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Ford Press Releases - Medicare, 1965-1966
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The original documents are located in Box D8, folder "Ford Press Releases - Medicare,
1965-1966" of the Ford Congressional Papers: Press Secretary and Speech File 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. The Council donated to the United
States of America his copyrights in all of his unpublished writings in National Archives collections.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.
Digitized from Box D8 of The Ford Congressional Papers: Press Secretary and Speech File at the Gerald R. Ford Presidential Library
Memo:
REP. JOHN W. BYRNES
8TH DISTRICT, WISCONSIN
HOUSE OF REPRESENTATIVES
February 2, 1965
WASHINGTON 25, D.C.
HEALTH CARE FOR AGED I outlined, at a press conference in the Capitol last week, a
proposal for a national health insurance plan for persons aged 65 and over. Legislation
embodying the plan is now being drafted and I will introduce the bill on my own behalf
and on behalf of the majority of the Republican members of the Ways and Means Committee
and with the support of the House Republican leadership. The plan is the result of long
study and consideration of the problems our elder citizens encounter in financing compre-
hensive medical care. It is advanced as an alternative to the Administration's Medicare
proposal under Social Security, a plan I consider inequitable, inadequate and a danger
to the future of the Social Security System.
HOW IT WOULD WORK Under my proposal, all persons over 65 would be eligible for
health insurance which would provide comprehensive medical, hospital, surgical and
nursing home benefits comparable to those now provided for federal employees. En-
rollment would be voluntary. Part of the cost of the plan would be borne by the
beneficiaries through payment of contributions based upon ability to pay (with
Social Security benefits used as a guide). The remainder would be paid by the fed-
eral government out of general revenues. States could contribute by insuring as
groups the medically indigent who are now receiving public assistance funds for
medical care. The health insurance fund would be administered by the Treasury;
payment of benefits from the fund would be the responsibility of the Surgeon Gener-
al who would contract with service agencies (such as Blue Cross) to handle this ad-
ministrative chore. (I will be glad to send complete details to those who are in-
terested.)
CONTRAST ... The plan is vastly different - in philosophy, in impact and in principle -
from the Administration's Medicare plan. It overcomes the deep-seated, basic objections
which many of us have had to that proposal:
COVERAGE The Administration' plan is compulsory; this plan is voluntary; it
preserves the right of choice Medicare restricts coverage; some groups are not
eligible; this plan is open to everyone.
BENEFITS In order to hold lown the payroll tax it requires, Medicare provides
inadequate benefits generally imited to hospital and nursing home care. This plan
provides the kind of comprehensive benefits which the Administration program would
eventually have to provide if it is to truly meet the medical needs of our elder
citizens. Included are hospital and nursing home care, medical services, surgery
and physician's fees, patterned after the federal employee program.
FINANCING ... Medicare's financing is inequitable and dangerous. It would be paid for
by a payroll tax upon the lowest wage levels - with the income being used to pay for
benefits of another group. This is tax regression with a vengeance. The plan I propose
would be financed by the contributions of those who participate and by federal funds de-
rived from taxes based upon ability to pay Medicare, moreover, would push the payroll
tax up to the limits of acceptability. Since Social Se-
curity is also financed by payroll taxes, future adjust-
ments in benefit levels for retirement, death and dis-
ability would be endangered. Finally, Medicare would
establish a bureaucracy under Social Security with the
dangers of government control over Medicare. This plan
John
minimizes government administration.
(Not printed at Government expense)
Congressional Record
United States
PROCEEDINGS
AND
DEBATES
OF
THE
89th
CONGRESS,
FIRST
SESSION
of America
COMPREHENSIVE HEALTH PLAN
REMARKS
In summary, the administration's
DESCRIPTION OF COMPREHENSIVE HEALTH
medicare proposal is unsound and
INSURANCE BILL
OF
dangerous. Its enactment would start
SUMMARY OF BENEFITS
HON. JOHN W. BYRNES
us down a path from which there is no
The program will provide for com-
returning-the path toward regimented
prehensive health insurance equivalent
OF WISCONSIN
and deteriorating medical care. We
to the medical services available to Gov-
IN THE HOUSE OF REPRESENTATIVES
propose a solution which we believe is
ernment employees under the high op-
Thursday, February 4, 1965
typically American-comprehensive, fair,
tion of the Governmentwide indemnity
voluntary, and oriented to individual
plan, modified in order to meet the spe-
Mr. BYRNES of Wisconsin. Mr.
freedom and initiative. This is the way
cial needs of the aged.
