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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.

Hon. HARRY BYRD,

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,

MAY OWEN, M.D.,
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.

PAUL HALL,

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.

T. A. FERRIER, M.D.

NEW YORK, N.Y.

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.

JOSEPH VOLPIAN,

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.

DANIEL FINE, M.D.

BELLAIRE, OHIO, June 29, 1960.

Hon. HARRY F. BYRD,

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

MILTON D. LEVINE, M.D.

STATEMENT OF THE AMERICAN OSTEOPATHIC ASSOCIATION BY CHARLES L. BALL

INGER, D.O.

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.

Furthermore, as we suggested to the Senate Subcommittee on Problems of the Aged and Aging during its hearings last August, we believe that more financial support should be made available for basic and applied research in geriatrics. The osteopathic schools of medicine, in common with the other medical schools, are participating in the research and training programs of the National Institutes of Health in such fields as cancer, cardiovascular diseases, arthritis and metabolic diseases, neurological diseases, and mental health, which may be said to bear a primary relation to aging. Lectures and clinical courses are given in the care of the aged, under the subject of gerontology, and kindred subjects throughout the curriculums in our colleges.

The American Osteopathic Association will continue to work with private organizations and Government agencies for the advancement of the health care and welfare of the aged, and desires to be of any possible assistance to this honorable committee in connection with the pending and related legislation.

AMERICAN OSTEOPATHIC ASSOCIATION,
Washington, D.C., July 1, 1960.

Re H.R. 1280.

Hon. HARRY F. BYRD,

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

DEAR SENATOR BYRD: Although Dr. Ballinger, of Coral Gables, Fla., has already filed with your committee a statement on the part of the American Osteopathic Association in connection with the social security amendments bill, H.R. 12580, an objectionable and gratuitous suggestion made by the International Chiropractic Association to your committee yesterday to change the form of reference to osteopathy in connection with the definitions of "physicians' services" and "physician" on page 165 of the bill calls for additional comment on our part.

The chiropractic proposal would revise lines 12-16, page 165 of H.R. 12580, to read as follows:

"(e) The term 'physicians' services' means services provided in the exercise of his profession in any State by a physician, osteopath, or chiropractor, licensed in such State; and the term 'physician' includes a physician, osteopath, or chiropractor licensed in such State."

The definition of "physician" on page 165 of the bill as it passed the House emphasizes osteopathic participation by incorporating by reference section 1101(a) (7), adopted in 1950, which includes doctors of osteopathy in the definition of physician applicable to the general provisions of the Social Security Act. We respectfully request that this form of reference be retained for purposes of osteopathic participation.

It was through application of the criterion that in order to qualify for inclusion under the term "physician," as used in the Social Security Act generally. one must be trained in the practice of the healing art in all its branches, that this committee in 1950, based upon the evidence submitted, found that the graduates of the osteopathic schools of medicine so qualified and included them under section 1101 (a) (7).

The Congress had similarly defined the terms "physicians" and "medical care" and "hospitalization" as inclusive of osteopathic physicians and hospitals under the provisions of the U.S. Employees Compensation Act in 1938 (52 Stat. 586). Previous to that, in 1929, the Congress, in regulating the practice of the healing art in the District of Columbia, provided: "The degrees doctor of medicine and doctor of osteopathy shall be accorded the same rights and privileges under governmental regulations" (45 Stat. 1329).

As above stated, we hope that the provision for osteopathic participation under H.R. 12580 will be retained in the form in which it passed the House.

Very truly yours,

C. D. SWOPE, D.O., Chairman.

MADISON, WIS., June 29, 1960.

Senator HARRY FLOOD BYRD,

Chairman, Senate Finance Committee,

Washington, D.C.:

Local 720 of the Wisconsin Council of County and Municipal Employees by unanimous vote urges your support of the McNamara amendment for medical care for aged to replace title 6 of the House-approved H.R. 12580.

MERCEDES DUFOUR, Secretary, City-County Building, Madison, Wis.

HUDSON, N. Y., June 29, 1960.

Senator HARRY F. BYRD,

Chairman of the Senate Committee on Finance,
Washington, D.C.:

On behalf of the Group Health Association of America I would like to testify in support of legislation to provide health benefits to the aged through contributory social security system. However, I do not want to delay completion of the work of your committee within the remaining days of this congressional session. If my personal appearance would in any way hold up the committee's deliberations I would prefer to be recorded as favoring adding health benefits to the OASDI system and having this telegram included in the committee record.

CALDWELL D. ESSELTYN, M.D.,

President, Group Health Association of America, Hudson, N.Y.

Senator HARRY F. BYRD,

NEW YORK, N.Y., June 29, 1960.

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

Would like to appear before your committee to testify in support of legislation to provide health benefits to the aged through contributory social security system. However, I do not want to delay completion of committee's work in closing days of congressional session. If my personal appearance would in any way hold up the committee's deliberations, I would prefer to be recorded in favor of adding health benefits to the OASDI system and having my telegram included in the committee's records. My own record and experience may be identified by reference to Who's Who in America.

Senator HARRY F. BYRD,
Committee on Finance,

Senate Office Building, Washington, D.C.:

row.

GEORGE BAEHR, M.D.

YELLOW SPRINGS, OHIO, June 29, 1960.

Have just learned of public hearing on health care for aged today and tomorI urge support of legislation to provide health benefits through OASI, if we are as a nation truly concerned to meet health problems of older people and maintain humane standards of quality and quantity of health services. This would permit contributions of individuals through employed lifetime and give widest flexibility in administration with least likelihood of regional and sectional variations in coverage and service.

Please include this telegram in committee's record.

JAMES P. DIXON, M.D., President, Antioch College.

WASHINGTON, D.C., June 29, 1960.

Senator HARRY F. BYRD.

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

Re Finance Committee hearings June 29 and 30 on health care for the aged. I wish to record with your committee my full support of legislation to provide health care to the aged through the contributory social security system. I would request the opportunity to testify re above but do not want to delay the

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