NATIONAL ORGANIZATIONS IN THE FIELD OF AGING

WEDNESDAY, AUGUST 5, 1959

U.S. SENATE,

SUBCOMMITTEE ON PROBLEMS OF THE AGED AND AGING

OF THE COMMITTEE ON LABOR AND PUBLIC WELFARE, Washington, D.C. The subcommittee met at 10 a.m., pursuant to recess, in room 4232, New Senate Office Building, Senator Pat McNamara (chairman of the subcommittee) presiding.

Present: Senators McNamara (presiding), Clark, and Randolph. Subcommittee staff members present: Sidney Spector, staff director, and Dr. Harold Sheppard, research director.

Committee staff member present: Stewart E. McClure, chief clerk; and Raymond D. Hurley, minority professional staff member. Senator MCNAMARA. The hearing will be in order.

STATEMENT OF DR. ETHEL PERCY ANDRUS, PRESIDENT; ACCOMPANIED BY MRS. RUTH LANA, EXECUTIVE SECRETARY, AND LEONARD DAVIS, BUSINESS ADVISER, NATIONAL RETIRED TEACHERS ASSOCIATION AND AMERICAN ASSOCIATION OF RETIRED PERSONS

Senator MCNAMARA. This morning I would like to hear from the American Association of Retired Persons, Dr. Ethel Andrus, president, as the first witness.

Good morning, Doctor.

Dr. ANDRUS. Good morning, Senator McNamara.

Senator MCNAMARA. I see you have a lengthy statement. I understand that you would like to have it filed for the record and summarize that portion that you wish. Does that suit you?

Dr. ANDRUS. Yes.

(The statement referred to follows:)

PREPARED STATEMENT OF ETHEL PERCY ANDRUS, PRESIDENT, NATIONAL RETIRED TEACHERS ASSOCIATION AND AMERICAN ASSOCIATION OF RETIRED PERSONS May I tell you my thanks for the opportunity to report the activities, accomplishments, and plans of our two associations, the National Retired Teachers Association, and the American Association of Retired Persons?

First, may I tell you something of our organizations and the concrete, tangible, affirmative steps it has taken in the field of aging? In 1947, the National Retired Teachers Association was a dream, but its purpose and its goals were very real. Without subsidy, but with an annual membership dues of $1, without pleas for financial aid of any kind, but with a journal of dignity and distinction; it now numbers 100,000 of the 175,000 retired teachers of the Nation. In those days of sudden retirement enforcement and meager retirement income, the NRTA was founded on the conviction (1) that the old were not discarded; they were not yet discovered; and (2) that lawmakers are not calloused;

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they may be uninformed. In the various State legislatures, we found them grateful, much disturbed, and most helpful. The results have been gratifying. Retirement income throughout the States have been liberalized. Much still needs to be done, particularly in rural areas and in the Deep South.

NATIONAL CAMPAIGN

When we turned to seek equitable relief in Federal income tax reports, NRTA spearheaded the campaign. In conjunction with civil service employees, it found success in the $240 tax credit, which still is regrettably below that granted other recipients. The vehicle used was the NRTA Journal, challenging old age to a future of activity and usefulness.

OTHER SHORTAGES PRESSED FOR ATTENTION-HOUSING

The need to help in the problem of housing came to us early. Our requests for help from two national philanthropic foundations were refused; they were interested in the young and the foreign born; the aged had not yet awakened their interest. Left to our own resources, we built a pilot retirement residence, unique in its being financed, administered and operated by the retired for the retired, on a life lease and monthly rate basis. We built a pilot project, Grey Gables in Ojai, Calif., now valued at $14 million, the proud and beautiful home of 82 men and women from places as remote as the Bahamas and Hawaii, this without subsidy or foundation aid or any other contribution. It has merited from the city council of Ojai a commendation for the contributions it and its residents have made to the beauty, the social value, and the efficiency of the city and its many civic activities.

This housing venture we realized served only a few-a favored few-but for the greater group, the driving force from the inception of NRTA, was the need of insurance as health protection.