Speaker, I am today introducing a bill
to meet the urgent needs of our elder citi-
The benefits under the program will
to provide for comprehensive health in-
zens in the financing of medical care.
greatly exceed the benefits provided for
surance for all persons aged 65 and over
In brief outline, the plan would work
in the King-Anderson bill (H.R. 1). The
on a uniform basis throughout the Unit-
as follows:
program provides for full coverage of the
ed States. The cost of the program will
All persons aged 65 or over would be
first $1,000 of hospital-or nursing
be shared by the individual participants
eligible, on a uniform basis, for insur-
home-room and board plus 80 percent
and the Federal Government. The pro-
ance protection equivalent to the Gov-
of any balance. This is the equivalent
gram will be entirely voluntary.
ernment-wide indemnity benefit plan.
to 50 days in the hospital or 100 days of
I am happy to state that joining me to-
Their participation would be voluntary;
a qualified nursing home without a de-
day in the introduction of identical bills
there would be no means test. Enroll-
ductible.
are Hon. JAMES B. UTT, of California;
ment would be during an initial enroll-
In addition, the program provides for
Hon. JACKSON E. BETTS, of Ohio; Hon.
ment period, followed by periodic enroll-
80 percent of all other hospital, surgical,
HERMAN T. SCHNEEBELI, of Pennsylvania;
ment periods.
and medical expenses, after a deductible
Hon. HAROLD R. COLLIER, of Illinois; Hon.
For those under social security-or
of $50, of which only $25 will apply to
MELVIN R. LAIRD, of Wisconsin; Hon. BEN
railroad retirement-enrollment would
other hospital charges. This includes
REIFEL, of South Dakota; Hon. WILLIAM
be exercised by an assignment of a
professional services of doctors, such as
L. DICKINSON, of Alabama.
premium contribution to be taken out of,
surgery, consultations, and home, office,
The plan will more adequately meet
or checked off, the individual's current
and hospital calls, professional services
the medical needs of the aged than the
social security benefit. Those not under
of registered nurses, diagnostic services,
administration's medicare proposal. It
social security would execute an applica-
rental of medical equipment, ambulance
will be more equitable. It will not en-
tion accompanying it with their initial
service, and prescribed drugs and
danger the soundness of the social se-
premium contribution. State agencies
medicines.
curity system. It will be voluntary in-
would be granted an option to purchase
The program covers the catastrophic
stead of compulsory.
the insurance for their old-age assist-
illness, with up to $40,000 in benefits.
The administration plan is generally
ance and medical assistance for the
No longer will the life savings of an el-
limited to hospital and nursing home ex-
aged recipients at a group rate.
derly person be wiped out because of a
penses. This plan will cover both hos-
Premium contributions by individuals
major illness.
pital and nursing home care and surgical
would be based upon the cash benefits
The program will pay the actual
and medical expenses. It is both com-
which they would either receive, or be
charges for the service, subject to the
prehensive in scope and comprehensive
entitled to receive, upon reaching age 65.
reasonable and customary test used by
in effect. It will cover up to $40,000 of
The premium would be 10 percent of the
private insurers.
expenses.
minimum social security benefit and 5
Except for the liberalization of the
The administration plan is compulsory.
percent of the balance. Those receiving
coverage of hospital room and board to
This plan is voluntary and every citizen
the lowest social security benefits would
include nursing homes, the program is in
over 65, without a means test, will be
pay the least. The average premium
all respects identical to the high option
eligible for coverage under it.
contribution on the basis of today's ben-
of the governmentwide indemnity plan
The administration plan is inequitable.
efit levels would be $6 per month per
offered to Federal employees. This
It requires wage earners to pay a regres-
person. Persons not under social secu-
means that an individual can undergo
sive payroll tax chargeable to the lowest
rity would pay a premium equivalent to
major surgery and have paid in full the
levels of income to provide medical bene-
the maximum contribution of an indi-
first $1,000 of hospital room and board
fits for others-a tax misleadingly justi-
vidual under social security. The re-
plus 80 percent of all other hospital and
fied on the basis that workers are prepay-
mainder of the cost of the insurance
medical expense incident to that opera-
ing for their own care. This plan will
would be paid by the Federal Govern-
tion after a deductible of not more than
mainly be financed from two sources-
ment out of general revenues.
$50. In addition, the program will cover
the beneficiaries themselves based upon
Benefits would be paid out of a na-
80 percent of all posthospital medical ex-
their ability to pay, and by the Federal
tional health insurance fund. The fund
pense after the deductible of $50 has
Government through general revenues
would receive as deposits the contribu-
been exceeded by prior expense, includ-
derived from taxes collected on the same
tions of individuals, contributions from
ing the $25 deductible applicable to the
principle. In addition, provision will be
the social security system and Railroad
hospital charges.
made for the States to share in financ-
Retirement Board on behalf of indi-
METHOD OF FINANCING
ing full participation for the medically
viduals covered under those systems,
indigent.
State contributions for OAA and MAA
The program would be financed by a
recipients, and annual appropriations
graduated premium contribution by the
The administration plan endangers
the adequacy of retirement, death, and
from the Federal Treasury. The Secre-
individual participants based on ability
disability benefits under the social secu-
tary of the Treasury would administer
to pay, supplemented by an annual ap-
rity system by pushing the regressive
the fund. The insurance program
propriation from the general revenues.
would be administered by the Depart-
By including a contribution or pre-
payroll tax to the limits of acceptability.
ment of Health, Education, and Wel-
mium charge, the cost of the program is
The insurance concept of this plan, its
fare, which would be charged with gen-
shared by those who receive the benefits
method of financing, and its administra-
tion are completely independent of the
eral administration, recordkeeping, and
and by the Government.
