Ruination where more and more people are living to be 65 years or older an American child born today can expect to live to 71.3 years 24 years longer than a child born in 1900 by the year 2001 and every five people in this country will be 65 years or older. Come along with me. The best is yet to be. Browning wrote that But can America's elderly of today or the long living of coming decades expect the senior years to be the best of their lives? The answer is quite obviously no. Unless we begin now to adapt our society to the era of long life, which is already well underway. The future of Aging in America will be Bleak indeed and the senior citizen further debased. Medicare was enacted to protect the elderly from The Tender Mercies of insurance actuaries. That is to say before Medicare. Most often when a person reaches age 65 or retired, they lost their health insurance and one serious illness could wipe out a lifetime of savings for hundreds of thousands of people. Yeah, present-day Society. Middle-income families can become poppers overnight when faced with extended nursing home bills for elderly parent or an elderly member of the family. In the dramas of your of your own particular lives. I'm sure you can recall as I can the examples of dedicated self-sacrificing individuals in your own home community. Who literally gave their lives to provide care and medical treatment for family members stricken with some long-lasting illness or incapacitation? And I think most of us can also recall the cases of good people who worked hard and lived thriftily all their lives. Only to find themselves suddenly faced with the twin spectres of poor health and financial need in their later years. nature abhors a vacuum and in recent years the nursing home industry has moved in to relieve the self-sacrificing family member and in many cases. To provide the answer to any remaining family solvency. Wow, housing construction has lagged proprietary nursing home construction has not. The cost per month average over $600 for each of the 1 million plus residents of skilled nursing homes. The manner in which some get and maintain profits? Is the focus of some of the more Grizzly Tales in the healthcare field? We all know for at least should know how most people feel when they are cajoled pressured or arbitrarily committed to a nursing home. I feel it's the beginning of the end like Farrah getting John cheever's new novel Falconer leaving behind forever. The only World he'd known the outside. Nursing homes and other institutions which harbor residents who do not need to be institutionalized are testimonials to rigidities and societal failures. They are a lot. They are a large and growing reality mainly because we have yet to make the commitment to a more compassionate Society for the elderly. This is particularly strange because there is an accumulation of evidence that in the health field. The widespread stimulated development of non-institutional Home Health and Social care services for the elderly and chronically ill would provide Farm far less costly and far more suitable Services than nursing homes and other institutions. I was over in England recently in one of the things that really appealed to me about their National Health Service. Was and I just stumbled on it. the neighborhood School Grammar School are the children lunch from 11:45 to 12:30 and then come in and have lunch at the grammar school. Now, this is provided for under the National Health Service as the Noonday meal for those who want to and that area as part of their system for helping people stay in their own homes still build an extra room on the house to keep an elderly parent there and they'll send in the services Meals on Wheels somebody to bathe them they'll do whatever is necessary to keep all of those who don't need to be institutionalized at home or in their own apartment. And here we have this tremendous Trent Warehouse in people and a non development of the alternative services. Many elderly people will require custodial care in nursing homes or other institutions. Not those people that I have reference to. My point is that alternative should be readily available for heart for all who do not require nursing home care. However, the range and supply of Alternative home-based Care. Are today clearly inadequate? There is an Healthcare perhaps a worst mismatch of services in relation to needs of the elderly that even in the housing and other human needs. Despite the enormous public and out-of-pocket expenditures for healthcare for the 65-plus population the services they need and want and which are the most appropriate at the lowest costs are simply not generally available. I do not believe they will become available except under a comprehensive national health insurance program. Such a program can contain Provisions or institutional long care for the elderly and other chronically ill persons who need it coordinated with a broad range of Home Health and Homemaker Services as well as programs of day hospitals and often make it possible for the infirm individual to live in his own home or the home of relatives instead of an institution. It is important to provide preventive services for the elderly as well as for the Young. An example of the type of preventive medicine needed by older people is proper Vision Care. Periodic eye examinations to diagnose and treat conditions of the eye would reveal eye diseases disorders and impairments among older people conditions such as glaucoma forms of ID generation and subnormal division require early diagnosis and treatment. Every industrial country in the world, except 261 industrial countries already have national health insurance plan. The only two that do not Are the United States and is in the union of South Africa? That's not the company we are being. I'm not saying that we are to replicate. The health insurance plan or the National Health Service any other country? I think that there's a lot we can learn from some other countries, particularly, Canada. I think the demographic characteristics of the Canadians are very much like Americans have had 10 years now of a national health insurance plan. They've got the bugs worked out. They've got a system that 86% of the people. Like and incidentally so does the medical association which party they wouldn't go back to the old system? I don't think even the Canadian system should be the model for our country. I think that there are particularly in this area of enrich development of Home Services more like what they've done in Germany and end in England. that we can adapt not from Canada's program, but from some others and not the depth exactly. What I'm saying is that there is a great deal of experience in other countries, and we can benefit from it. We can benefit from the mistakes. We've made in this country Medicare and Medicaid and Blue Cross Blue Shield or 1800 insurance company selling health insurance. That's a mistake all by itself. The fastest growing item in the entire cost of living is not oil costs. Is not Hospital cost hospital or second. The fastest growing