The CHAIRMAN. Our next witness is Mr. Whitney Young, executive director of the National Urban League. Welcome Mr. Young.

Mr. YOUNG. I know we are pushed for time. My formal statement is available to you.

I do want to express my very strong support for what I regard as one of the most significant pieces of legislation before the Senate in many, many decades. I am wearing three hats. I am here on behalf of the Health Security Action Council and as the executive director of the National Urban League, and the president of the National Association of Social Workers.

Wearing all of these hats, I bring you my constituents' concerns. It is an unfortunate situation when a society like ours lacks the capability to provide for the health care of its citizens. But it is criminal when it has the capability to provide good services, as we clearly do, and fails to provide for necessary needs of the people of the country.

I would like to reemphasize the point that national health insurance is inevitable in this society, just as social security back in 1932 was inevitable, but it took us 3 years to get it. The issue is whether the Senate wants to be the reflector or the leader of this society, whether it wants to sit back and await massive demands and urgent and tragic confrontations before it does what it knows it should do.

The issue before the Senate is: Is it going to be the caboose or the engine in this whole effort to bring about what is inevitable and, I think, obvious: national health insurance.

I am dismayed by the allegations as to costs. I am dismayed by this kind of inconsistent appreciation of values. This is what has our young people most disturbed in our society. The amount of money we are talking about is minimal, if you consider what it costs for not doing what needs to be done.

I think we spend entirely too much time talking about what is an expenditure when, in fact, it is an investment. The costs of not providing adequate medical care in this country, in terms of human potential, in terms of human resources, is staggering.

So what we are talking about is investing in what I would regard as America's most prized possession. The notion that this helps poor people or black people or minorities is a fallacious idea. The middle class and lower middle class people of this country, the so-called political majority, in this country, are the greatest victims of inadequate medical care.

I think the sooner this majority is made aware of the fact that it is being given a snow-job, that overnight a catastrophic illness can completely deplete their whole family savings and resources, the better off we are going to be. Language, like "throwing out the baby with the wash," is more scare language-we are trying to get the baby to participate in the bath, not throw it out with the water.

I think the time has come when we have to speak honestly. We have to use the facts and the figures that will show the problems-take the case of black people, about which I am most concerned right now. We estimate that probably 30 percent or maybe more of black mothers, at the time of childbirth, have never seen a doctor until the actual birth itself. Loss of prenatal care means a great deal in the future development and health of the child. These figures are very much the same for other minority groups as well.

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Let me give you a few figures. Life expectancy is much lower for blacks than for whites. The average black baby, man or woman, will not live long enough to collect social security.

The black maternal death rate is almost four times the white rate; almost twice as many black as white families have no hospitalization or surgical insurance coverage.

The test of society, in the final analysis, is whether we have the basic things and meet the basic needs of our people-not how many SST's, or spaceships, or how many flights to the moon. If we don't meet our people's needs, we are basically an immoral society.

I commend the Senators who join in sponsoring this legislation. The legislation, and the problems it seeks to overcome must be dramatically projected to the people in this country, and I think the Senate is in the best position to do this. National health insurance is going to come. We can be the midwives or we can be the abortionists; we have to make the decision as to what we are going to do.

I cannot state too strongly my deep concern about what is happening in the delivery and the organization of medical care. We are not talking about money. We are talking about a system that does not work. To say that we must cling to the past because there is a past, although the past has not worked, is terribly regressive thinking.

The organizations that I represent, the National Urban League, the social workers of the country, as well as the Health Security Action Council, are behind this legislation.

The CHAIRMAN. Thank you for that statement. I want to assure you there will be adequate leadership in the Senate.

This Health Subcommittee, which I chair this year, is not a subcommittee where we have to pull somebody in and ask them to serve, as with many committees. These dynamic Senators you see here and more who could not be here are pushing for leadership on this Health Subcommittee.

When I came to the Senate over 12 years ago, few Senators made this committee their first choice on which to serve, but now they are pushing, the young, dynamic Senators are fighting for leadership. They know the needs of the country and I believe we are going to see this bill enacted faster than many people in this country think.

