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Older Americans Issues - GRF Statements - General
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Older Americans Issues - GRF Statements - General
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The original documents are located in Box F54, folder "Older Americans Issues - GRF Statements - General" of the President Ford Committee Campaign Records at the Gerald R. Ford Presidential Library. Copyright Notice The copyright law of the United States (Title 17, United States Code) governs the making of photocopies or other reproductions of copyrighted material. Gerald R. Ford donated to the United States of America her copyrights in all of her husband's unpublished writings in National Archives collections. Works prepared by U.S. Government employees as part of their official duties are in the public domain. The copyrights to materials written by other individuals or organizations are presumed to remain with them. If you think any of the information displayed in the PDF is subject to a valid copyright claim, please contact the Gerald R. Ford Presidential Library. OLDER AMERICANS "Older Americans continue to enrich our lives with their vision, strength and experience. They have earned the right to live securely, comfortably, and independently. The proposals that I am sending to the Congress offer sig- nificant improvements in the quality of life for all older Americans. 11 Remarks upon signing Older Americans Message to Congress February 9, 1976 "As President, I intend to do everything in my power to help our nation demonstrate it deep concern for the dignity and well-being of our older generation. 11 Remarks to a group of Senior Citizens St. Petersburg, Florida February 14, 1976 SOCIAL SECURITY TRUST FUND "I am concerned about the integrity of our Social Security Trust Fund that enables people--those retired and those still working who will retire to count on this source of retirement income. Younger workers watch their deductions rise and wonder if they will be adequately protected in the future. We must meet this challenge head on. Simple arithmetic warns all of us that the Social Security Trust Fund is headed for trouble. Unless we act soon to make sure the fund takes in as much as it pays out, there will be no security for old or young. I must, therefore, recommend a 3/10 of one per cent increase in both employer and employee social security taxes effective January 1, 1977. This will cost each covered employee less than one extra dollar a week and will insure the integrity of the trust fund." State of the Union Address January 19, 1976 "I will continue to push, prod, and press the Congress to make sure that your social security benefits now, as well as in the future, will be responsibly funded and fully protected.' Remarks at Tampa, Florida February 29, 1976 DEPARTMENT FORD LIBRARY CATASTROPHIC HEALTH INSURANCE "I am proposing catastrophic health insurance for every- body covered by Medicare--and that includes both the elderly and the disabled. Under this proposal, no one who is 65 years or older would have to pay more than $500 a year for hospital or nursing home care nor more than $250 a year for doctor's bills. President Ford has stated that millions of older persons live in fear of being stricken by an illness that will call for expensive hospital care over a long period of time. "Most often they do not have the resources to pay the bills We have been talking about this problem for many years. We have it within our power to act now so that today's older persons will not be forced to live under this kind of a shadow. 11 GERALD R. FORD LISA TAX REFORM Q. One of the proposals now before the House Ways and Means Committee, submitted by Rep. James A. Burke of Massachusetts, would change the social security tax law to lessen the payments now made by employers and employees and would raise the income limits so that wage earners with an income of $25,000 would pay a social security tax on that full amount. Do you support that tax reform? A. As I spelled out in my State of the Union address, it is vital that we maintain a sound, reliable Social Security System. I have therefore proposed that the full cost of living increase be paid to all Social Security beneficiaries, We must also recognize, as Rep. Burke has, that the Social Security Trust Fund -- the foundation of the system -- is running out of money. I have therefore proposed that in order to preserve the integrity of the trust fund and to protect future benefits, we enact a modest increase in Social Security payments, effective January 1, 1977. For employees, this will mean an increase of less than a dollar a week in additional payments. Rep. Burke's proposal would result in a significant portion of Social Security benefits being financed from general revenues. I oppose this approach for two reasons. First, Social Security was set up as a form GERALD R. FORD LIBRARY 2 of personal insurance; we ought to maintain it as such, and not turn it into a general welfare program. Secondly, we just don't have general revenues to put into Social Security. As matters now stand, the Federal Government during fiscal year 1976 will be borrowing over $70 billion to pay its bills. It makes no sense to me to keep living beyond our means and expect the future to take care of itself. Social Security was intended as a means to provide for the future, and we ought to stick to that sound principle. oston Herald American Written Interview February 4, 1976 GERALD A FORD LID, climination of the GI educational benefits for those vet- It was a voting record that called them as I saw them crans who have served in wartime. for the overall benefit of the United States, and Presi- Let me make one alternative comment. The GI bill dent I have carried out precisely. the same policy. was passed during World War II for those 16 million Q. Thank you. Americans who served so when they got out they could get an education. It expired after World War II. Korea THE PRESIDENT'S PLANS IF ELECTED came along, again combat, and it was reenacted. Q. President Ford, my name is Paul Walton, and I After the end of the Korean War-combat having am on the California Exchange Program from San Diego. ceased-it expired. When the Vietnam War came along, I would like to know that if you were elected to the Presi- it was reenacted. The