item is Blue Cross and Blue Shield and Commercial health insurance premiums they went up 30% last year. 28% the year before last year we paid. Health insurance companies in this country last year for every hundred dollars that they paid to doctors. benefits of our premiums They paid themselves $53 / $53. That's how much it's costing us. That's how much is not getting into the house system. It added up to 5.5 billion dollars. The difference between their premium intake for health insurance and what they pay out in benefits. The rest are their operating expenses. advertising costs acquisition costs profits I wouldn't have any quarrel with that. If the system was working well if if there was Universal coverage, but after 40 years. They failed to provide Universal, just feel 40 million people with no coverage and the benefits that are provided are only covering 40% of the cost of those with the insurance. and certainly in the area of development resource development are necessary resources. They fell completely instead of that 5 billion dollars going for all of these. Acquisition costs be going into development of the kinds of Home Health and Social care services that are desperately needed in this country. and I believe that President Carter will give These Concepts that I'm talking about. the kind of leadership and support that will achieve a comprehensive national health insurance plan. I think you just study. my history how important domestic legislation in this country. He will find that there's never been any. Until you have four elements in place. First is the active leadership and strong support of the president United States. You know, they see the Roosevelt call the White House the bully pulpit. and by that he meant that only the president through his command of patronage through his Billy the capture the media didn't caught media those days, but it to his ability to capture the media when he wants to do his ability and only his ability educate the American people about issues. only the president and are in our society. has the capability of leading the nation forward on important social legislation, but even with the president as mentioned that Harry Truman tried very hard to get national health insurance in his book. He wrote that was his greatest disappointment. He was very bitter about that wrote about how the AMA had hired a public relations organization in San Francisco named Whitaker and Baxter and how they had succeeded in defeating him with scare words. They coined the word socialized medicine. Most people don't know what that means, but it worked. Dream with the president's leadership. You need more. The second thing you need. His the high priority interest. a leading members of the Congress out in the bill that are committee develop and supports that'll security Bill Kennedy carmenville. There are more than a hundred members of the Congress. We're supporting that include. most of the leaders we would hope that that kind of political support will be noticeable to those in the White House who are developing the president's plan and its Concepts. If not, his details will be in body and what the administration produces its basic concept. Is it Healthcare out of be a right and not tied to employment not tied to means-test not tied to work earnings test not tied anything except the need for care with great emphasis on prevention early diagnosis of disease as well as Rehabilitation and with a special resources Development Fund made up of what we would otherwise paid to the Blue Cross and Blue Shield and the other insurance companies of the kinds of services. Protectli for the chronically ill 1/8 and elderly that we've been talkin about. the third thing history would inform us that is essential. is the support of private organizations in this case the constituency for national health insurance is very brought. It includes the one issue in which part of the labor unions agree. There's no difference between the teamsters in the Auto Workers of the AFL-CIO or the Mine Workers. They're all supported. It's an issue that is growing in importance among most of the church groups. I think the church groups are beginning to see this issue much like they saw civil rights 15 years ago. and of course the fourth thing that you need and it hurt room and didn't have and didn't develop. was an active Grassroots demand Harrison Gallup and Cambridge and Roper with one exception that exception was a paid for Apple. But the pause all show. The two-thirds the American people favor national health insurance comprehensive or any other bill, but it does show a degree of dissatisfaction. Either with costs when were the excess or with whatever? That is very pronounced and that will be a my opinion a telling component. in the legislative process during the campaign Jimmy Carter on three occasions. So promised comprehensive National Health Insurance. Donell Lewis Center pre-election promises presuppose post-election good faith Reason, I know that is it Carter said that I looked it up. It was accurate. I think and we'll all sit together. But I think that literally after a half a century more than a half-century that this Administration will produce such a bill, you know, they've had national health insurance in Germany since bismarck's time. First president to propose in this country was Theodore Roosevelt. Franklin Roosevelt tried to get it didn't succeed Harry Truman didn't succeed. Carter says as he recalls all of this that he intends to get it. I think that it's important. That you and anyone else who has an interest in this feel right to the president. The address is the White House Washington DC to all five of them and tell him what you think tell him what you think I ought to be in a national health bill or telling what you think shouldn't be in a pill I would hope. That you would direct at least part of your letter. To the problem of the elderly and chronically ill. Because there is a terrible Miss match. House available services In terms of the needs of the elderly. Remember up. I like Senator Everett Dirksen used to tell a story. Not knowing what you should get his wife for some anniversary 40th anniversary. And he was passing a pet shop and he saw some puppies in the window and he walked in. And there he saw the perfect gift a mynah bird. I tell the proprietor deliver it to my house 5:30. My wife won't be getting home till after that. I want to be there. Receive it I want to surprise her. But he was delayed in the Senate and he didn't get home until 6:30. I rushed into the house and his wife was standing there. Did you see the bird? She said yes. He said where is it? She said it's in the oven. Any race back to the kitchen and open the oven door and there's the third row seat in my car. when is pica be at time I think that's I think that's appropriate closing. I think there's time but I think those who are genuinely and seriously concerned. With this problem and in particular a problem. Have the health needs of the elderly and the chronically ill you have time but not a heck of a lot of time. Thank you very much.