INSURANCE PROTECTION

For 5 years, I visited and I was refused by 42 insurance companies. Protection for the retired could not be initiated except at an exorbitant rate; it was often terminated at retirement, and, if continued, it was subject to a greater premium and smaller benefits.

In 1954, there came the first breakthrough for group insurance coverage, granted the N.Y. State Retired Teachers Association-this without the insurer's right to terminate, with no age requirement, and with present physical conditions accepted. In 1955, NRTA expanded this service into the first national coverage ever offered. It has since aided the National Retired Association of Civil Employees and the Emeritus Census, to a similar benefit. There has followed, as you know, a whole host of commercial imitators, and for the people being served we are grateful. At the time of gaining this service, we offered to the Department of Health, Education, and Welfare, the sponsorship of this program.

SPECIAL SERVICES

Over the years, we have developed other special services for our people. We have opened and are maintaining a year-round reception center in St. Petersburg. We have provided European group travel at a modest nonprofit rate. Six hundred retired folk have in this fashion realized a lifelong ambition for a trip abroad. We are offering a drug service at cost, again a nonprofit venture, with a minimum of 25 percent reduction from the usual rates. We are sponsoring, as a major project, voluntary help as aides in the Veterans' Administration volunteer program; we are organizing a program of thoughtful exploration and devoted service in connection with the White House Conference on Aging and its forthcoming meeting in 1961. Our forum at St. Petersburg in this connection, planning for the participation of 2,500 members, is scheduled for the week of January 18, 1960.

THE FOUNDING OF AARP

These services grew with the growth of the society as the needs arose. Then came another challenge. Thousands of letters kept coming from NRTA members-not satisfied that these services were not available to their relatives and friends of older years. If we served them it must needs be through another association. We realized the inherent danger in such an organization. Fifteen

percent of the Nation's population, if it became radical or selfishminded, might become an articulate pressure group.

Looking for confirmation and reassurance, we contacted the National Council on Aging; we also talked with leaders in gerontology and geriatrics, and here in Washington with the Department of Health, Education, and Welfare. In October 1958, with a prayer and a sense of responsible dedication, we founded the American Association of Retired Persons. It was organized not to redefine the problems of the aging, but to find positive answers to those needs that the Government could not supply. The AARP was organized to share with all older folk achievements gained by NRTA and to press on to greater benefits, to build morale and encourage the disheartened, killing the terror of loneliness and boredom, and banishing the feeling of being unwanted. Its vehicle, Modern Maturity, has already achieved distinction as a quality magazine. AARP has grown, since October 1958, to a membership of 50,000, perhaps because it is designed with them in mind.

The AARP has no desire to build associations. It is eager to displace nothing and no one. It is mindful that the problems of the aging can only be solved by a nationwide effort. Congress, municipal authorities, social agencies, community groups, churches and synagogues, business and professional groups, boards of education, universities, industry, labor, all have a part. AARP hopes to be for them a forum, passing on the good word of their accomplishments and encouraging others to do likewise. For instance, we hope to identify leaders, to build self-help agencies for job placement, to be a showcase of what old folk can do, and do do, and be a sounding board for the inarticulate.

THE STRUCTURE OF AARP

AARP is structured to work with advisory boards, with national groups interested in the cause of aging. AARP is itself autonomous; it divides its services into four major areas-the major needs of the retired as we see them: (1) Health, (2) surveys and research as to jobs and income, (3) housing and, (4) activities financially rewarding and otherwise.

Under the subject of health protection, among the special services AARP offers, is group insurance. Group insurance for the aged is, we realize, in part the reason of the growth in our membership; so greatly was it needed. Its offer in Modern Maturity was the occasion of the breakthrough of a nationwide publicity of similar offers. We like modestly to affirm that our offer is still superior to others in the field. We have further expanded it-in limited fashion-to include for the first time nursing home care, drugs and doctors' visits-in and out of the hospital. However, good as our offerings may be, they are still insufficient and we are very eager to expand them.

