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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.
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 plea for help they built their own retirement residence, today a beautiful 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.
there. They have done a host of things. But I would like just to stress two of their current activities, one with the Veterans Administration, where they are giving of themselves to their fellows of like age. They realize the finest therapy in the world is stooping down and lifting someone else.
Then their other activity in which they are absorbed is the preparation for the White House Conference. They felt proud that one of their number was asked to present the views of the association in that conference.
They are trying to find realistic answers to the Nation's needs to find what are the things that America can do for her aged. Their report will not be sentimental; it will not be somber, pitiful, or gloomy. It will be a realistic story. In that connection it might be of interest to know that in St. Petersburg the week of January 18 we are holding a series of meetings for aged people on the needs of the aged, with 2,500 participants. We feel the aged best could answer, both as to their psychological and their material needs.
We feel that the problem of material needs only you, America, could solve. But there are some things that we ourselves could do to help.
Inflation, of course, is our cruelest absorption and terror; about that we can do practically nothing. But we can ask of you your help in some of the things that we need in the question of money, because after all our need is money-money in its two aspects, money in actual tangible cash and currency, and money that we can save by buying prudently and getting a better value for our money.
First of all, we want for those who wish it the right to earn; to maintain that right. We feel that age discrimination is a cruel tragedy that robs older people of the right to earn, the right to give themselves the kind of living they should have, and at the same time hurts the national economy.
We urge for opportunities for reemployment, and we earnestly protest the limitations that have been placed on social security beneficiaries. We feel very definitely that a man or woman between the ages of 65 and 71 ought to have the opportunity without limitation to earn. We feel definitely, too, that it is a tragedy for men and women under such enforcement to yield to the temptation to become petty criminals in making false reports to their Government on income tax or on the other hand becoming disgruntled wasters and loafers. We are interested, too, in asking for increased or equitable exemption from income tax report, and we petition for an increase in social security benefits that would allow our people with modest incomes to have the power to buy for themselves health protection.
In that connection, Senator McNamara, I would like to refer to the testimony I made last week or a week ago before the Ways and Means Committee in connection with the Forand bill. We believe, all of us, that there should be provided health protection for our people. The only thing that keeps our people from realizing that dream is the method of getting that health protection and there we have opposing factions-irreconcilable opposing factions. Our solution is a compro
Our answer is the formation of trusteeships such as our own, with all segments of society represented; this trusteeship to ask the insurance industry, the Blue Cross and Blue Shield to compete against each other in the open market to provide the finest insurance cover
age that can be had for the older people at the lowest possible rate; and then to make such protection available to all older people, not just the recipients of social security benefits as in the Forand bill but to all men of 65 and over, women of 62 and over, so they may profit by it, if they so desire. Then as a matter of economic operation on one hand and for the convenience of the members and the continuity of the service on the other hand, to ask congressional action to permit the Social Security Administration to process, for the trusteeship, without Government expense, the automatic deduction of this premium from the social security warrant for those requesting it.
The only thing necessary to implement this plan would be for the administration of social security to be empowered, on the voluntary request of the beneficiaries, to withdraw from the monthly payments the premium amount.
We want you to know that we are interested in doing things for ourselves that we can do. So in our study of this health problem, when we came upon the surprising fact that our people tell us that they are spending $10 a month on drugs alone, we felt that this was a challenge to us. In consequence we are offering to the 150,000 members of our association the right to buy drugs at a 25-percent discount. We realize this service is not going to save much money, but it is going to stretch that $10 and give it an equivalent of $2.25 purchasing power for something else. We want you to know, too, that in our nursing home, in our various activities, in our group travel for our people, and in our low-cost rental service and, as we hope to go into food, that we are trying to give our people something in value more than the current purchasing power of their dollar.
We would like to have you know, too, that we have given our people under this same idea a budget-price group type of insurance, the first national insurance ever offered retired people.
Senator MCNAMARA. Is this health insurance?
Dr. ANDRUS. What?
Senator MCNAMARA. Health insurance?
Dr. ANDRUS. Health insurance. In 1954 we broke the barrier. We had tried for 5 years and had interviewed 42 insurance companies which had said to us that we were too old, the price would be exorbitant, and so on. We knew we were old and that was bad and because we were old we knew the answer was not final. So finally in 1954 we broke that barrier, and in 1955 we made our offering national. Just this August we are opening in California, as another experiment, a group health insurance that gives us protection not only as we have in the other, noncancelable by the insurer, giving permission for spouses, taking care of the present situation physically, but also care in nursing homes and doctors' visits in and out of hospitals, and drugs on a coinsurance plan.
Those are the things that we are doing for ourselves in solving our problems. Our association, Senator McNamara, is strong in stature. It has grown in numbers, but it is growing because it has been an association of forward-looking self-service. We here offer you our real appreciation for your concern in this cause. We are very proud to give you in any way our support, all of our resources, and we thank you for this courtesy of appearing before you.