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About Medford mail tribune. (Medford, Or.) 1909-1989 | View Entire Issue (March 10, 1961)
10 B FRIDAY, MARCH 10. 1961 MEDFORD MAIL TRIBUNE, MEDFORD, ORE. Medical Care for Aged Program Said To Be Center of Confused Controversy Washington -(CQ)- Presi dent Kennedy's proposal for Social Security financed health benefits for the aged, submitted to Congress in Feb- ruary, has unleashed again the confusing torrent of argu mcnts that arose over similar proposals in I960. In addition to the Presi dent's health plan, he has pro posed a five-point liberaliza tion of other Social Security benefits. Together, the two plans eventually would in crease individual Social Se curity taxes by as much as $106 annually, adding cries of "over-taxation" to the protests of "socialized medicine which came in 1960. The American Medical As tofialion. leader of the oppo sition to Kennedy's health care plan, said in its Feb. 20 issue of the AMA Jews that doctors "must be willing lo face up to the deadly serious ness of the challenge lo iree medicine." The AMA offered for use in physicians' offices a ful-Dafie poster, entitled M open letter lo my patients: So cialized Medicine ana iou. The poster says the freedom of a Datient to choose his own doctor and of the doctor to eive individual confidential treatment are at stake. It urges patients to tell their . Congressmen that "socialized medicine i not for us.". The News sueeested doctors use the poster as a "conversation piece." Ribicoff Cilei 'Guarantee' Asked for comment on the poster campaign, Secretary Abraham A. Ribicoff of the Department of Health, Education- and Welfare . Feb. . 25 said he could see no relation ship -between- the. poster and the Administration program. "Our measura has nothing to do with doctors whatsoever. The doctor - patient relation ship is' guaranteed," he said. The "guarantee" Ribicoff referred to is covered in the Administration bills intro duced Feb.' 13 by Rep.' Cecil R. King (D-Calif.) and Sen. Clinton P. Anderson (D-N.M.). The bills specify that benefits do not include doctors' or sur geons' fees except in such areas as radiology and admin istration of anesthetics. Doctors would have to ex amine and refer patients in order for them to be eligible for their hospitalization and other Social Security benefits, but this referral would be paid for by the batients them selves, Fee-Setting Feared Critics say that what the AMA fears most is not that the Social Security plan would bring In" doctors in Its present form, but that it might be amended to do so in future years. What this would mean, among other' things, is that the doctors could no longer set their fees at will for mil lions of Social Security bene ficiaries. Instead, they would be paid by the government on a "reasonable cost" basis, with the amounts determined through negotiations, as would be the case with other sec-,, tions of the proposed pro gram. Such payments to doc tors were included In the original "Forand bill" for So cial Security medical care last year, but were knocked out of later ' bills sponsored by Kennedy in the Senate. What ii covered President Kennedy's 1061 medical care proposals would cover the cost of the following for Social Security recipients, excluding the cost of doctors' and surgeons' fees: Hospitalization - Up to 90 days for each illness, with the patient paying the first $10 each day for the first nine days, 'with a minimum pay ment by the patient of $20, and with no coverage for pri vate duly nurses or for TB and mental institutions. Nursing homes - Up lo 1R0 days care after . hospital dis charge, but somewhat less if the patient remains in the hos pital the full 90 days. Outpatient care-Charges of more than $20 for any one required diagnostic study. . Home care-Up to 240 visits a year for such purposes as nursing care and therapy. The benefits would go into effect Oct. 1, 1962, except for nursine home care which would begin July 1, 1963. Who It Covered An estimated 13,750,000 So cial Security recipients over 65 and a half million railroad retirees would be eligible for benefits, provided a doctor certified that they needed them. Payments would be made directly to the hospitals and other institutions from the Social Secuity trust. Par ticipating institutions would have to meet stale licensing criteria and be acceptable to the HEW Secretary, and would provide services on the basis of agreements with him. Patients would have a free choice among the institutions signing such agreements. While the AMA opposes this program, it docs support a medical care program enacted part of the 1061 Social Security amendments and known as the Kerr-Mills plan. This plan provides for federal- state matching grants for old persons who cannot afford to pay for medical care. The states may set up programs to meet some of these costs, including the payment of doc tors' bills, if they choose to do so. Advocates of the Social Se curity approach term the pro gram inadequate on grounds that many states cannot im plement it for lack of ample resources, and that benefits would vary greatly from state to state. So far, six stales have set up programs under the Kerr-Mills provisions. Critics of the AMA say the organization is inconsistent in supporting a plan that can cover doctors' bills and op posing a plan that docs not, while complaining that the latter interferes with doctor- patient relationships! Other Benefits In addition to health bene fits, President Kennedy is pro posing the following changes in general Social Security benefits: A monthly increase from $33 to $43 in the minimum benefit for the retired worker. Permission for men as well as women to begin collecting benefits on a permanently re duced basis at the age of 62, Increase in widow's bene fits from 75 per cent to 85 per cent of husbands' bene fits. Broadening of disability In surance to provide benefits af ter a worker had been totally disabled six months, instead of only when disability was expected to result in death or to last for a long, Indefinite period. A change In the require ment that, to get benefits, an employee must have held So-cial-Security-covered Jobs for ono out of every three cal endar quarters after 1950 lo one quarter out of every four. These benefits would go in to effect April 1, 1961 if en acted that soon. Cost of Programs Together, the two programs would cost over $2 billion an nually. HEW experts have calcu lated the cosls over an In definite number of years, and tho taxes proposed by Presi dent Kennedy are geared ex actly to cover these costs. An additional V of 1 per cent Social Security payroll tax would be levied on both em ployers and employees and ? of 1 per cent on the self employed. The taxes would cover the first $5,000 of wages rather than the first $4,800 as at present. The new rates would be in addition to increases already scheduled to go into effect in 1963, 1966 and 1069. The pres ent rate is 3 per cent each for employees and cmployers-a maximum of $144 a yenr each on $4,800 in wages. On Jan. 1, 1963 the tax would go to 4 per cent under the new proposals and the taxable wage base lo $5,000-a max imum of $200 a year. In 1966, the tax would be raised to 4 Vi per cent, and in 11)69 to 5 per ccnt-a $250 maximum annual payment by both em ployees and employers. The Increased revenues would go into the Social Se- proposals they would dip projected tax rates, curity trust funds, from which about $2 billion in the next The ultimate result of the the benefits are paid. These two years, and then increase program would be to spread funds currently total some to many times their present the costs of aged medical care $22.5 billion. Under current size over the years, based on among the younger working population and over the life span of the individual recip ient through compulsory tax ation. Experts agree that this is the only way to solve on a national basis whatever problems exist in this area. Arguments are expected to continue in Congress, how ever, whether the flat rate Social Security tax or the graduated income tax is the best financing mechanism, whether the states should con tinue to have a major respon sibility, and whether the tax; money should be used to sub sidize private health insur ance policies as an option to paying for benefits directly, as the Eisenhower Adminis tration proposed last year. Copyright 1961, Congressional Quartely. Inc.) S TAR G AZER O Ff)35.37.4(MM TAURUS APR. 21 I iV MAY 2 fUn iS 87-89 OIMINI MAY -2! 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