social security system. Social security
so forth, but would not process the claims
Unlike the King-Anderson bill, the
benefits are used merely as a test of abil-
or bills of hospitals, physicians, and the
program does not rely upon a regressive
1ty to pay the individual contribution.
like. The Surgeon General would con-
payroll tax for financing. The program
The social security system's only in-
tract with private agencies-Blue Cross-
thus avoids the dangerous fiction inher-
Blue Shield, for example-which would
ent in the King-Anderson bill that,
volvement is the assignment of a speci-
process and pay the claims of those
through the use of a payroll tax, today's
fied percentage of an individual's social
furnishing services and would then be
workers and their employers are prepay-
security benefits to a health insurance
fund administered by the Secretary of
reimbursed from the national health in-
ing the cost of health protection for their
surance fund.
later years. The fact is that the regres-
the Treasury.
CONGRESSIONAL RECORD
sive payroll tax will be financing the cost
For a couple receiving the maximum
The Office of the Surgeon General will
of medicare for those currently over 65.
social security benefit-currently $190-
be charged with the administration of
Under our program, the Government's
the cost of the insurance will be $11.50
the benefit provisions of the program.
share of this cost will be paid from the
per month. A couple receiving the mini-
The Surgeon General will utilize estab-
general funds of the Government.
mum social security benefit-currently
lished health insurance organizations to
ELIGIBILITY FOR COVERAGE
$60-will be able to buy the same health
process the claims-bills-of the hos-
All persons upon attaining age 65 will
insurance at a cost of $5 per month. The
pitals, physicians, and other organiza-
amount of the Government subsidy thus
be eligible for coverage on a voluntary
tions rendering the service. Payment for
varies with the economic status of the
basis. Following enactment of the pro-
health service will be processed in the
gram, there will be a 6-month enrollment
individual, as measured by social secu-
same manner as a charge presently cov-
rity benefits.
period during which all persons 65 years
ered by Blue Cross-Blue Shield or a
of age and over will be eligible to elect
At the conference on the social secu-
private insurer. The hospital, physician,
to participate. Thereafter, there will be
rity amendments bill of 1964, it was vir-
and the like will send their bills to the
periodic enrollment periods. All per-
tually agreed that OASI cash benefits
accredited health organization desig-
sons upon reaching age 65 will have 7
should be increased by 7 percent with a
nated to process claims. After the cus-
months within which to elect to partici-
minimum increase of $5 per month. We
tomary verification, such organization
can assume that an increase will be en-
will pay the charge. The paying organi-
pate.
Under the King-Anderson bill, all per-
acted this year at least equal in amount.
zation will then be reimbursed by the
sons aged 65 and over—except Federal
This will provide the OASI beneficiaries
Treasury for the charges paid together
employees-are automatically covered
with additional funds required to par-
with an agreed upon fee or handling
regardless of their wishes in the matter.
ticipate in the insurance program.
charge.
This results in the inclusion of persons
Persons who are not under social secu-
Examples showing comparable benefits under
opposed to such coverage, for example,
rity may participate by a premium con-
King-Anderson bill (H.R. 1) and under
the Amish, Christian Scientists, as well
tribution equal in amount to the maxi-
this program
as those already covered by group insur-
mum contribution of those eligible under
CASE A-HOSPITAL
social security. Where payment of the
Amount
ance programs.
Hospital room and board
$441
The voluntary concept avoids excess
premium would represent an undue
Hospital ancillary charges
353
coverage. Since there is a cost to the
hardship, such as in the case of a per-
Surgeon and anesthetist
260
insured, those who already have ade-
son under old-age assistance, the in-
Other physicians
200
quate programs paid for by their former
dividual could be included under the
Private duty nurse
85
employers or through associations and
group buy-in option extended to the
Out-of-hospital drugs
75
the like, may decide not to participate in
States.
Other expense
15
the Government-sponsored program.
The insurance concept is completely
Total medical expense
The automotive workers, the chemical
independent of the social security sys-
1,429
Recovery under King-Anderson bill
-754
workers, and other large industrial
tem. Social security benefits are used
groups, have fully paid comprehensive
merely as a test of ability to pay in deter-
Cost to insured under King-
health plans for retired workers. To the
mining the amount of the individual con-
Anderson bill
675
extent that these do not participate, the
tribution. The assignment of a predeter-
Additional recovery under this pro-
cost to the Government is reduced.
mined percentage of these benefits to the
gram
438
MANNER OF ELECTION
health insurance fund is the only rela-
tionship of the program to the OASDI
Cost to insured under this pro-
For those under social security-or
gram
237
railroad retirement-the election will be
system.
exercised by authorizing a "check-off"
PARTICIPATION BY STATE AGENCIES-GROUP
CASE
NONHOSPITAL
BUY-IN OPTION
or assignment of the prescribed premium
Surgery
10
contribution out of the individual's cur-
State agencies will have the option to
Nonhospital physician visits
120
purchase the plan benefits for their old-
Nonhospital nurse visits
8
rent monthly social security benefit. An
election by those not under social se-
age assistance-OAA-and medical as-
Prescribed drugs
94
sistance for the aged-MAA-recipients
Other nonhospital care
18
curity-or railroad retirement-will be
evidenced by execution of an application
at a group rate equivalent to the weighted
Total medical expense
250
for participation in the program and the
average rate applicable to the social se-
Recovery under King-Anderson bill
0
payment of premium contributions.
curity beneficiaries, which is presently
about $6 per month.
