(The table accompanying Senator Williams' remarks follows:)

THE SOCIAL SECURITY OFFSET SCHEDULE

The following table applies to all active members in the retirement system who were in public employment on January 1, 1955.

NOTE. The above table does not consider the problem of those individuals who may earn $4,800 during the final year in which they will achieve the number of quarters needed for social security coverage. Anyone whose earnings reach $4,800 during the final year is automatically credited with 4 quarters for that year under social security.

The CHAIRMAN. Thank you, Senator Williams.

The next witness is Senator Warren G. Magnuson, U.S. Senator from the State of Washington.

Senator, please take a seat.

STATEMENT OF SENATOR WARREN G. MAGNUSON, U.S. SENATOR FROM THE STATE OF WASHINGTON

Senator MAGNUSON. Mr. Chairman and members of the committee, I appreciate the opportunity to appear before you to speak briefly about one of the most important subjects of the day which demands the full attention of our minds and energies in this session of the Congress. This is the problem of adequate and reasonable medical care for the aged and aging population of our country.

We are living in an age of amazing technological progress. The pace is so swift and so varied as to distract and confuse all of us at times. We talk in terms of outer space, of planetary exploration, of moon shoots, of supersonic jet transportation and other subjects that previously existed only in the pages of the uninhibited fiction writers or in the vocabularies of isolated students of esoteric phenomena. While our attention is necessarily attracted to these new horizons, I think, many of us tend to forget that we have a few, simple but difficult problems of mankind right on this planet which require attention and immediate action. One of them involves the health of our aged who, in this surging, changing world, are oft lost sight of or forgotten.

What does it profit us as a Nation if we solve these problems of outer space and in so doing, ignore such basic needs as the health of our aged.

We have a beacon to guide us in our approach to this problem. Let me quote from the Charter of the World Health Organization:

Enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political beliefs, or economic and social condition.

Good health is a "state of complete physical, mental, and social wellbeing and not merely the absence of disease or infirmity."

Medicine, like the other sciences, has not stood still in recent years. Our problem, however, is to harness it, for the benefit of the greatest possible number of our fellow citizens-to employ it for the advancement of the common good of this country. During the past half century, this Nation has witnessed the realization of astonishing advances in the field of medical science. Diseases formerly thought incurable have been conquered. Longevity has markedly increased. With the benefits achieved by these medical advances, however, there has arisen simultaneously a great new challenge-utilizing the additional years of life with purpose ***happily and usefully. Certainly this challenge requires the resolution of a host of problems but I think no problem is more demanding of solution than that involving the health of our aged-providing them with the means of maintaining good health.

Consider just a few of the many facts which demonstrate this need. Our aged population is increasing by 1,000 per day. Today there are approximately 16 million people age 65 and over. By 1980 there will be nearly 25 million. Yet 60 percent of our aged population have money incomes of less than $1,000 annually. Cost of living has continually risen-medical costs have risen twice as fast. Our aged require nearly 211⁄2 times more hospital care than do those under 65. Yet less than half of our aged have medical insurance-and those who have such insurance generally find it inadequate.

Medical science has given us the precious gift of added life but it has been accompanied by a feeling of profound insecurity in many of our aged. A constituent wrote me recently, saying, "We are two old people, living in fear" *** fear of being unable to financially meet their medical needs. There are those of course who would answer by saying that free medical aid is available to the indigent. This may be true. But to assume this questionable status and therefore qualify, one must sacrifice nearly every asset which took a lifetime to accumulate and literally, take a pauper's oath. Good health should be a matter of right, not charitable caprice. If a right exists, the fear is dispelled and a sense of security restored. By providing such security, we enable our aged to live their remaining years with dignity. The blessing of medical science should not be bestowed on the arbitrary basis of ability to pay. Our aged have contributed immeasurably in achieving the standard of living which this Nation enjoys today. In so doing, they have guided us through periods of economic insecurity, a catastrophic depression, World Wars and vast economic and social changes. These events, coupled with such factors as increased living costs, have rendered it impossible for many to adequately provide for their remaining years despite their thrift and frugality.

We know the problem-we see it on every hand. The question then is how to meet and solve it. I am convinced that only through an insurance system, utilizing the existing social security machinery, can this problem best be met. The social security system is well established-it is sound, efficient, successful, and economical. The advantages of improving this existing structure are manifold. For example, the additional number of personnel which would be required, would not be large. The insurance would be noncancelable. A change in employment or retirement would not affect one's rights. The financial strain on hospitals would be decreased since the requirement for indigent care would be less. The coverage would almost be universal— eventually 9 out of 10 persons presently employed would be covered. Some may say "Why not let private insurance companies solve the problem through conventional private insurance channels?" The answer is that private insurance has not demonstrated its ability to adequately provide for the medical needs of the aged at premiums which they can afford. This is not meant as an adverse reflection on the private insurance companies. I think they have accomplished a great deal and they are to be commended for their efforts. But they do not have the means of doing as an effective job as can be accomplished through a federally sponsored program. Private insurance companies need have no fear of being replaced in the health field. A Federal program will simply provide a firm basis upon which they can build and supplement with additional coverage.