Vietnam War has now been over dency of the United States, what new changes would take for a year or more, as far as WC are concerned. place? Now the question is whether in peacetime you should THE PRESIDENT. Let's take foreign policy. We are at continue giving educational benefits to those who serve peace, as I said in my opening remarks. We have strength- under an all-volunteer system? ened our relations with the NATO nations in Western Q. I think you should. How do you feel? Europe, and they are getting better every day. THE PRESIDENT. Let me raise a question. We want an We have the best, the finest relations with Japan we all-volunteer service, and we have got it. There is no more have ever had. We are making excellent headway in draft. I am all for it: But if you give educational benefits pushing for a permanent and a fair and equitable peace in to an all-volunteer force, and you want them to stay in the Middle East. so we have career personnel and, at the same time, you We are keeping a dialog with words and not bullets give them educational benefits SO that is an incentive for with the Soviet Union, and we are making, improving them to get out, it doesn't make much sense from the relations with the People's Republic of China. In foreign point of view of the Government. policy we are going to keep moving ahead on the same So, we are going to give every GI who entered the policy of achieving peace, maintaining peace that we service his GI benefits if it was it matter of law at that have had. time. But it raises a serious question, whether you should In the domestic policy area, I think we are on the right give it to some fellow who volunteers on his own initiative course for us to continue to improve our economic situa- and then provide an incentive for him to get out at the tion. We are going to continue the downward trend in end of 3 years SO he can go to school. inflation. We have made a lot of progress from what it Now, I think we can solve it, and this is the way it ought was 18 months ago. It was over 12 percent-a-year. It is to be solved. If a young man volunteers, he has a high 6 percent-a-year now, and it is going down. hool education, we ought to give him educational op- Unemployment is headed in the right direction, down, gortunities in the service so that he can go to school, get the trend of the Gross National Product is in the right di- his college degree so the service will have him with a higher rection. So we are going to keep a firm, steady hand to education rather than having him get out to get an edu- make sure that these trends continue. cation. That is the better way to solve it. That will take a lot of hard work, a little confrontation Q. Thank you very much, Mr. President. with my friends in the Congress. But I think we will come out in good shape, and America will be a better country THE PRESIDENT'S VOTING RECORD in 1977 and the years thereafter. Q. Mr. President, sir, my name is Bonzo, and I am an Thank you all very much. escapee from an old Ronald Reagan flick. I have been NOTE: The President spoke at 7:05 p.m. in Lundholm Gymnasium challenging him all over the country as the candidate at the University of New Hampshire. of big business, as the fat cat's candidate. The way you talk about freedom for the giant corporations, I will be forced to challenge you as well, sir. Why should you not be called the big business candidate? Older Americans THE PRESHIENT. Why should I not be? Q. Why should you not be called that, sir? The President's Remarks pon Signing His Message to THE PRESIDENT. Well, I think if you look at my voting Congress. February 9, 1976 record for 25-plus years in the House of Representatives where I voted over 4,000 times, if you will look at the Today I am sending a message to the ress that voting record, you will find that it could not be categorized expresses my confidence and support of older Americans, as a candidate of big labor, big business. my very deep concern about the problems of the aging, GERALD R. FORD Volume 12-Number 7 LIBRARY them. Society owes a very deep debt of gratitude to all to limit Medicare reimbursement rates 11) 7 reent for older persons who have worked hard and contributed hospital services and 4 percent for physician services. significantly to our Nation's progress. These proposals are of particular importance in achieving Older Americans continue to enrich our lives with their my goal of helping all Americans live in dignity, security vision, strength and experience. They have earned the and good health. right to live securely, comfortably and independently. The I hope you will join me in efforts to secure agressional proposals that I am sending to the Congress offer signifi- passage of these important proposals. We must show our cant improvements in the quality of life for all older commitment to a cause that is often too long neglected- Americans. the dignity and well-being of America's older generations. Wc all have a great stake in fighting inflation, but older I will now sign the messages to the Gongress-one to Americans living on fixed incomes are especially hard hit. the House and one to the Scnate urging that they under- I pledge to continue the fight against inflation. take the enactment of this necessary legislation. To provide special relief to the elderly, I am requesting Thank you very much. in my budget for fiscal year 1977 that the full cost of living NOTE: The President spoke at 10:05 a.m. at a ceremony in the Oval increase in social security benefits are paid during the Office at the White House. coming year. The value of the social security system is beyond chal- lenge. I am concerned, however, about the integrity of the Security Trust Fund that enables people to count on this source of retirement income. I am concerned be- Older Americans cause the system now pays out more in benefits than it receives in tax payments. The President's Message to the Congress. To prevent a rapid decline in the Trust Fund over the February I, 1976 next few years, I had to make a very difficult decision. I am proposing a small payroll tax increase of three-tenths To the Congress of the United States: of one percent each--for employees as well as employ- I ask the Congress to join with me in making improve- ers-of covered wages. The alternative would have been ments in programs serving the elderly. to limit