Cost to insured under King-
BASIS FOR PREMIUM CONTRIBUTIONS
The program preserves fully the role
Anderson bill
250
The premium contributions by the par-
of the States in providing for those who
Additional recovery under this pro-
ticipants are graduated according to abil-
gram
are in need. The State agency will have
160
ity to pay as evidenced by their old-age
considerable flexibility in meeting the
insurance benefit. The premium is an
Cost to insured under this pro-
requirements of these groups. If the in-
amount equal to 10 percent of the mini-
gram
90
dividual is a social security beneficiary,
mum cash benefit of a primary benefi-
presumably the State would require the
ciary-currently $40 per month-plus 5
individual to elect the benefits through
percent of the additional cash benefit
the assignment of social security benefits
payable to the primary beneficiary and
and increase the individual's old-age as-
his spouse-if over age 65. This will re-
sistance cash allowance to make up the
PUBLIC BILLS AND RESOLUTIONS
sult in an average premium contribution
difference. Other recipients of State aid
Under clause 4 of rule XXII, public
of $6 per month per person.
could be blanketed in at the group rate.
bills and resolutions were introduced and
If an individual otherwise entitled to
receive cash benefits under social se-
Thus, while the individual contribu-
severally referred as follows:
curity is ineligible for such benefits-or
tions will vary, all persons over 65 will
such benefits are reduced-on account of
be eligible for the identical comprehen-
By Mr. BYRNES of Wisconsin:
the earnings test, this will not affect the
sive protection. No distinction is made
H.R. 4351. A bill to establish a program of
individual's contribution. The amount
between the person covered on an indi-
voluntary coomprehensive health insurance
vidual basis, the recipient of OAA or the
for all persons aged 65 or over; to the Com-
of the individual's contribution will be,
paid by the Social Security Administra-
recipient of MAA.
mittee on Ways and Means.
tor to the insurance program irrespec-
ADMINISTRATION OF PROGRAM
tive of earnings. To this extent, there
is an automatic liberalization of the
There will be established a national
earnings test.
health insurance fund. The fund will be
At the existing level of social security
administered by the Secretary of the
cash benefits, the premium contributions
Treasury. Premium contributions of the
required for select benefit levels would
individual participants will be deposited
be as follows:
directly to the credit of the fund. An
appropriation will be made annually to
Monthly benefit of aged family unit and
provide for the additional amount re-
monthly health contribution
quired by the fund in order to finance
$40 (single worker)
$4.00
benefits for the ensuing benefit period.
$60
5.00
875
5.75
The general administration of the in-
$105
7.25
surance program will be entrusted to the
$150
9.50
Department of Health, Education, and
$190
11.50
Welfare. That Department will be
1 Present monthly minimum of $40 for
charged with the responsibility of mak-
worker and $20 for wife.
ing known the program to those pres-
2 Present monthly maximum of $127 for
ently over age 65; notifying those reach-
worker and $63 for wife.
ing age 65 in the future of their rights
Railroad retirement contributions
to participate; maintaining records; pre-
would be based upon the same formula as
paring actuarial studies; and presenting
the social security contributions, up to
the appropriation requests for the pro-
the maximum payable by social security
gram to the committees of the Con-
participants.
gress, and so forth.
(Not printed at Government expense)
Congressional Record
United States
of America
PROCEEDINGS AND DEBATES OF THE
89th
CONGRESS, FIRST SESSION
COMPREHENSIVE
HEALTH
CARE
PLAN
In summary, the administration's
DESCRIPTION OF COMPREHENSIVE HEALTH
REMARKS
medicare proposal is unsound and
INSURANCE BILL
OF
dangerous. Its enactment would start
SUMMARY OF BENEFITS
HON. JOHN W. BYRNES
us down a path from which there is no
The program will provide for com-
returning-the path toward regimented
prehensive health insurance equivalent
OF WISCONSIN
and deteriorating medical care. We
to the medical services available to Gov-
IN THE HOUSE OF REPRESENTATIVES
propose a solution which we believe is
ernment employees under the high op-
Thursday, February 4, 1965
typically Ameriçan-comprehensive, fair,
tion of the Governmentwide indemnity
voluntary and oriented to individual
plan, modified in order to meet the spe-
Mr. BYRNES of Wisconsin. Mr.
freedom and initiative. This is the way
cial needs of the aged.