I find it regrettable that this plan of health insurance which I, and so many others, envision, is labeled by some as "socialism." This label is misleading and false. I have no sympathy with those who approach a great humanitarian cause as a game in semantics. The plan is strictly one of insurance, under Federal auspices, extended to cover a much larger number of persons, than would be feasible under a privately sponsored program. It would be financed by individual and employer contributions and served by private medical personnel and

facilities. The Government would not interfere in the administration of a hospital and would not attempt in any way to prescribe the manner in which a physician conducts his practice.

To date no satisfactory alternative to a federally sponsored insurance program has been proposed. If there had been, I would have been the first to support it. But we have reached a point where the problem grows more acute each day. We are aware of the need and we cannot in conscience adopt the expediency of head-in-the-sand ignorance.

S. 3503 introduced by the very able and distinguished Senator from Michigan, Mr. McNamara, is a forward-looking and constructive bill. It is an excellent bill and one which I am privileged to cosponsor. I am hopeful that this committee will give serious consideration to the measure and that it will act favorably thereon. I cannot emphasize too strongly my conviction that this legislation is vital and that it should be enacted during this session of Congress. We cannot cure tomorrow the disease which must be cured today. We cannot save tomorrow the life which must be saved today.

The CHAIRMAN. Thank you, Senator Magnuson.

The next witness is John W. Nagle of the National Federation of the Blind.

All right, Mr. Nagle, we are glad to have you, sir, and you proceed.

STATEMENT OF JOHN W. NAGLE, NATIONAL FEDERATION OF THE BLIND

Mr. NAGLE. Thank you, Mr. Chairman.

Mr. Chairman and members of the committee, my name is John F. Nagle. I am the representative of the National Federation of the Blind in Washington. According to figures contained in the MayJune Social Security Bulletin, a publication of the Department of Health, Education, and Welfare, there were 108,644 blind aid recipients in the United States in February of this year.

How many of these men and women, though blind, though able and willing to work, will be on public assistance the rest of their lives?

How many of them, physically able to work, filled with the overwhelming desire to work, must continue on the public aid rolls because they must eat, must feed their families, because they lack the opportunity to work, are denied the incentive and the encouragement to work?

We of the National Federation of the Blind believe that at least one quarter of these people and perhaps more could and should be working; could be and should be earning their living, supporting themselves and their families contributing by their tax paid dollars to assist in meeting the needs of those less fortunate than themselvesthose physically unable to work.

Mr. Chairman, the bill S. 3449-introduced into the Senate by Hon. Vance Hartke, of Indiana, a member of this committee, and cosponsored by Hon. Paul Douglas, of Illinois, also a member of this committee, and 15 other distinguished members of the Senate this bill, S. 3449, would amend title X of the Social Security Act so as to make of this title, the blind aid section of the social security law, a

means by which those dependent upon public aid may work their way off public aid and into employment and economic self-sufficiency.

Although I urge that all provisions of this bill be adopted by your committee as amendments to the social security law, I particularly urge that you adopt the first portion of S. 3449 which would exempt $1,000 plus 50 percent of the yearly net earned income of a blind aid recipient from meeting his living expenses.

Why do this?

Why shouldn't every cent a blind aid recipient earns be used by him to live on, and if he doesn't have enough, then the difference be met by a public assistance grant?

Why treat needy blind persons different from other aid categories? The answer is a simple one: Because blindness can strike at any time in a person's life, when he is old and infirmed or when he is young and vigorous and prepared to meet head on the challenges of life, because many blind persons have an employment potential, and if given the opportunity and the encouragement will transform this work potential into wages and salaries.

This very committee recognized the significance of this difference when it includes the exempt earnings concept in its amendments to title X of the Social Security Act in 1950.

Senator George, then chairman of this committee, recognized this difference by his stanch support of the exempt earnings principle in 1950 and because of this support, because of the enlightened leadership given by this man it became a part of the social security amendments enacted into law in that year, and this, in spite of the refusal of the House originally to accept this principle, in spite of the active and vigorous opposition of the administration to the inclusion of the exempt earnings principle into the law.

I would like to read briefly from the report of this committee made in 1950 with reference to H.R. 6000:

Under title X of the Social Security Act the States are required, in determining the need for assistance, to take into account the income and resources of claimants of aid to the blind. Your committee believes this requirement stifles incentive and discourages the needy blind from becoming self-supporting and that therefore it should be replaced by a requirement that would assist blind individuals in becoming self-supporting and that therefore it should be replaced by a requirement that would assist blind individuals in becoming useful and productive members of their communities. Accordingly the committeeapproved bill would require all States administering federally approved aid to the blind programs to disregard earned income up to $50 per month of claimants of aid to the blind.

Aid to the needy blind, in the judgment of your committee, is not in the same category with assistance programs for other needy individuals. Opportunities for gainful employment for blind individuals are limited and their necessary expenditures are increased by the need for special books, for special medical treatment in some cases, and for guide service and readers. As with concessions and special provisions for the blind in other laws, the exemption of earnings up to $50 is not regarded by your committee as a precedent for similar treatment for individuals who are not blind.

For 10 years, the earned income concept has been in operation in the Federal-State aid to the blind programs-but as the years have passed, as costs of living have soared higher and ever higher, the $50 monthly limit on exempt earned income has decreased in value as a means by which a man may cross over from dependence to independence.