expected increases in retirement and disability As President, 1 intend to do everything in my power payments. This proposed tax increase will help to stabilize to help our nation demonstrate by its deeds a deep con- the Trust Fund so that current and future recipients will cern for the dignity and worth of our older persons. By be fully assured of receiving the benefits they are so doing, our nation will continue to benefit from the entitled to. contributions that older persons can make to the strength- I am also very concerned about the effect of cata- ening of our nation. strophic illnesses. I want to lighten the financial burden The proposals being forwarded to Congress are directly which now strikes after prolonged hospitalization-when related to the health and security of older Americans. the elderly and their families can least afford it. Therefore, Their prompt enactment will demonstrate our concern I am proposing catastrophic health insurance for the more that lifetimes of sacrifice and hard work conclude in hope than 24 million Americans and disabled Americans pro- rather than despair. tected by Medicare. The single greatest threat to the quality of life of older No one who is covered by Medicare would have to pay Americans is inflation. Our first priority continues to more than $500 a year for covered hospital or nursing be the fight against inflation. We have been able to re- home care. No one who is covered by Medicare would duce by nearly half the double digit inflation erienced have to pay more than $250 for one year's doctor bills. in 1974. But the retired, living on fixed incomes, have been Beneficiaries and their physicians now have little incen- particularly hard hit and the progress we have made in tive to limit the duration of hospitalization for less scrious reducing inflation has not benefited them enough. We conditions. will continue our efforts to reduce federal spending, bal- To encourage economic use of covered health services, ance the budget, and reduce taxes. The particular vul- I am also proposing changes in cost-sharing arrange- nerability of the aged to the burdens of inflation, how- ments. As under the current system, a beneficiary who is ever, requires that specific improvements be made in two in the hospital will pay $104 a day for the first day of hos- major Federal programs, Social Security and Medicare. pital services. In addition, he or she will pay 10 percent We must begin by insuring that the Social Security of additional charges up to an annual maximum of $500. system is beyond challenge. Maintaining the integrity of For covered physician services, my proposal would in- the system is a vital obligation each generation has to crease the annual deductible from $60 to $77 and would those who have worked hard and contributed in it all continue the current 20 percent cost sharing. their lives. I strongly reaffirm my commitment FORD stable Volume 12-Number 7 1976 169 and financially sound Social Security system. My 1977 First, I propose extending Medicare benefits by providing budget and legislative program include several elements coverage for unlimited days of hospital and skilled nursing which I believe are essential to protect the solvency and facility care for beneficiaries. Second, I propose to limit integrity of the system. the out-of-pocket expenses of beneficiaries, for covered First, to help protect our retired and disabled citizens services, to $500 per year for hospital and skilled nursing against the hardships of inflation, my budget request to services and $250 per year for physician and other non- the Congress includes a full cost of living increase in institutional medical services. Social Security benefits, to be effective with checks rc- This will mean that each year over a billion dollars of ceived in July 1976. This will help maintain the pur- benefit payments will be targeted for handling the finan- chasing power of 32 million Americans. cial burden of prolonged illness. Millions of older persons Second, to insure the financial integrity of the Social live in fear of being stricken by an illness that will call for Security trust funds, I am proposing legislation to increase expensive hospital and medical care over a long period payroll taxes by three-tenths of one percent each for cm- of time. Most often they do not have the resources to pay ployees and employers. This increase will cost no worker the bills. The members of their families share their fears more than $1 a week, and most will pay less. These addi- because they also do not have the resources to pay such tional revenues are needed to stabilize the trust funds SO large bills. We have been talking about this problem for that current income will be certain to either equal or many years. We have it within our power to act now SO exceed current outgo. that today's older persons will not be forced to live under Third, to avoid serious future financing problems I this kind of a shadow. I urge the Congress to act promptly. will submit later this year a change in the Social Security Added steps are needed to slow down the inflation of laws to correct a serious flaw in the current system. The health costs and to help in the financing of this cata- current formula which determines benefits for workers strophic protection. Therefore, 1 am recommending that who retire in the future does not properly reflect wage the Congress limit increases in medicare payment and price fluctuations. This is an inadvertent error which rates in 1977 and 1978 to 7% a day for hospitals and could lead to unnecessarily inflated benefits. 