Speaker, I am today introducing a bill
to meet the urgent needs of our elder citi-
The benefits under the program will
to provide for comprehensive health in-
zens in the financing of medical care.
greatly exceed the benefits provided for
surance for all persons aged 65 and over
In brief outline, the plan would work
in the King-Anderson bill (H.R. 1). The
on a uniform basis throughout the Unit-
as follows:
program provides for full coverage of the
ed States. The cost of the program will
All persons aged 65 or over would be
first $1,000 of hospital-or nursing
be shared by the individual participants
eligible, on a uniform basis, for insur-
home-room and board plus 80 percent
and the Federal Government. The pro-
ande protection equivalent to the Gov-
of any balance. This is the equivalent
gram will be entirely voluntary.
ernment-wide indemnity benefit plan.
to 50 days in the hospital or 100 days of
I am happy to state that joining me to-
Their marticipation would be voluntary;
a qualified nursing home without a de-
day in the introduction of identical bills
there be no means test. Enroll-
ductible.
are Hon. JAMES B. UTT, of California,
ment would be during an initial enroll-
In addition, the program provides for
Hon. JACKSON E. BETTS, of Ohio; Hon.
ment period, llowed by periodic enroll-
80 percent of all other hospital, surgical,
HERMAN T. SCHNEEBELI, of Pennsylvania;
ment periods.
and medical expenses, after a deductible
Hon. HAROLD R. COLLIER, of Illinois; Hon.
For under social security-or
of $50, of which only $25 will apply to
MELVIN R. LAIRD, of Wisconsin; Hon. BEN
railroad retirement-enrollment would
other hospital charges. This includes
REIFEL, of South Dakota; Hon. WILLIAM
be exercised by an assignment of a
professional services of doctors, such as
L. DICKINSON, of Alabama.
premium contr to be taken out of,
surgery, consultations, and home, office,
The plan will more adequately me
or checked off, the individual's current
and hospital calls, professional services
the medical needs of the aged than the
social security benefit. Those not under
of registered nurses, diagnostic services,
administration's medicare proposal. It
social security would execute an applica-
rental of medical equipment, ambulance
will be more equitable. It will not en-
tion accompa it with their initial
service, and prescribed drugs and
danger the soundness of the social se-
premium contribution. State agencies
medicines.
curity system. It will be voluntary in-
would be granted an option to purchase
The program covers the catastrophic
stead of compulsory.
the insurance for their old-age assist-
illness, with up to $40,000 in benefits.
The administration plan is generally
ance and medical assistance for the
No longer will the life savings of an el-
limited to hospital and nursing home ex-
aged recipients.at a group rate.
derly person be wiped out because of a
penses. This plan will cover both hos-
Premium contributions by individuals
major illness.
pital and nursing home care and surgical
would be based upon the cash benefits
The program will pay the actual
and medical expenses. It is both com-
ich they would either receive, or be
charges for the service, subject to the
prehensive in scope and comprehensive
en itled to receive, upon reaching age 65.
reasonable and customary test used by
in effect. It will cover up to $40,000 of
The premium would be 10 percent of the
private insurers.
expenses.
minimum social security benefit and 5
Except for the liberalization of the
The administration plan is compulsory.
percent of the balance. Those receiving
coverage of hospital room and board to
This plan is voluntary and every citizen
the lowest social security benefits would
include nursing homes, the program is in
over 65, without a means test, will be
pay the least. The average premium
all respects identical to the high option
eligible for coverage under it.
contribution on the basis of today's ben-
of the governmentwide indemnity plan
The administration plan is inequitable.
efit levels would be $6 per month per
offered to Federal employees. This
It requires wage earners to pay a regres-
person. Persons not under social secu-
means that an individual can undergo
sive payroll tax chargeable to the lowest
rity would a premium equivalent to
major surgery and have paid in full the
levels of income to provide medical bene-
the maximum ribution of an indi-
first $1,000 of hospital room and board
fits for others-a tax misleadingly justi-
vidual under social security. The re-
plus 80 percent of all other hospital and
fied on the basis that workers are prepay-
mainder of the cost of the insurance
medical expense incident to that opera-
ing for their own care. This plan will
would be paid by the Federal Govern-
tion after a deductible of not more than
mainly be financed from two sources-
ment out of general rev nues.
$50. In addition, the program will cover
the beneficiaries themselves based upon
Benefits would be paid out of a na-
80 percent of all posthospital medical ex-
their ability to pay, and by the Federal
onal health insurance fund. The fund
pense after the deductible of $50 has
Government through general revenues
would receive as deposits the contribu-
been exceeded by prior expense, includ-
derived from taxes collected on the same
tior of individuals, contributions from
ing the $25 deductible applicable to the
principle. In addition, provision will be
the ocial security system and Railroad
hospital charges.
made for the States to share in financ-
Retirement Board on behalf of indi-
METHOD OF FINANCING
ing full participation for the medically
viduals covered under those systems,
indigent.