We offer as a compromise to the Forand bill with its two provocative features that are the subject of opposed opinions: (1) the compulsory aspect and (2) the contemplated costs. This compromise consists of (1) the formation of a trusteeship similar to our own to handle, without profit, the matter of securing the best possible health coverage at the lowest possible cost, through open competition with the insurance industry and Blue Shield and Blue Cross. The membership of this trusteeship would be chosen from all interested segments of society, other than Government, (2) making available to all older persons-not only social security beneficiaries as in the Forand bill--this prepaid health protection, and for the further purpose of reducing operating expense, making also available, at cost, the processing of premium insurance payment through automatic deduction from the social security warrant of those social security recipients requesting such a service.

The only congressional action needed to implement this plan at once as proposed would be an empowering act to permit social security to perform at cost for the trusteeship a clerical service of processing insurance premiums through automatic deduction in social security warrants. The insurance coverage, as discussed in this plan, is identical with that envisioned in the Forand bill, and under such a trusteeship would cost $6 a month.

From the enthusiasm such provisions have engendered, it might be inferred by the layman that they cover complete health care. Such is not the case. Complete health care for the average older person more nearly approximates $16 to $20 a month. The necessary extra $10 to $14 are not provided for in this suggestion which is made as a compromise proposal to the Forand bill; with the hope that its speedy enactment might grant the health relief for the elderly-no longer overdue.

Among our retired, there are three groups we might medically differentiate: the indigent, those "not able to pay," and the increasingly large segment caught betwixt and between. Financial relief should be found to permit our aged to have care and to limit their medical fears and anxieties. Social security liberalization, increasing 37 percent between the congressional enactment in 1952 and now, should be expanded to make possible this humanitarian service. The most basic need in the field of health we all realize is the shortage of physicians. We are told that it costs, conservatively, $16,000 or $17,000 to educate a doctor, but that is only one-fifth of what it costs to educate one jet military pilot. We realize that both fill a nationwide need.

While still discussing health services, we report that our next driving need in the health correction field is for nursing homes. We are told that the colonies brought from England three institutions; the church, the jail, and the poorhouse, and so deplorable at times are the reports of nursing houses that we feel we have not gone far away from that primitive institution of the poorhouse. Efficient, well-staffed, and pleasant nursing homes are unique needs for the elderly. The hospital, we all agree, should be reserved for the acute and critical illnesses of all ages. It is now overcrowded with the chronically ill, the postoperative, and the homeless, denying to many the services the hospital was designed to give. To relieve this congestion and at the same time-and at much less expense, and to give fitting and gracious service to the elderly, there is a need of thousands of such facilities for the elderly. We believe in this need so thoroughly that on September 1, 1959, we are opening our first project, the Acacias in Ojai, Calif., a pilot nonprofit health center, a 24-bed nursing home that will be patient-centered and not disease-centered. It will differ from a hospital in that there will be recreational and occupational areas; a relaxed and congenial atmosphere with plans flexible enough to meet the ever-changing needs of our clientele. We hope that it will be the first of many. We have spoken of our concern for better health for older people. Now we face another problem-that of money.

INCOME

The question of income has many facets. Our first concern is that of compulsory retirement. We believe it would be difficult to conceive a more vast waste of manpower and/or production. We challenge the thinking of society that decides that older persons, many capable and desiring self-support, should be supported by the productivity of the young. We plead that the aged be granted

more flexible hours of work, a more flexible wage structure that will permit the right of contribution to their own support and that of national production. In addition to the financial side, we must note that the loss of job is often the start of the physical, emotion decline all too often found among retired folk.

The increasing smallness of job opportunities is another problem affecting the aged. Society may however be willing to utilize the increased potential of older people when we note that the wage discrimination law passed in Connecticut is becoming operative in October. Just how much effect these antidiscrimination laws in Massachusetts, Pennsylvania, Rhode Island, and New York have on work retention and hiring practices we do not know, but it is a promising straw in the wind.