4% for physician services. The change I am proposing will not affect cost of living Additional cost-sharing provisions are also needed to increases in benefits after retirement, and will in no way encourage economical use of the hospital and medical alter the benefit levels of current recipients. On the other services included under Medicare. Therefore, I am rec- hand, it will protect future generations against unneces- ommending that patients pay 10% of hospital and nurs- sary costs and excessive tax increases. ing home charges after the first day and that the existing I believe that the prompt enactment of all of these deductible for medical services be increased from $60 to proposals is necessary to maintain a sound Social Security $77 annually. system and to preserve its financial integrity. The savings from placing a limit on increases in medi- Income security is not our only concern. We need to care payment rates and some of the revenue from in- ocus also on the special health care needs of our elder creased cost sharing will be used to finance the cata- citizens. Medicare and other Federal health programs strophic illness program. have been successful in improving access to quality medi- I feel that, on balance, these proposals will provide our cal care for the aged. Before the inception of Medicare elder citizens with protection against catastrophic illness and Medicaid in 1966, per capita health expenditures costs, promote efficient utilization of services, and moder- for our aged were $445 per year. Just eight years later, atc the increases in health care costs. in FY 1974, per capita health expenditures for the elderly The legislative proposals which I have described are had increased to $1218, an increase of 171 percent. But only part of the over-all effort we are making on behalf despite the dramatic increase in medical services made of older Americans. Current conditions call for continued possible by public programs, some problems remain. and intensified action on a broad front. There are weaknesses in the Medicare program which We have made progress in recent years. We have re- must be corrected. Three particular aspects of the cur- sponded, for example, to recommendations made at the rent program concern me: 1) its failure to provide our 1971 White House Conference on Aging. A Supplemental elderly with protection against catastrophic illness costs, Security Income program was enacted. Social Security 2) the serious effects that health care cost inflation is benefits have been increased in accord with increases in having on the Medicare program, and 3) lack of incen- the cost of living. The Social Security retirement test was tives to encourage efficient and economical use of hospi- liberalized. Many inequities in payments to women have tal and medical services. My proposal addresses each of been climinated. The 35 million workers who have earned these problems. rights in private pension plans now have increased In my State of the Union Message I proposed protec- protection. tion against catastrophic health expenditures for Medi- In addition we have continued to strengthen the Older care beneficiaries. This will be accomplished in two ways. Americans Act. I have supported GERALLO concept FORD of the Older Volume 12-Number 7 LISAARY its progress in pan by its ability to rec. gnize, vember signed the most recent amendments into law. respect and renew the contributions of carlier generations. A key component of the Older Americans Act is the I believe that the Social Security and Medicare improve- national network on aging which provides a solid founda- ments I am proposing, when combined with the action tion on which action can be based. I am pleased that we programs under the Older Americans Act, will insure a have been able to assist in setting up this network of 56 measure of progress for the elderly and thus provide real State and 489 Area Agencies on Aging, and 700 local hope for us all. nutrition agencies. These local nutrition agencies for ex- GERALD R. FORD ample provide 300,000 hot meals a day five days a week. The White House, The network provides a structure which can be used to February 9, 1976. attack other important problems. A concern of mine is that the voice of the elderly, as consumers, be heard in the governmental decision-making process. The network on aging offers opportunities for this through membership Department of Health, on advisory councils related to State and Area Agencies on Aging, Nutrition Project Agencies and by participation Education, and Welfare in public hearings on the annual State and Arca Plans. Such involvement can and will have a significant impact Announcement of Intention To Nominate on determining what services for the aging are to be given William H. Taft IV To Be General Counsel. the highest priorities at the local level. February 9, 1976 The principal goal of this National Network on Aging The President today announced his intention to nomi- is to bring into being coordinated comprehensive systems nate William H. Taft IV, of Alexandria, Va., to be Gen- for the provision of service to the elderly at the community eral Counsel of the Department of Health, Education, level. I join in the call for hard and creative work at all and Welfare. Hc will succeed John Rhinelander, who was levels-Federal, State and Area in order to achieve this appointed Under Secretary of the Department of Housing objective. I am confident that progress can be made. and Urban Development on September 11, 1975. Mr. Toward this end, the Administration on Aging and a Taft has been Assistant to the Secretary of HEW since number of Federal Departments and agencies have signed March 1973. agreements which will help to make available to older Mr. Taft was born on September 13, 1945, in Wash- persons a fair share of the Federal funds available in ington, D.C. He attended Yale University and received his such areas as housing, transportation, social services, law B.A. degree in 1966. Hc received his J.D. from Harvard enforcement, adult education and manpower-resources Law School in 1969. which can play a major role in enabling older persons to In January 1970, Mr. Taft became an attorney-advisor continue to live in their own homes. in the Office of the Chairman of the Federal Trade Com- Despite these efforts, however, five percent of our older mission. He was appointed Special Assistant in the men and women require the assistance provided by skilled Deputy Director of the Office of Management and Budget nursing homes and other long term care facilities. To assist in August 1970. From August 1972 to March 1973, he these citizens, an ombudsman process, related solely to the was Executive Assistant to the Director of OMB. persons in these facilities, is being put into operation by Mr. Taft is married to the former Julia Vadala. the National Network on Aging. We believe that this pro- gram will help to resolve individual complaints, facilitate important citizen involvement in the vigorous enforcement of Federal, State and local laws designed to improve health and safety standards, and to improve the quality of care Assistant