State contributions for OAA and MAA
The program would be financed by a
recipients, and annual appropriations
graduated premium contribution by the
The administration plan endangers
the adequacy of retirement, death, and
from the Federal Treasury. The Secre-
individual participants based on ability
disability benefits under the social secu-
of the Treasury would administer
to pay, supplemented by an annual ap-
rity system by pushing the regressive
the fund. The insurance program
propriation from the general revenues.
would be administered by the Depart-
By including a contribution or pre-
payroll tax to the limits of acceptability.
ment of Health, Education, and Wel-
mium charge, the cost of the program is
The insurance concept of this plan, its
fare, which would be charged with gen-
shared by those who receive the benefits
method of financing, and its administra
tion are completely independent of the
eral administration, recordkeeping, and
and by the Government.
social security system. Social security
so forth, but would not process the claims
Unlike the King-Anderson bill, the
benefits are used merely as a test of abil-
or bills of hospitals, physicians, and the
program does not rely upon a regressive
ity to pay the individual contribution.
like The Surgeon General would con-
payroll tax for financing. The program
The social security system's only in-
tract with private agencies-Blue Cross-
thus avoids the dangerous fiction inher-
Blue Shield, for example-which would
ent in the King-Anderson bill that,
volvement is the assignment of a speci-
process and pay the claims of those
through the use of a payroll tax, today's
fied percentage of an individual's social
furnishing services and would then be
workers and their employers are prepay-
security benefits to a health insurance
reimbursed from the national health in-
ing the cost of health protection for their
fund administered by the Secretary of
the Treasury.
surance fund,
later years. The fact is that the regres-
CONGRESSIONAL RECORD
sive payroll tax will be financing the cost
For a couple receiving the maximum
The Office of the Surgeon General will
of medicare for those currently over 65.
social security benefit-currently $190--
be charged with the administration of
Under our program, the Government's
the cost of the insurance will be $11.50
the benefit provisions of the program.
share of this cost will be paid from the
per month. A couple receiving the mini-
The Surgeon General will utilize estab-
general funds of the Government.
mum social security benefit-currently
lished health insurance organizations to
ELIGIBILITY FOR COVERAGE
$60-will be able to buy the same health
process the claims-bills-of the hos-
All persons upon attaining age 65 will
insurance at a cost of $5 per month. The
pitals, physicians, and other organiza-
amount of the Government subsidy thus
be eligible for coverage on a voluntary
tions rendering the service. Payment for
varies with the economic status of the
basis. Following enactment of the pro-
health service will be processed in the
gram, there will be a 6-month enrollment
individual, as measured by social secu-
same manner as a charge presently cov-
rity benefits.
period during which all persons 65 years
ered by Blue Cross-Blue Shield or a
of age and over will be eligible to elect
At the conference on the social secu-
private insurer. The hospital, physician,
to participate. Thereafter, there will be
rity amendments bill of 1964, it was vir-
and the like will send their bills to the
periodic enrollment periods. All per-
tually agreed that OASI cash benefits
accredited health organization desig-
sons upon reaching age 65 will have 7
should be increased by 7 percent with a
nated to process claims. After the cus-
months within which to elect to partici-
minimum increase of $5 per month. We
tomary verification, such organization
can assume that an increase will be en-
will pay the charge. The paying organi-
pate.
Under the King-Anderson bill, all per-
acted this year at least equal in amount.
zation will then be reimbursed by the
sons aged 65 and over-except Federal
This will provide the OASI beneficiaries
Treasury for the charges paid together
employees-are automatically covered
with additional funds required to par-
with an agreed upon fee or handling
regardless of their wishes in the matter.
ticipate in the insurance program.
charge.
This results in the inclusion of persons
Persons who are not under social secu-
Examples showing comparable benefits under
opposed to such coverage, for example,
rity may participate by a premium con-
King-Anderson bill (H.R. 1) and under
the Amish, Christian Scientists, as well
tribution equal in amount to the maxi-
this program
as those already covered by group insur-
mum contribution of those eligible under
CASE A-HOSPITAL
social security. Where payment of the
Amount
ance programs.
Hospital room and board
$441
The voluntary concept avoids excess
premium would represent an undue
Hospital ancillary charges
353
coverage. Since there is a cost to the
hardship, such as in the case of a per-
Surgeon and anesthetist
260
insured, those who already have ade-
son under old-age assistance, the in-
Other physicians
200
quate programs paid for by their former
dividual could be included under the
Private duty nurse
85
employers or through associations and
group buy-in option extended to the
Out-of-hospital drugs
75
the like, may decide not to participate in
States.
Other expense
15
the Government-sponsored program.
The insurance concept is completely
Total medical expense
429
The automotive workers, the chemical
independent of the social security sys-
Recovery under King-Anderson bill
-754
workers, and other large industrial
tem. Social security benefits are used
groups, have fully paid comprehensive
merely as a test of ability to pay in deter-
Cost to insured under King-
health plans for retired workers. To the
mining the amount of the individual con-
Anderson bill
675
extent that these do not participate, the
tribution. The assignment of a predeter-
Additional recovery under this pro-
cost to the Government is reduced.
mined percentage of these benefits to the
gram
438
MANNER OF ELECTION
health insurance fund is the only rela-
tionship of the program to the OASDI
Cost to insured under this pro-
For those under social security-or
gram
237
railroad retirement-the election will be
system.
exercised by authorizing a "check-off"
PARTICIPATION BY STATE AGENCIES-GROUP
CASE B-NONHOSPITAL
BUY-IN OPTION
or assignment of the prescribed premium
Surgery
10
contribution out of the individual's cur-
State agencies will have the option to
Nonhospital physician visits
120
purchase the plan benefits for their old-
Nonhospital nurse visits
8
rent monthly social security benefit. An
election by those not under social se-
age medical as-
Prescribed drugs
94
Other nonhospital care
curity-or railroad retirement-will be
sistance for the aged-MAA-recipients
18
evidenced by execution of an application
at a group rate equivalent to the weighted
Total medical expense
250
for participation in the program and the
average rate applicable to the social se-
Recovery under King-Anderson bill
0
payment of premium contributions.
curity beneficiaries, which is presently
BASIS FOR PREMIUM CONTRIBUTIONS
about $6 per month.
