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MADISON, WIS., June 29, 1960.

Senator HARRY F. BYRD,

Chairman, Senate Finance Committee,
Washington, D.C.:

To save time of committee I am sending this telegram instead of appearing personally. As you know I was Chairman of Technical Board which prepared original Social Security recommendations and I also directed administration of all phases of Social Security Act from 1935 to 1953. Based on that experience

I am sure that contributory social insurance method is far superior to FederalState noncontributory means test method for proving health benefits to aged workers, widows, and orphans. Official studies by this administration and previous administrations demonstrate need and administrative feasibility. fore I urge action at this session.


ARTHUR J. ALTMEYER, Former Commissioner for Social Security.


Mr. Chairman, I want to record my support for S. 3503 as a substitute for section XVI of H.R. 12580.

I think it has been demonstrated overwhelmingly that this Nation needs a truly effective program of health assistance for our elder citizens. The question before the Congress, as I see it, is how to provide an effective program. Section XVI in the House bill, in my opinion, falls far short of meeting the problem. I do not intend to dwell in detail on the obvious inadequacies of section XVI. But I do want to point out that even under the most ideal conditions, where many or all of the States could find the means of participating in the program, it would mean an additional burden on general revenues.

I agree wholeheartedly with the supplemental views of the eight members of the House Ways and Means Committee who stated on page 326 of House Report 1799 that:

"We are shocked that after 23 years of successful operation of the social security system there are those who would have us rely still on relief and assistance as the sole governmental approach to meeting a major economic hazard of universal occurrence."

There are those who will persist in claiming that it is "socialistic" and somehow un-American to finance a health program for the aged through the social security tax structure. Mr. Walter Lippmann, who is by no means considered a wild-eyed Socialist, has very ably analyzed the situation in a column published in the Washington Post of June 16. In that column Mr. Lippmann states:

"Among the opponents of medical insurance there seems to be a vague and uncomfortable feeling that it is a new-fangled theory, alien to the American way of life and imported, presumably, from Soviet Russia.

"The Founding Fathers were not subject to such theoretical hobgoblins. In 1798 Congress set up the first medical insurance scheme under the U.S. marine hospital service. The scheme was financed by deducting from seamen's wages contributions to pay for their hospital expenses.

"If that was 'socialized medicine,' the generation of the Founding Fathers was blandly unaware of it."

The magazine Business Week, which is certainly not considered a Socialist organ, has concluded that medical care for the aged can be handled best through the social security system:

"The only way to handle their health problem, therefore, is to spread the risks and costs widely. And that can best be done through the social security system to which employers and employees contribute regularly."

Under S. 3503, health assistance would be financed largely through social security tax increases. The program would cost an estimated $1.5 billion a year, of which $1.14 billion would come from a one-quarter of 1 percent increase in the social security tax on employee and employer. This increase would provide benefits for 11.3 million beneficiaries of old-age and survivors' insurance. Benefits to an additional 1.7 million old-age assistance recipients would cost $180 million a year, to come from general revenues. Benefits to 1.8 million other persons (re

tired men over 65 and retired women over 62) would cost $190 million, also from general revenues. But the Federal Government is already spending an estimated $238 million a year for old-age assistance and other programs which provide medical care for the aged so the net increase in expenditures from general revenues would be about $132 million, or less than a dollar per capita for the Nation.

I therefore urge adoption of S. 3503 as the soundest and most effective approach to the problem of medical care for the aged.

Senator HARRY F. BYRD,

Senate Office Building, Washington, D.C.

ANDERSON, IND., June 28, 1960.

DEAR SENATOR BYRD: I want you to know of my opposition to H.R. 12580. As of 1956 only 17 percent of doctors 75 years of age or over were retired. Many of these men are unable financially to retire completely, and others prefer to remain active. Most of those men who remain active see but very few patients, but their income will be greater than $1,200 a year. Therefore, they would not be eligible for social security benefits.

To me, including doctors in the social security program is a thinly disguised effort to promote additional tax revenues with no intention on the part of Government to ever return any of it to these men who will be paying tax ostensibly for retirement benefits. This is a shameful subterfuge, and Congress should be above stooping to such measures.

I realize that more and more revenue will be necessary to maintain the social security program, because it is an actuarially unsound arrangement. But, if Congress is intent on maintaining it, they should have the fortitude to increase the tax on people who are going to benefit from it. This will not be popular, I know, but it is the only honest thing to do.

I hope you will be one Senator who believes in honesty, and will shun the Marxian philosophy "From each according to his ability, and to each according to his need." We already have too much Russian ideology pervading the of certain Government officials.

You know my opinion, I would appreciate knowing yours.

Yours truly,

H. H. DUIN, M.D.


Chairman, Senate Finance Committee,
New Senate Building, Washington, D.C.:

SAN FRANCISCO, CALIF., June 30, 1960.