Another troubling facet of the problem of earned income is the $1,200 restriction by social security limitations. Particularly, we feel that wage earners between the ages of 65 and 71 should be permitted to earn substantially more before forfeiting their social security benefits. We believe that men and women of that age should be encouraged to work, either full or part time, or put it very simply, we believe that they should not get less, sometimes for doing more, and that is exactly what is happening under social security. We extremely regret too, the temptations yielded to by recipients affected by this limitation, to either become a loafer, a petty criminal, or in the dishonest report of earned income to one's Government.

While social security benefits did keep pace with the increase in price level between 1950 and 1958, they did not match wage gains during this period. We feel it important to keep the amount of social security benefit payments in line with the general economy by periodic review and adjustments, or through some kind of automatic device. Involved in this same problem of economic shortages is the major problem of housing. Our people tell us that rent is possibly the most burdensome item of all their items of expense. We all admit that our society has failed to anticipate the needs of aging in community planning; often they are relegated to the blighted and unwanted areas while the charming trim, new places are constructed for younger folk. In this social revolution of age,

through which we are passing, we must note that earlier marriages and the earlier completion of family responsibilities bring about the need for older people to have increased security and appropriate living arrangements, when possible, outside the family circle. We hope that this trend will not mean age stratification; against such a separation we militantly protest. The ideal site we agree is a balanced population of all age groups, granting to each a variety of housing accommodations; separate houses, apartments for independent living, hotels, residence clubs, institutional living, boarding homes, etc. We note that FHA rules tend to encourage large unit construction. Although economical in price, this fails to take into consideration the urge of many older folk for a bit of ground on which they may plant a garden. We hope for the liberalization of FHA requirements. Separate homes with additional medical facilities will extend for a decade or two the independence of the elderly, through outpatient treatment and medical rehabilitation centers.

Finally, may I say that for the retired the greatest drawback is, of course, inflation. The economic squeeze brought on by continuing inflation makes it most difficult for those with static incomes to negotiate with the continually depreciating dollars they may receive from social security, or may have from savings.

In summary, whatever we of NRTA and AARP have accomplished in the past is nothing in comparison to our dreams of future services. We hope to advance our programs in health centers and in retirement housing, to continue our saving projects in the protection of income maintenance; these are in our agenda. To implement these plans, we have secured the services of outstanding leaders in their respective fields. We frankly acknowledge that we have tried realistically to meet some of the health, social, and economic problems of retirement; we know that we have not solved them, but we know that we are making a beginning from the grass roots. So, we offer you all our resources-both material and spiritual-to help in your program of maintaining the respect and the deserved dignity of our Nation's aging.

Dr. ANDRUS. May I present my two colleagues? Mrs. Ruth Lana, executive secretary, and Mr. Leonard Davis, our business adviser. Senator MCNAMARA. Very glad to have your colleagues with you. You may proceed in your own manner.

Dr. ANDRUS. Thank you.

We are very glad to report for our two associations their activities in the field of aging. They have not been very much interested in redefining the needs because they have been living them firsthand. And they have been trying definitely to find concrete and constructive answers to those problems. They realize as teachers that old age was not just to discard. It was a land yet not discovered. Like the Greeks who called everything barbarian that was not known, they decided because they all their lives taught adjustment that they must themselves adjust to this situation, this manmade tragedy of enforced retirement which had come upon them unawares and without preparation.

They found that there were two needs: one their inner needs and the other the material.

The things they did to serve themselves and to serve their fellows are interesting. First of all, they founded two magazines. They petitioned two philanthropic foundations for help in the founding of a retirement residence for teachers. They were told they did not qualify because they were not young and they were not foreign born. So they were left to their own resources. Without subsidy or p'ea for help they built their own retirement residence, today a beautifu! estate of 8 acres with 82 people proudly happy to be there.

They are building and opening on September 1 their first nonprofit nursing home. They have opened and are maintaining in St. Petersburg, Fla., a hospitality and reception center for the aged who visit