Press Secretary in these facilities. to the President Today's older persons have made invaluable contribu- tions to the strengthening of our nation. They have pro- Announcement of Appointment of Larry Speakes. vided the nation with a vision and strength that has February 9, 1976 resulted in unprecedented advancements in all of the arcas of our life. Our national moral strength is due in no small The President today announced the appointment of part to the significance of their contributions. We must Larry Speakes, of Merigold, Miss., as Assistant Press Sec- continue and strengthen both our commitment to doing retary to the President. He became a member of the staff everything WC can to respond to the needs of the elderly of the Office of the Press Secretary in August 1974. and our determination to draw on their strengths. Born in Cleveland, Miss., on September 13, 1939, Mr. Our entire history has been marked by a tradition of Speakes attended the University of Mississippi where hc growth and progress. Each succeeding generation can majored in journalism. Volume 12-Number 7 R. GERALD PEOPLE 3/5/76 3/5/76 Older American * Signed into law Title XX of the Social Security Act which provides 2.5 billion dollars to the states for social services. Under Title XX older persons will receive increased services, planned and implemented by state and local governments -- needs and services determined not in Washington but at the local level, with the partici- pation of the older Americans who will receive the services. And lastly, under President Ford's new Title XX proposal, states would no longer be required to give the federal government money in order to obtain federal monies in return. President Ford has supported the concept of the Older Americans Act since its inception in 1965. This past November the President strengthened the Act when he signed into law amendments creating new services and goals. Under President Ford's Administration -- $272 million -- almost seven times the amount available three years earlier went to this program. Through the Administration on Aging a00 created by this Act, a national network on aging composed of state, area and nutrition agencies has been established As an example of what the Act does, nutrition agencies serve older persons over 300,000 hot meals a day, five days a week at 5,000 locations. This network helps older. people to: Know what resources are available Secure services enabling them to live in their own homes. Meet their needs for transportation Provide for the weatherization of their homes. Obtain legal services Continue to be involved by serving in full-time, part-time and volunteer positions serving the community. Cope with housing problems Have a meaningful voice in setting priorities for meeting their needs at the ločal level. GE, IBRARY The Presic Report is The President Ford Committee, Howard H. Callaway, Chairman, Robert Mosbacher, National Finance Chairman, Robert C. Moot, Treasurer A Report is filed with the Federal Election Commission and is available for purchase from the Federal Election Commission, Washington, SUPPLEMENTAL RETIREMENT PROGRAMS Upon being asked his opinion on legislation permitting all citizens to provide for a portion of their retirement through the mechanism of the individual retirement accounts, the President responded: "I was a supporter of what we call the Keogh plan, and I am sure you are familiar with that. That has been increased from $1500 to $2500, as I recollect. There is the IRA program. I have recommended something along this line so that individuals can invest in American corporations and get a tax deferral. In other words, I think it is $1500 a year. If they invest in American corporate securities, they can then get a deferral of their tax and pay the tax when they retire at the retirement age. I happen to believe very strongly in supplemental retirement programs, whether it is Keogh or any one of the others. So, anything that can be jus- tified within reason, the answer is categorically yes. " President Gerald R. Ford Q & A Session at Public Forum Champaign, Illinois March 6, 1976 GERALD R. LIBRARY FORD OLDER AMERICANS SPECIAL MESSAGE QUESTION: Mr. President, I am retired from the U.S. Air Force, a Pearl Harbor survivor. What I would like to know, sir, is do you have any program with relation to pay for the retired service people of the United States? THE PRESIDENT: Well, I recognize the problem that all people who are retired have with inflationary difficulties that we have had in the country for the last 18 -- well, the last three years, really. We are making headway on that, but with the escalator clauses that we have in military retirement, Social Security, railroad retirement and so forth, I think we can honestly say that those who are retired are considered to get an adequate amount for the benefit of their future and I intend to see that those escalator clauses are maintained. I believe that as we attack effectively inflation that those who are retired, whether it is military retirement or Social Security, railroad retirement or Government retirement, can feel a security and a sufficiency in their older years, and I will fight to maintain those. President Ford March 13, 1976 West Wilkes High School Gym. Wilkesboro, North Carolina LIBRARY of GERALD SOCIAL SECURITY SOCIAL PROGRAMS QUESTION: My question relates to Social Security. In 1975, the maximum amount of Social Security paid on behalf of any one person was a maximum of $348. Now in 1976 someone earning $15, 300 pays a combined employee-employer total of $1790, so in just over ten years we had a 414 percent increase in the cost to middle income American taxpayers. And there is no end in sight, apparently, because a deficit occurred this year for the first time so more and more money is going to have to be raised, so your solution is to increase regressiveness of that tax by increasing another three-tenths of one percent and further burdening the low and middle income taxpayers in this country. But let me answer the other question, and I am glad you brought it up. It is a very serious problem we are facing. The Social Security Trust Fund this year will have a deficit between income and outgo of $3 billion. Next year it will have a deficit of: $3.5 to $4 billion, the next year it will be closer to $5 billion. At the present time we have a Trust Fund of about $40 billion, so if we do nothing, you are bound to have, in a relatively short period of time, some time early in the 1980's, a deficit. There won't be any Trust Fund. So you really have about three different answers. You can either do as I recommended, which I think is the honest and straightforward approach, to say that we have got to increase the taxes three-tenths of one percent on or one-sixth of one percent on the employer and the employee. GERALD so President Gerald Ford Mary E. Sawyer Auditorium LaCrosse, Wisconsin March 27, 1976 94th Congress, 2d Session - - - House Document No. 94-363 IMPROVING PROGRAMS FOR THE ELDERLY MESSAGE FROM THE PRESIDENT OF THE UNITED STATES TRANSMITTING PROPOSALS FOR IMPROVEMENTS IN PROGRAMS SERVING THE ELDERLY FEBRUARY 9, 1976.