Request the following statement be read to the Senate Committee on Finance, and inserted into the record of current hearings on social security bill: The California Labor Federation, representing more than 1,300,000 AFL-CIO members in this State, urges the adoption of a social security measure which contains health care provisions for the aged within the social security system. Our membership is categorically opposed to medical care benefits based on any kind of a means test. It must be recognized that senior citizens of this State and Nation, as a group, have recognized health and medical care needs which are substantially greater than those of younger age groups, and which, in terms of cost, far exceed the financial means of our aged population.

Despite labor's efforts to the contrary, under the widespread development of voluntary prepaid medical care programs in the past decade, the aged have been generally and effectively isolated from the rest of the community to be "experience-rated" by themselves under programs designed less to take care of their extensive needs than to extract the last profit dollar out of their human misery. Thus, the aged, in such isolated high-cost groups, cannot possibly insure themselves adequately as now being proposed by private insurance carriers, the medical associations and other vendors of medical care programs in their advocacy of low-benefit, high-cost plans that would "experience-rate" them apart from the community.

The provision of adequate health care for the aged on a prepaid basis therefore requires the adoption of a social insurance principle of financing such prepaid care as proposed in Forand-type legislation vigorously supported by all AFL-CIO members, based on the concept of providing benefits as a matter of right with dignity and respect for the individual.

The Eisenhower administration's State-Federal program, based on the concept of public assistance and handouts rather than social security with dignity, satisfies virtually no one. It is dependent on State action for implementation and would require the average aged individual with a meager income of less than $1,000 a year to pay out of pocket $250 for medical care, or more than 25 percent of his income, before he could realize benefits equal to 80 percent of his remaining medical care costs in return for a $24 annual contribution. The House-approved social security bill contains medical care provision which compound the evils of the Eisenhower Federal-State program of public assistance with a "pauper's oath" approach in a new program designed to assist States in providing limited medical benefits for the aged who may be determined by the States, as they may choose, to fall into a new category of medical indigents. This is a sham and a disgrace. We urge the Senate Finance Committee to take prompt action to approve a sound health care measure for the aged, based on the social insurance concept which would adequately reward our senior citizens with dignity and legal rights for their years of productive efforts and contribution to the welfare of the Nation. We recognize that time is short in this session of Congress but certainly there is time for men of conviction and courage to act on this matter by passing a health care measure within the social security system that gives recognition to the basic needs of the aged. THOS. L. PITTS, Secretary-Treasurer, California Labor Federation AFL-CIO.


AUSTIN, TEX., June 30, 1960.

Chairman, Committee on Finance, care Mrs. Elizabeth B. Springer, Chief Clerk, Senate Finance Committee, Room 2227, New Senate Office Building, Washington, D.C.:

MY DEAR SENATOR BYRD: The Texas Medical Association wishes to present for the records of the Committee on Finance of the U.S. Senate, the following statement on H.R. 12580.

We urge that physicians not be included under social security coverage. Our membership responded 10 to 1 against inclusion when polled. This past April, our 202 member house of delegates representing 8,200 physicians passed a resolution, without opposition or a dissenting vote, against such coverage for physicians.

Texas physicians neither expect nor want the Federal Government to provide retirement or survivorship benefits for themselves and family. It would seem strange indeed to force the payment of Federal funds upon persons who neither wish nor seek them.

May I thank you for the opportunity to have the views of the Texas Medical Association, Inc., into the records of the Committee on Finance.

Respectfully submitted,

President, Texas Medical Association,

Austin, Tex.

BROOKLYN, N.Y., June 29, 1960.

Senator HARRY F. BYRD,

Chairman, Senate Finance Committee,
New Senate Office Building, Washington, D.C.:

The Seafarers International Union of North America, representing over 70,000 American merchant seamen and maritime workers, strongly urges your full support of medical care benefits for aged within structure Federal social security system. We oppose means in test requirements in this legislation which would label necessary medical care as Federal handout at expense of all taxpayers. Aged workers who have contributed so much to progress of this Nation are entitled to this protection as a matter of earned right in keeping with objectives of social security system. Attempts to limit benefits to a means requirement flaunt urgent needs of all the aged for decent medical care.


President, Seafarers International Union of North America, AFL-CIO.

PITTSBURGH, PA., June 29, 1960.

Senator HARRY F. BYRD,

Chairman, Senate Finance Committee,
Senate Office Building, Washington, D.C.:

Inasmuch as appearance before your committee in the closing days is impractical and might tend to delay completion of the committee's work, I would prefer to be recorded as favoring adding health benefits to the OASI system and have this telegram included in the committee record.



Senator HARRY F. BYRD,

Chairman, Senate Finance Committee,
Senate Office Building, Washington, D.C.:

Urge strong support for legislation creating medical care benefits for the aged within Federal social security structure. Any means test would destroy objectives of providing decent medical care to meet pressing needs of all the aged. Experience with 50 different unemployment compensation laws and other State programs emphasizes urgent need for uniform Federal program. Medical care for aged should not be treated as charity at the expense of all taxpayers. As director of Social Security Department of Seafarers welfare plan serving 20,000 seamen and maritime workers urge your support to defeat any means test requirement and other burdensome limitations of this legislation.


