no one not being cared for. The existing laws take care of those that honestly need it. Most of our aged citizens have private insurance, or prepayment plan. This list is growing every day. It would seriously lower the quality of medical care. It has in every country that has had it. England, Sweden, Norway, and New Zealand tried it and threw it overboard. In each of these countries, medicine was at its highest, but since socialized medicine came in, the medical care has deteriorated. Only in New Zealand has the quality started to rise, then only since socialized medicine was expelled. It should take care of those who need the care, and not those who do not. There are several people in my county that are hoping to get on this care, if passed. They are malingerers, and will be first in line. This would result in filling up of hospitals, with people that can (and are now), being adequately taken care of at home. This bill also would hurt the use of free choice of hospitals that sign up with agreements with the Government and those physicians who care to practice in those hospitals. The cost of the program would be staggering. England started with honeycoated insignificant costs. It has grown now to a staggering sum of money over the original suggested sum. This has happened repeatedly in every country trying socialized medicine. Canada came out recently with a statement that they were able to cut their original cost. Outwardly this is so, but inwardly, sums were taken from other projects to bolster this misstatement, so the people of Saskatchewan are being misled. This bill would be death knell of all voluntary health insurances, hence throwing more of a load on the cost of Government. The cost would be again doubled as the amount of take-home pay would be less, because of the inevitable increase on social security taxes. The last reason is that it would lead to full-fledged socialized medicine, which would in turn increase the Government spending and debt. The Government has no money, only the part it can take from the people by increased taxes. yours, as well as mine, also from the poor people you seek to help. For the cost of living would rise accordingly. This would be charged to aged, as they would have to buy clothes and bread. Also, it takes away from us, the citizens of the United States, our birthright, the God-given right to take care of our sick, and not some bureau in Washington. Jesus never said, "Beloved John and Peter, hie yourselves to Rome and get a few shekels for the poor and the sick we have with us." For these reasons, I hope you seriously oppose H.R. 3920 (King-Anderson bill). I wish this letter to be written into the minutes of the hearing now going on in the Ways and Means Committee of the House. Yours truly, S. A. WEEKS, M.D., Representative of the State of Montana. (The following statement was submitted for the record by Hon. Ben F. Jensen, Member of Congress, Iowa:) Mr. Chairman and members, it is my pleasure to introduce a statement submitted for the record by Iowa State Senator Ed Wearin. Senator Wearin is a man who states his position on any and all issues straight from the shoulder. (The senator's statement follows:) TESTIMONY IN OPPOSITION TO H.R. 3920 BY EDWARD A. WEARIN, RED OAK, IOWA Mr. Chairman and members of the Committee on Ways and Means. Thank you for the courtesy of your times and for this privilege to testify. I. INTRODUCTION I wish to be specific in stating that I testify as an interested citizen. I am a member of the Iowa Senate. I do not speak for any group and obviously do not speak for my State senate. This is part of my experience, however, and I use my service there as part of the background from which I speak. Iowa has more people 65 and over, in relation to its total population, than any other State in the Union. Montgomery County, which I represent, is second among the 99 counties in Iowa in percentage of citizens 65 and over. Thus, I live in and work within an area which knows the concerns of the aged. |