-Message referred to the Committee on Ways and Means and ordered to be printed U.S. GOVERNMENT PRINTING OFFICE 57-011 WASHINGTON : 1976 FORD R. GERALD LIBRARY To the Congress of the United States: I ask the Congress to join with me in making improvements in pro- grams serving the elderly. As President, I intend to do everything in my power to help our nation demonstrate by its deeds a deep concern for the dignity and worth of our older persons. By SO doing, our nation will continue to benefit from the contributions that older persons can make to the strengthening of our nation. The proposals being forwarded to Congress are directly related to the health and security of older Americans. Their prompt enactment will demonstrate our concern that lifetimes of sacrifice and hard work conclude in hope rather than despair. The single greatest threat to the quality of life of older Americans is inflation. Our first priority continues to be the fight against inflation. We have been able to reduce by nearly half the double digit inflation experienced in 1974. But the retired, living on fixed incomes, have been particularly hard hit and the progress we have made in reducing infla- tion has not benefited them enough. We will continue our efforts to re- duce federal spending, balance the budget, and reduce taxes. The par- ticular vulnerability of the aged to the burdens of inflation, however, requires that specific improvements be made in two major Federal programs, Social Security and Medicare. We must begin by insuring that the Social Security system is beyond challenge. Maintaining the integrity of the system is a vital obligation each generation has to those who have worked hard and contributed to it all their lives. I strongly reaffirm my commitment to a stable and financially sound Social Security system. My 1977 budget and legisla- tive program include several elements which I believe are essential to protect the solvency and integrity of the system. First, to help protect our retired and disabled citizens against the hardships of inflation, my budget request to the Congress includes a full cost of living increase in Social Security benefits. to be effective with checks received in July 1976. This will help maintain the pur- chasing power of 32 million Americans. Second, to insure the financial integrity of the Social Security trust funds, I am proposing legislation to increase payroll taxes by three- tenths of one percent each for employees and employers. This increase will cost no worker more than $1 a week, and most will pay less. These additional revenues are needed to stabilize the trust funds so that cur- rent income will be certain to either equal or exceed current outgo. Third, to avoid serious future financing problems I will submit later this year a change in the Social Security laws to correct a serious flaw in the current system. The current formula which determines benefits for workers who retire in the future does not properly reflect wage and price fluctuations. This is an inadvertent error which could lead to unnecessarily inflated benefits. (1) H.D. 363 2 3 The change I am proposing will not affect cost of living increases The savings from placing a limit on increases in medicare payment in benefits after retirement, and will in no way alter the benefit levels rates and some of the revenue from increased cost sharing will be used of current recipients. On the other hand, it will protect future gen- to finance the catastrophic illness program. erations against unnecessary costs and excessive tax increases. I feel that, on balance, these proposals will provide our elder citi- I believe that the prompt enactment of all of these proposals is zens with protection against catastrophic illness costs, promote efficient necessary to maintain a sound Social Security system and to preserve utilization of services, and moderate the increases in health care costs. its financial integrity. The legislative proposals which I have described are only part of Income security is not our only concern. We need to focus also on the over-all effort we are making on behalf of older Americans. Cur- the special health care needs of our elder citizens. Medicare and other rent conditions call for continued and intensified action on a broad Federal health programs have been successful in improving access front. to quality medical care for the aged. Before the inception of Medicare We have made progress in recent years. We have responded, for and Medicaid in 1966, per capita health expenditures for our aged example, to recommendations made at the 1971 White House Confer- were $445 per year. Just eight years later, in FY 1974, per capita health ence on Aging. A Supplemental Security Income program was en- expenditures for the elderly had increased to $1218, an increase of 174 acted. Social Security benefits have been increased in accord with percent. But despite the dramatic increase in medical services made increases in the cost of living. The Social Security retirement test was possible by public programs, some problems remain. liberalized. Many inequities in payments to women have been elimi- There are weaknesses in the Medicare program which must be cor- nated. The 35 million workers who have earned rights in private pen- rected. Three particular aspects of the current program concern me 1) sion plans now have increased protection. its failure to provide our elderly with protection against catastrophic In addition we have continued to strengthen the Older Americans illness costs, 2) the serious effects that health care cost