Director Social Security Department, Seafarers Welfare Plan.

CHICAGO, ILL., June 29, 1960.

Senator HARRY F. BYRD,

Chairman, Committee on Finance,
U.S. Senate, Washington, D.C.:

Urge your committee to support legislation to provide health benefits to aged through contributory social security system. Would be willing to testify in behalf of such legislation, but prefer having this telegram on record of your committee.

WILLIAM S. HOFFMAN, Ph. D., M.D., Medical Director Sidney Hillman Health Center of Chicago.

Senator HARRY F. BYRD,

NEW KENSINGTON, PA., June 29, 1960.

Chairman, Senate Finance Committee,

Senate Office Building, Washington, D.C.:

One of many physicans who disagree with AMA opposition to health legislation. I and many other physicians strongly urge passage of bill providing health benefits for the aged, financed by OASDI system.


BELLAIRE, OHIO, June 29, 1960.


Senate Office Building, Washington, D.C.:

The social security mechanism is reasonably economical. Don't discard a good system just because the AMA opposes. cians, particularly on social matters.

AMA does not represent all physi




I am

Mr. Chairman and members of the committee, I am Dr. Charles L. Ballinger, of Coral Gables, Fla., representing the American Osteopathic Association. also a fellow and secretary of the American College of Osteopathic Surgeons, an affiliate organization.

We very much appreciate the privilege of submitting comment on the pending social security amendments bill, H.R. 12580, section 601, which would establish a new title XVI of the Social Security Act to initiate a new FederalState grants-in-aid program to help the States assist low-income aged individuals who need assistance in meeting their medical expenses.

We are gratified that in connection with the proposed new title XVI of the Social Security Act, the House-passed bill H.R. 12580 emphasizes osteopathic participation in the medical services for the aged program by express reference to section 1101(a)(7) of the Social Security Act on page 165 of the bill.

It was the Senate Committee on Finance that authored osteopathic inclusion in the Social Security Act definition of "physician" and "medical care" and "hospitalization" (sec. 1101 (a) (7)) in 1950.

Several years ago the American Osteopathic Academy of Geriatrics was set up to make special studies, and to organize study groups to interest the members of the osteopathic profession in the subject of geriatrics and to keep them abreast of developments. A number of State laws require refresher courses for osteopathic licensees, and these sessions afford additional opportunity for considerations of current developments. In addition, the profession actively participates in conferences on aging at the National and State and local levels. The American Osteopathic Association is represented on the 150-member National Advisory Committee for the White House Conference on Aging, January 9 to 12, 1961.

Some 14,000 physicians of the osteopathic school of medicine are in legalized practice in all the States.

More than 400 nongovernment hospitals are staffed by physicians and surgeons (D.O.), 93 of which have been approved by the association for the training of interns and 56 of which are approved by the association for the training of residents. There are 54 government (district, county, or city) hospitals staffed in part or entirely by physicians and surgeons (D.O.). After completion of their internship, osteopathic graduates obtain residency training in one or more of the 12 fields recognized by approved specialty examining boards:

American Osteopathic Board of Anesthesiology.
American Osteopathic Board of Dermatology.

American Osteopathic Board of Internal Medicine.

American Osteopathic Board of Neurology and Psychiatry.
American Osteopathic Board of Obstetrics and Gynecology.

American Osteopathic Board of Ophthalmology.

American Osteopathic Board of Pathology.

American Osteopathic Board of Pediatrics.

American Osteopathic Board of Physical Medicine and Rehabilitation.
American Osteopathic Board of Proctology.
American Osteopathic Board of Radiology.

American Osteopathie Board of Surgery.

An applicant for certification by the American Osteopathic Board of Surgery or for membership in the American College of Osteopathic Surgeons must be a graduate of an approved college of osteopathy and surgery, which requires a minimum of 3 years' preprofessional college work for entrance and 4 years of professional college work for graduation, must have at least 1 year of internship, and a minimum of 3 years of formal training subsequent to internship, must have assisted in not less than 400 major surgical operations, and I call your attention to the fact that is the minimum and most men in their training period do assist in many times that minimum number, and must have performed a minimum of 200 major surgical operations upon his own responsibility subsequent to the completion of the minimum required period of formal training. All the specialties require 3 years special training beyond internship.

These physicians and surgeons and these hospitals are utilized by the Bureau of Employees Compensation for care of Federal civil employees for injuries and illnesses incurred in the course of their employment. They are used in the medicare program of the Defense Department for the care of dependents of members of the armed services. They are available to Federal civil employees under the Federal employees health benefits program, under voluntary health insurance plans.

In connection with any social security medical care program for the aged which is or may be inaugurated, Federal incentives should be provided for encouragement of prepaid health insurance plans on a voluntary basis.

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