Cost to insured under King-
The program preserves fully the role
Anderson bill
250
The premium contributions by the par-
of the States in providing for those who
Additional recovery under this pro-
ticipants are graduated according to abil-
gram
are in need. The State agency will have
160
ity to pay as evidenced by their old-age
considerable flexibility in meeting the
insurance benefit. The premium is an
Cost to insured under this pro-
requirements of these groups. If the in-
amount equal to 10 percent of the mini-
gram
90
dividual is a social security beneficiary,
mum cash benefit of a primary benefi-
presumably the State would require the
ciary-currently $40 per month-plus 5
individual to elect the benefits through
percent of the additional cash benefit
the assignment of social security benefits
payable to the primary beneficiary and
and increase the individual's old-age as-
his spouse-if over age 65. This will re-
sistance cash allowance to make up the
PUBLIC BILLS AND RESOLUTIONS
sult in an average premium contribution
difference. Other recipients of State aid
Under clause 4 of rule XXII, public
of $6 per month per person.
could be blanketed in at the group rate.
bills and resolutions were introduced and
If an individual otherwise entitled to
receive cash benefits under social se-
Thus, while the individual contribu-
severally referred as follows:
curity is ineligible for such benefits-or
tions will vary, all persons over 65 will
such benefits are reduced-on account of
be eligible for the identical comprehen-
By Mr. BYRNES of Wisconsin:
the earnings test, this will not affect the
sive protection. No distinction is made
H.R. 4351. A bill to establish a program of
individual's contribution. The amount
between the person covered on an indi-
voluntary coomprehensive health insurance
vidual basis, the recipient of OAA or the
for all persons aged 65 or over; to the Com-
of the individual's contribution will be
recipient of MAA.
mittee on Ways and Means.
paid by the Social Security Administra-
tor to the insurance program irrespec-
ADMINISTRATION OF PROGRAM
tive of earnings. To this extent, there
is an automatic liberalization of the
There will be established a national
earnings test.
health insurance fund. The fund will be
At the existing level of social security
administered by the Secretary of the
cash benefits, the premium contributions
Treasury. Premium contributions of the
required for select benefit levels would
individual participants will be deposited
be as follows:
directly to the credit of the fund. An
appropriation will be made annually to
Monthly benefit of aged family unit and
monthly health contribution
provide for the additional amount re-
quired by the fund in order to finance
$40 (single worker)
$4.00
$60
benefits for the ensuing benefit period.
5.00
$75
5.75
The general administration of the in-
$105
7.25
surance program will be entrusted to the
8150
9.50
Department of Health, Education, and
$190
11.50
Welfare. That Department will be
1 Present monthly minimum of $40 for
charged with the responsibility of mak-
worker and $20 for wife.
ing known the program to those pres-
Present monthly maximum of $127 for
ently over age 65; notifying those reach-
worker and $63 for wife.
ing age 65 in the future of their rights
Railroad retirement contributions
to participate; maintaining records; pre-
would be based upon the same formula as
paring actuarial studies; and presenting
the social security contributions, up to
the appropriation requests for the pro-
the maximum payable by social security
gram to the committees of the Con-
participants.
gress, and so forth.
Excerpts from the remarks by Rep. Gerald R. Ford
HOUSE OF REPRESENTATIVES
April 8, 1965
Mr. Chairman,
I conclude with these observations. The House Republican Policy
Committee and the House Republican Conference have endorsed H.R. 7057,
the Byrnes bill, as the motion to recommit. H.R. 7057 was unanimously
endorsed by all of the Republican members of the Committee on Ways and
Means. I commend the Republicans on the Committee for their hard and
constructive work. I especially commend Congressman John Byrnes for his
leadership in drafting H.R. 7057 which is constructive legislation, far
preferable to the Committee proposal.
As far as final passage is concerned, if the motion to recommit fails,
neither the House Republican Policy Committee nor the House Republican
Conference have recommended any guidelines. This is quite understandable,
The Committee bill, H.R. 6675, is to a substantial degree Republican
legislation, except that part which incorporates the Administration's
King-Anderson proposal for hospital care financed by a payroll tax.
Many of my Republican colleagues, in weighing the Republican portions
of H.R. 6675 against the Administration's part of the same bill, with
understandable logic will vote for the bill on final passage. On the
other hand some of us, including myself, have strongly and consistently
opposed the regressive payroll tax method of financing hospital care for
the aged.
In my judgment that portion of H.R. 6675 which is unsound, outweighs
the good. In the final analysis it is one's own conscience, not a
Republican policy position, that will determine how Republicans will vote
on final passage.