inflation is Act. I have supported the concept of the Older Americans Act since having on the Medicare program, and 3) lack of incentives to en- its inception in 1965, and last November signed the most recent courage efficient and economical use of hospital and medical services. amendments into law. My proposal addresses each of these problems. A key component of the Older Americans Act is the national net- In my State of the Union Message I proposed protection against work on aging which provides a solid foundation on which action can catastrophic health expenditures for Medicare beneficiaries. This will be based. I am pleased that we have been able to assist in setting up be accomplished in two ways. First, I propose extending Medicare this network of 56 State and 489 Area Agencies on Aging, and 700 benefits by providing coverage for unlimited days of hospital and local nutrition agencies. These local nutrition agencies for example skilled nursing facility care for beneficiaries. Second, I propose to provide 300,000 hot meals a day five days a week. limit the out-of-pocket expenses of beneficiaries, for covered services, The network provides a structure which can be used to attack other to $500 per year for hospital and skilled nursing services and $250 important problems. A concern of mine is that the voice of the elderly, per year for physician and other non-institutional medical services. as consumers, be heard in the governmental decision-making process. This will mean that each year over a billion dollars of benefit pay- The network on aging offers opportunities for this through member- ments will be targeted for handling the financial burden of prolonged ship on advisory councils related to State and Area Agencies on Aging, illness. Millions of older persons live in fear of being stricken by an Nutrition Project Agencies and by participation in public hearings on illness that will call for expensive hospital and medical care over a the annual State and Area Plans. Such involvement can and will have long period of time. Most often they do not have the resources to pay a significant impact on determining what services for the aging are to the bills. The members of their families share their fears because they be given the highest priorities at the local level. also do not have the resources to pay such large bills. We have been The principle goal of this National Network on Aging is to bring talking about this problem for many years. We have it within our into being coordinated comprehensive systems for the provision of power to act now SO that today's older persons will not be forced to service to the elderly at the community level. I join in the call for hard live under this kind of a shadow. I urge the Congress to act promptly. and creative work at all levels-Federal, State and Area in order to Added steps are needed to slow down the inflation of health costs achieve this objective. I am confident that progress can be made. and to help in the financing of this catastrophic protection. There- Toward this end, the Administration on Aging and a number of fore, I am recommending that the Congress limit increases in medicare Federal Departments and agencies have signed agreements which will payment rates in 1977 and 1978 to 7% a day for hospitals and 4% for help to make available to older persons a fair share of the Federal physician services. funds available in such areas as housing, transportation, social serv- Additional cost-sharing provisions are also needed to encourage ices, law enforcement. adult education and manpower--resources economical use of the hospital and medical services included under which can play a major role in enabling older persons to continue to live in their own homes. Medicare. Therefore, I am recommending that patients pay 10% of hospital and nursing home charges after the first day and that the Despite these efforts. however, five percent of our older men and existing deductible for medical services be increased from $60 to $77 women require the assistance provided by skilled nursing homes and annually. other long term care facilities. To assist these citizens, an ombudsman GRAPY H.D. 363 H.D. 363 4 process, related solely to the persons in these facilities, is being put into operation by the National Network on Aging. We believe that this pro- gram will help to resolve individual complaints, facilitate important citizen involvement in the vigorous enforcement of Federal, State and local laws designed to improve health and safety standards, and to improve the quality of care in these facilities. Today's older persons have made invaluable contributions to the strengthening of our nation. They have provided the nation with a vision and strength that has resulted in unprecedented advancements in all of the areas of our life. Our national moral strength is due in no small part to the significance of their contributions. We must continue and strengthen both our commitment to doing everything we can to respond to the needs of the elderly and our determination to draw on their strengths. Our entire history has been marked by a tradition of growth and progress. Each succeeding generation can measure its progress in part by its ability to recognize, respect and renew the contributions of ear- lier generations. I believe that the Social Security and Medicare im- provements I am proposing, when combined with the action programs under the Older Americans Act, will insure a measure of progress for the elderly and thus provide real hope for us all. GERALD R. FORD. THE WHITE HOUSE, February 9, 1976. H.D. 363 94th Congress, 2d Session - House Document No. 94-383 Feb 26, 1976 FINANCIAL ASSISTANCE FOR HEALTH CARE MESSAGE FROM THE PRESIDENT OF THE UNITED STATES URGING ENACTMENT OF LEGISLATION TO REFORM FEDERAL HEALTH CARE PROGRAMS FEBRUARY 26, 1976.-Message referred to the Committee on Interstate and Foreign Commerce and ordered to be printed U.S. GOVERNMENT PRINTING OFFICE 57-011 WASHINGTON : 1976 SEHALD R. FORD LIBRARY 00 To the Congress of the United States The health of our people is one of our Nation's most vital resources. Significant progress has been made in improving the health of the Nation's people during the last 25 years, as can be seen in the reductions in the infant mortality rate, increases in life expectancy, and the con- quering of some communicable diseases. This progress has come under a largely private health care system with the support of public funds. In the past 10 year period (1965-1975) Federal spending for health has increased from $5 billion to $37 billion. With greater Federal funding has come a multitude of Federal programs, regulations and restrictions-all motivated by the best of intentions but each adding to the confusion and overlap and inequity that now characterizes our efforts at the national level. Today I am proposing to the Congress legislation that addresses these problems. I am asking Congress to enact the Financial Assist- ance for Health Care Act which will consolidate Medicaid and 15 categorical Federal health programs into a $10 billion block grant to the States. I am proposing that future Federal funding for this new program be increased annually in increments of $500 million plus the amounts needed after 1980 to ensure that no State will in the future receive less under this proposal than it received in fiscal year 1976. The Financial Assistance for Health Care proposal is being sub- mitted after extensive consultation with organizations representing the publicly elected officials who will be responsible for administering the program. I believe this proposal represents a major step toward overcoming some of the most serious defects in our present system of Federal financing of health care. My proposal is designed to achieve a more equitable distribution of Federal health dollars among States and to increase State control over health spending. My proposal also recognizes the appropriate Federal role in providing financial assistance to State and local gov- ernments to improve the quality and distribution of health services. The enactment of this legislation will achieve a more equitable dis- tribution of Federal health dollars by providing funds according to a formula giving primary weight to a State's low-income population. The formula also takes into account the relative "tax effort" made by a State and the per capita income of that State. Let me emphasize that every State will receive more Federal funds in fiscal years 1977, 1978 and 1979 under the block grant than it re- ceived in fiscal year 1976. My proposal also allows for a gradual phase-in of the distribution formula in future years to ensure a sys- tematic, orderly transition that will permit States to adjust to the new program. To assure accountability and responsiveness to the public, my pro- posal requires each State to develop an annual health care plan as a condition to receiving Federal funds. This plan will be developed (1) H.D. 383 2 3 through a Statewide public review and comment process which will as- needed now. The Medicare Improvements of 1976 that I recommended sure participation by all concerned parties. Thus, increased State re- to the Congress on February 11 also represents a balanced response to sponsibility will be coupled with expanded public participation, and needed program reforms. This proposal is designed to improve cata- accountability in the development of State health policies. strophic health cost protection for our aged and disabled, restrain cost This proposed consolidation of health programs is essential to con- increases in the Medicare program and provide training for the hos- tinue our national progress in the field of health. It is designed to per- pital insurance trust fund. mit States greater flexibility in providing for delivery of health care I request that the Congress give both these measures the earliest services to those with low income. It eliminates the requirements for possible consideration. State matching. And it recognizes the need for a cooperative relation- GERALD R. FORD. ship among governments at all levels. My proposal would reduce Fed- THE WHITE HOUSE, February 25, 1976. eral red tape, increase local control over health spending, and expand public participation in health planning. While I am proposing to increase State control over health spending, we will continue to concentrate our efforts in areas of appropriate Fed- eral responsibility. For example, my budget proposals for 1977 include the following: In food and drug safety, I have asked for $226 million in 1977, an increase of $17 million, to enable further progress in priority areas; In the area of drug abuse prevention, I propose almost $500 mil- lion for prevention and treatment to expand national drug abuse treatment capacity to meet the current need; My budget requests more than $3 billion for health research, in- cluding continued support of major national efforts in cancer and heart disease research and support for new scientific opportuni- ties in the fields of environmental health, aging, and immunology In our effort to improve the training and utilization of doctors and other health professionals, I have requested new legislation and funding of $319 milloin, designed to concentrate on the prob- lems of geographic and specialty maldistribution of health professionals; To assist local communities to attract physicians, dentists and other health professionals to underserved areas, I am proposing to expand the National Health Service Corps demonstration pro- gram 38 percent from $18 million to $25 million. To assist the development of a strong health maintenance al- ternative, I have directed HEW to move rapidly in administering the dual option provisions of the HMO Act. And, to complete the 5-year effort to demonstrate and test the health maintenance or- ganization concept, I have requested an additional year's authori- zation for new commitments. As of last June, there were 10 health maintenance organizations certified through the dual option provisions; To provide improved health services to American Indians and Alaska Natives, I am asking for $355 million. Spending by the Indian Health Service alone in 1977 will result in over $685 per beneficiary, or over $2,740 per Indian family of four; In the area of veterans' health care, I have requested $4.5 billion to assure continued quality care by providing for increases in medical staff and research related to VA health care delivery. GEHALD H. FORD A realistic assessment of the present health care programs and the responsibilities of Federal, State, and local governments fully demon- strates that the reforms I am proposing in Federal health care are LIBRARY H.D. 383 H.D. 383