It is of great importance to have organizations like yours support us. We thank you for this statement.

I order Mr. Young's full statement printed in the record. (The prepared statement of Mr. Young follows:)

Testimony of

WHITNEY M. YOUNG, JR.
National Urban League

before the

Senate Committee on Labor and Public Welfare

on

National Health Insurance

Room 1202, New Senate Office Building

September 23, 1970

Mr. Chairman and members of this Committee, my name is Whitney M. Young, Jr. I appear before this Committee on Health as part of a panel of representatives of the Health Security Action Council. On a day-to-day basis however, I serve as executive director of the National Urban League.

The National Urban League is a professional, non-profit, non-partisan community service organization founded in 1910 to secure equal opportunity for black Americans and other minorities. It is governed by an interracial Board of Trustees and is concerned with fostering good race relations and increased understanding among all people of these United States.

The League seeks solutions to problems of income, employment, education, housing, health, and civil rights for the masses of black and brown Americans who want a better way of life. It recognizes that any meaningful and significant changes in these problem areas rest with changing the network of systems which produce black-white disparities.

It works through local affiliates in some 97 cities located in 36 states and the District of Columbia, five regional offices, and a Washington Eureau. These units are staffed by some 1,600 persons, trained in the social sciences and related disciplines, who conduct the day-to-day activities of the organization throughout the country.

Strengthened by the efforts of upward of 10,000 volunteers who bring expert knowledge and experience to the resolution of minority problems, the National Urban League is unique as the only national educational and

community service agency which devotes its entire resources to the use of social work and research techniques for bettering the lives of the

disadvantaged and for improving race relations.

This means,

Mr. Chairman, that I appear here today as the wearer of two hats---one as executive director of a community service organization and the other as vice chairman of a group dedicated almost exclusively to improving health services to the Nation. These two hats, however, are not totally dissimilar because much of the League's effort is also devoted to improving health services.

While the details differ somewhat, both of these groups support the concept of a national health insurance program. Because I know, Mr. Chairman, of your broad knowledge of national health insurance programs as reflected in S. 4323 which you recently introduced and S. 4297 which you co-sponsored with Sen. Edward Kennedy and more than a dozen other members of this august body, I will not dwell too long on details. In the interest of time I would like to touch on some general components of the proposed health security legislation.

So much has been said and written about national health insurance in recent months that there is little new that can be added to the body of knowledge already available to this Committee. Few knowledgeable people argue about the need for expanded health services.

The program being proposed by the Committee for National Health

Insurance would:

provide comprehensive health care to all Americans;

pay for such services with contributions from employers, employees, the self-employed and a general trust fund;

cover all necessary health care wherever it is given; substantially expand preventive health care and improve early diagnosis of illness; and

establish a Resources Development Fund to expand group

medical practice and other approaches to easing the shortage

of health manpower.

Such a program appeals to most Americans because it touches their daily lives. People want to be healthy; they want to protect their health with the best possible medical practices; and they want to maintain their health at a reasonable cost. These three facts motivate Americans to spend an estimated $63 billion annually for health services. The problem is that the cost of health services is so high that few people can afford to get sick.

Even with the private health insurance plans we now have, the average person could be financially ruined by a spell of sickness which hospitalized him for more than three weeks. The average uninsured person simply cannot afford to be hospitalized. Some experts are already predicting that the cost of hospitalization for a serious heart attack will approach $16,000 within the next three years. That amount of money could wipe out a substantial number of "family nest eggs" and rob many young people of the college educations Americans save their money for.

It is important to bear in mind that the problem is now more than the inadequacy of medical care available to the poor. As medical technology has advanced, it has also raised the cost of care beyond the reach of many poor people. Good medical care is rapidly becoming a privilege of the middle-class citizenry.

The National Center for Health Statistics, Public Health Service, estimates that between 1962-1963 some 34 per cent of all decedents were individuals or members of families with a total income of less than $2,000 during the last calendar year before death. This may indicate that rich people don't die as rapidly simply because they can afford the diagnostic, preventive, and therapeutic care denied poor people.