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
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APR. 21
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-Br CLAY R. POLLAN-
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