I conclude, however, by re-emphasizing that the Republican motion to
recommit is sound. It is our policy as a party. I urge that my colleagues
support the Byrnes substitute, H.R. 7057.
Excerpts from the remarks by Rep. Gerald R. Ford
HOUSE OF REPRESENTATIVES
April 8, 1965
Mr. Chairman,
I conclude with these observations. The House Republican Policy
Committee and the House Republican Conference have endorsed H.R. 7057,
the Byrnes bill, as the motion to recommit. H.R. 7057 was unanimously
endorsed by all of the Republican members of the Committee on Ways and
Means. I commend the Republicans on the Committee for their hard and
constructive work. I especially commend Congressman John Byrnes for his
leadership in drafting H.T 7057 which is constructive legislation, far
preferable to the Committee proposal
As far as final passage is ancerned, if the motion to recommit fails,
neither the House Republican Policy Committee nor the House Republican
Conference have recommended any guidelines. This is quite understandable.
The Committee bill, H.R. 6675, is to a substantial degree Republican
legislation, except that part which incorporates the Administration's
King-Anderson proposal for hospital care financed by a payroll tax.
Many of my Republican colleagues, in weighing the Republican portions
of H.R. 6675 against the Administration's part of the same bill, with
understandable logic will vite for the Bill on final passage. On the
other hand some of us, including myself, have strongly and consistently
opposed the regressive payroll tax method of financing hospital care for
the aged.
In my judgment that portion of H.R. 6675 which is unsound, outweighs
the good. In the final amalysis it is one's own conscience, not a
Republican policy position that will determine how Republicans will vote
on final passage.
I conclude, however, by re-emphasizing that the Republican motion to
recommit is sound. It is our policy as a party. I urge that my colleagues
support the Byrnes substitute, H.R. 7057.
FOR THE SENATE:
FOR THE HOUSE
Everett M. Dirksen, Leader
THE JOINT SENATE-HOUSE
OF REPRESENTATIVES:
Gerald R. Ford, Leader
Thomas H. Kuchel, Whip
REPUBLICAN LEADERSHIP
Leslie C. Arends, Whip
Bourke B. Hickenlooper, Chr.
Melvin R. Laird,
of the Policy Committee
Press Release
Chr. of the Conference
Leverett Saltonstall, Chr.
John J. Rhodes, Chr.
of the Conference
of the Policy Committee
Thruston B. Morton,
H. Allen Smith,
Chr. Republican
Ranking Member
Senatorial Committee
Rules Committee
Bob Wilson,
PRESIDING OFFICER:
Chr. Republican
Congressional Committee
The Republican
Charles E. Goodell,
National Chairman
Chr. Committee on
Ray C. Bliss
Planning and Research
IMMEDIATE RELEASE
March 29, 1966
STATEMENT BY THE
JOINT SENATE-HOUSE REPUBLICAN LEADERSHIP
The Republican Congressional Leadership today introduced Medicare
legislation to extend through August 31, 1966 the initial enrollment
period for coverage under the program of supplementary medical
insurance benefits for the aged.
Senator Everett McKinley Dirksen and Representative Gerald R. Ford
announced the filing of identical bills for this purpose in the Senate
and House of Representatives in fulfillment of the Republican Co-
ordinating Committee pledge to do so.
The law presently requires registration for these benefits by
March 31st but once it became clear that over 5 million older persons
would be unable to register by that date, the Republican Congressional
Leadership took action to prevent the denial of such benefits to these
millions of citizens.
The supplemental benefits portion of the law was added to Medicare
on the insistence of Republican Congressmen John W. Byrnes of Wiscon-
sin. Republican congressional agreement and insistence upon extension
of the enrollment period is unanimous.
Room S-124 U.S. Capitol-CApitol 4-3121 . Ex 3700
Staff Consultant John B. Fisher
REpublican NATiONAL COMMiTTEE
1625 EYE STREET, NORTHWEST, WASHINGTON, D. C. 20006
NATIONAL 8-6800
NEWS
FOR RELEASE
Tuesday, A.M.
March 29, 1966
STATEMENT ON MEDICARE ISSUED BY THE REPUBLICAN COORDINATING COMMITTEE
AT ITS MEETING IN WASHINGTON, D. C., MARCH 28, 1966
We must warn Americans of an acute crisis developing under the Medicare and
Supplemental Medical Insurance Program which were passed more than a year ago.
The law requires registration for certain benefits by March 31st.
The supplemental medical benefits portion of the law was added to medicare
on the insistence of Republican Congressian John W. Byrnes. It becomes
effective July 1.
It now appears that some 5 million older persons may begunable to register
by the required date. They will be denied these benefits.
The inability of these older persons to qualify has been caused by a clumsy
and obstructive bureaucrace. The aged have been bewildered and harassed by
cumbersome technical requirements. They have been victimized by endless
red tape.
We insist that these 5 million people not be denied these benefits because
of the inexcusable administrative failures of the Johnson-Humphrey Administra-
tion.
The Republican Congressional Leadership will introduce legislation to
change the registration date to September 1. We call upon the Administration
to give full support to this legislation so it can be enacted at once.
% / #: