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Too many of us-unable to obtain employment, although we wanted to work; although we were qualified and able to work, and asked only for the chance to demonstrate our ability to fill a particular job-too many of us have been obliged to apply for public or private help in our desperate need.

Too many of us know of the endless questionings and have experienced the exhaustive inquiries, the suspicious searchings for hidden assets and nonexistent resources when we applied for public or private help in our desperate need.

Too many of us blind people have had our families burdened with the cost of our care which the law imposed upon them—and we know too well of the resentments and antagonisms which are engendered when our needs are a drain upon family resources and earnings, when payment of our bills amounts to the denial of the hopes and plans of others.

We of the National Federation of the Blind endorse the social insurance method, contained in S. 880, for paying the price exacted for restored health and repaired bodies.

We much prefer the "advanced payments with established rights" method, to the public or private charity or responsible relatives method. We support S. 880, because it would provide benefits specified and described in Federal law and regulation, rather than have such benefits dependent upon a social caseworker's uncertain whim or biased judgment.

We support S. 880, because as Federal law it would provide benefits by right to those who establish eligibility for them, in accordance with standards specified and described in Federal law and regulation, rather than have receipt of such benefits dependent upon a "means" test standard of proven poverty or demonstrated destitution.

But, Mr. Chairman, just as the men and women who are elderly and retired on social security must live and manage on very limited income have a need that their health care costs be met by the social insurance method, so too is it necessary that the health care costs of those who must live and manage on limited income because they are disabled and beneficiaries of the Federal disability insurance program be met by the same concept of social insurance enacted into law.

The limited income problem of the disability of insurance beneficiary is the same as that of the retired elderly person-for the amount of his payment is the same as the amount of the old-age benefit for which he would be eligible if he were to retire.

We would also remind you, gentlemen, that disabled persons must have medically determinable disabling conditions to qualify for disability insurance benefits, and oftentimes these conditions are chronic, requiring constant hospital and medical assistance, while elderly persons, although advanced in years, may still be robust and well during their years of retirement.

We of the National Federation of the Blind are peculiarly aware of the need for including disabled persons within the scope of S. 880. As a result of the removal of the 50-year age eligibility requirement in the disability insurance program by the 1960 amendments to the Social Security Act, a number of persons whose disability is blindness, and previously recipients of aid to the blind, were able to qualify for disability insurance cash payments.

This change from a relief program to a "rights" program was cause for much satisfaction to these people but they soon learned that there was no provision for their health care needs under the social security system.

These people soon learned that, if their disability payments exceeded their need, determined by public assistance standards, that they would even lose their entitlement to medical care protection under public welfare, and would gain no comparable protection as disability insurance beneficiaries.

Under such circumstances, the only recourse available to these people when they are ill or injured is general relief or private charity.

So, Mr. Chairman, the disabled person, rescued from the "means" test of public assistance by action of the 86th Congress, at last able to claim benefits rightfully his because he has paid for them during his working years, still must turn to the local welfare doctor when he needs medical help, still must go to the charity ward when he needs hosiptal care.

Gentlemen, the rescue was not a rescue after all.

Therefore, Mr. Chairman, members of the committee, not only do we urge you to approve S. 880 for the benefit and protection of elderly persons retired under social security, but we ask you to expand the scope of S. 880 to include disability insurance beneficiaries within its provisions.

Thank you, Mr. Chairman, for this opportunity to appear.

Senator TALMADGE. Thank you, Mr. Nagle, for a very fine statement. (The following statement submitted by Mr. George E. Keane in behalf of the Industrial Home for the Blind was inserted in the record by order of the chairman.)

Hon. HARRY BYRD,

THE INDUSTRIAL HOME FOR THE BLIND,
Brooklyn, N.Y., August 5, 1964.

Chairman, Finance Committee, U.S. Senate,
Senate Office Building, Washington, D.C.

DEAR SENATOR BYRD: I know that you will have before you H.R. 11865 for consideration this week, amendment to the Social Security Act. I am taking this opportunity to put into the record of your hearing, if you will permit us to, the point of view of the legislative committee of the American Association of Workers for the Blind. It has been considered with interest and very real satisfaction at the convention of the American Association of Workers for the Blind, held in New York this past week and I have been directed by the convention to urge the Finance Committee to take favorable action on this matter. We think that it does much to improve and increase the benefits of our people throughout the country, but we were disappointed that some proposals which our association made were not considered in the House. However, you have before you a measure by Mr. Humphrey, S. 1268, which we hope your committee may consider in planning amendments to the House bill. Mr. Humphrey's proposals do two or three very important things for those who become eligible under the disability insurance of the act because of loss of sight. First, it reduces the quarter number to six, we think that this is important and in fact from an insurance point of view we have thought many times that there should be no requirements for periods of coverage when blindness occurs after the individual has been employed. It is logical regardless of the number of periods of coverage, that a permanent and total disability might occur anytime and should be insured against from a praetical point of view. However, we understand that some period of employment must be indicated, but six quarters or a year and a half seems like quite a long time.

Mr. Humphrey's bill also provides for a change in the definition of blindness as it is now contained in the act so that it would coincide with the definition of blindness for assistance and for special additional exemptions for income tax.

This definition, 20/200, visual acuity in the better eye is one which is used throughout the States and it seems unfortunate to require a narrower definition simply because financial benefits are involved. In any case, may we urge your committee to consider Mr. Humphrey's approval.

GEORGE E. KEANE, Chairman, Legislative Committee, AAWB.

(The following statement was made a part of the record at the direction of the chairman:)

STATEMENT OF PAUL KIRTON, AMERICAN COUNCIL OF THE BLIND, FAIRFAX, Va.

The American Council of the Blind is a young but rapidly growing organization, composed primarily of blind persons, with membership now numbering several thousand. We are incorporated under the laws of the District of Columbia and have as a primary purpose the improvement of culture, social and economic opportunities for all handicapped persons, the improvement of the public image of blindness, and the education of the blind in their obligations to the public. Our officers and directors serve on a volunteer basis and are elected from the membership as a whole. Most of the members are independent, selfsupporting citizens who wish to donate a portion of their time and effort to make it easier for blind and other handicapped persons to achieve this same position of self-support and independence.

My name is Paul Kirton, I am an attorney in the Office of the Solicitor in the Department of the Interior, and a member of the board of directors of the American Council of the Blind. Our organization appreciates the opportunity to appear before you and express its approval of the basic ideas incorporated in the two pieces of legislation which you are now considering: H.R. 11865 and H.R. 9393. We are particularly appreciative of the provisions in H.R. 9393 which will again permit the retroactive determination of disability. We have no criticism of this bill to make at this time.

We also wish to express our support of the general principles incorporated in H.R. 11865. The recipients of social security definitely need an increase in benefits. The 5-percent increase provided in H.R. 11865 seems quite inadequate and it is not even keeping pace with the increased cost of living since the last increase in benefit payments.

The new provisions to permit the continuation of a child's benefits while in school are badly needed. All those persons who are concerned about the welfare of our Nation and the future of our youth are enthusiastically supporting this principle. However, the very piece of legislation which purports to make it easier for these children to go to college also adds the new subsection (s) to section 203 of the Social Security Act. For example the mothers' payment should definitely be continued while the child is in college. The woman who is able to go to work and who can find work will automatically do so because she can obtain a substantially higher standard of living by doing so. However, many women in the age group to have college-age children have neither the experience nor the skills to find work, nor are they in the age group to start a new employment career. By cutting off the payment of mothers' benefits there is a strong economic compulsion on the child to go to work in order to support the mother instead of going to college.

There is far more cause to believe that children 18 to 22 and in college will seriously consider marriage than those children under 18. It may be good public policy to discourage and even penalize marriage prior to the age of 18, but we feel that the policy of discouraging early marriage is less important than the encouragement of education. Therefore, if any change in attitude were to be made it should be in favor of continuing the social security payments regardless of marital status to the child in college.

The other provisions in H.R. 11865 are desirable and needed changes. We solicit your assistance in submitting these proposals to the Senate at an early date. We also wish to express our appreciation for this opportunity to state our views.

Senator TALMADGE. The next witness is Mr. Nelson A. Cruikshank, AFL-CIO, accompanied by Mr. Andrew J. Biemiller.

STATEMENT OF NELSON H. CRUIKSHANK, DIRECTOR, DEPARTMENT OF SOCIAL SECURITY OF AFL-CIO; ACCOMPANIED BY ANDREW J. BIEMILLER, DIRECTOR, AFL-CIO DEPARTMENT OF LEGISLATION; AND LISBETH BAMBERGER, ASSISTANT DIRECTOR OF THE AFL-CIO DEPARTMENT OF SOCIAL SECURITY

Mr. CRUIKSHANK. Thank you, Mr. Chairman.

Senator TALMADGE. We are happy to have you before our committee and you may proceed at will.

Mr. CRUIKSHANK. Thank you, Mr. Chairman.

Mr. Chairman, my name is Nelson H. Cruikshank and I am director of the Department of Social Security of the AFL-CIO, and together with Mr. Andrew J. Biemiller, director of the AFL-CIO Department of Legislation, I am appearing on behalf of the AFLCIO. With us also is Miss Lisbeth Bamberger, assistant director of the AFL-CIO Department of Social Security.

Let me assure you at the outset that my presentation will be briefand not only because of the commonsense time limitations established by the committee.

I will be brief because the distinguished members of this committee are informed in the field of social security. Some of you agree with us, and others do not. But there is no question that all of the members of the committee will know what I am talking about. Therefore, I will not waste your time by belaboring the fundamentals.

The position of the AFL-CIO on the legislation before you is simple and clear. Only 5 days ago, the AFL-CIO Executive Council, meeting in Chicago, took up this matter and adopted the following policy resolution:

The AFL-CIO has supported every increase in social security benefits and coverage since the original enactment of the program nearly 30 years ago. Therefore, we welcome the modest increase in benefits provided in H.R. 11865, the social security amendments passed by the House on July 29. For people depending mainly on social security benefits averaging less than $80 per month, even $3 and $4 monthly increases are important. For those elderly for whom this bill will provide increases of only $2 a month or less, even this small amount will be welcome, although it is obviously not enough.

So we will continue our fight to improve the social security benefit structure. And let the record show that we have likewise supported the increased taxes on wages and other income necessary to keep the system financially sound. This will continue to be our policy.

This year's House-passed bill, however, must be evaluated not only for the needs it meets but for the needs it fails to meet.

The ever-present danger of a hospitalized illness remains the most serious threat to the economic security of the elderly. And the only practical way to provide protection again this threat is by an extension of the social security principle.

The public assistance or Government relief method-has been tried. After nearly 4 years, the Kerr-Mills Act is meeting but a fraction of the need and it is still not in operation in all States.

Private insurance, as the recent McNamara committee hearings so clearly documented, is providing protection of a minimum adequacy for only about a quarter of the elderly.

Neither the incantations of the AMA nor the inflated statistical claims of the insurance industry have solved the problem of health care for the elderly The AFL-CIO will continue its efforts to meet the problem through the social security method. We are in this struggle to win.

That ends the quotation of the executive council's statement. We are pleased that H.R. 11865 provides for the inclusion of tips as a part of basic wages, for social security purposes.

Of course, all sorts of philosophical arguments can be made about the whole subject of tipping, but there is no indication that the custom is fading away. Therefore, it is essential to deal with the realities.

Tipped workers are obliged to pay income tax on tips. In recent years, especially, the Internal Revenue Service has exerted considerable effort to make sure of it. It is obviously a matter of simple justice that money taxed as income should also be part of a worker's wage base in calculating his benefits under the social security system. Anything less would be and has been-an unjustifiable double standard.

In essence, then, we endorse the benefit provisions of H.R. 11865.

Now we come to the basic issue that is not encompassed by the bill before you and which we think belongs in the bill. We have no bombshells to explode here. We have been over the ground many times before.

We are here to say to you-as a matter of conscience, as a matter of deep conviction, on behalf of many millions of Americans who cannot come before you-we are here to say that hospital insurance for the aged must be incorporated into the social security system.

We make this plea in the firm belief that no member of this outstanding body has a closed mind and so we reject the cynical suggestion that we can gain nothing by bringing this issue before you. You have given us the opportunity to appear here, and we have no doubt that our case-even though it may be familiar-will be carefully weighed.

Let me start with a brief restatement of our basic position:

We say that many millions of elderly citizens, living on earned retirement, are each year reduced to penury by catastrophic medical

costs.

We assert that private insurance programs, even when they have the best of intentions, cannot prevent this disaster.

We insist that charity-public or private-is an unacceptable remedy for independent, self-respecting Americans.

All this would sound hopelessly unrealistic, as it might have sounded 20 years ago, except for the dedicated, hardheaded work of men and women who refused to recognize the impossible.

There is now before you a sound, practical plan for national hospital insurance to protect the aged. The essence of the plan is an extension of the social security system which already provides for old-age benefits, disability benefits, widows' and orphans' payments, and so on.

That system, surely one of the great achievements of American society in this century, can and should-in our view-be extended to cover this great need for hospital insurance to protect the aged.

With respect to the details of this plan, we are flexible; we, too, have open minds. Some of the criticisms that were made of the proposal we first supported had real merit, and we welcomed them.

We are not committed to a formula, but we are deeply committed to a result. And that result, simply stated, is a hospital insurance program for the aged as part of the social security system.

36-453-64- 13

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