Statement by Senator John F. Kennedy on the Senate Floor on Medical Care for the Aged

Mr. President, I join with the Senator from New Mexico in urging the Senate to adopt the amendment I have cosponsored with him. Of the alternatives offered, it best meets the needs of the aged for medical care.

This proposal extends to 9 million of our elder citizens a life policy of paid-up medical insurance. It affords them hospital benefits, nursing home benefits, home nursing benefits, and outpatient diagnostic care. It relieves the burden upon our hospitals by providing incentives for nonhospital treatment. It emphasizes preventive medicine. It is fiscally sound. It is administratively simple; and the benefits are responsive to individual preference.

It reflects four basic principles:

First. Major health costs can be met without a humiliating means or income test.

Second. There can be action now, without awaiting indefinitely for further action by Congress and the State legislatures.

Third. There is freedom of choice in the selection of hospitals, nursing homes, and doctors.

Fourth. It does not depend upon the uncertainties of financing from general revenues.

I feel strongly that there must be no means test in providing medical care insurance. Already 2 1/4 million of our older citizens must rely on public assistance for their daily needs. We must not force another 14 million to rely on public assistance. To impose such a test is to ask a man to declare himself indigent and incapable of self-help before we lend him a hand. It comprises the meanest form of discrimination, because it hurts the weak without helping the strong.

On the other hand, the social security approach is proved and successful. There is no new principle involved. It is consistent with human dignity and individual self-reliance. It emphasizes insurance as against charity. And it requires no special appropriations action by the Congress and the 50 States. Without this amendment, the pending bill - if implemented in all 50 States - would cost over $2 billion annually. The Federal share would be over $1 billion. Only with this insurance amendment, in other words, can we prevent an enormous potential drain on the Treasury.

The President has insisted that any new welfare proposal should include the provision for the taxes to pay for it. This is the only medical benefit program which meets that test.

Mr. President, this month we are celebrating the 25th anniversary of one of the most constructive pieces of social legislation ever written. I refer, of course, to the Social Security Act of 1935. It is particularly appropriate that we mark that anniversary by the extension of the system to include medical care insurance for our older citizens.

A quarter of a century ago, the people of the United States turned their back on the dole and the means test, and chose instead to rely on self-financed insurance, paid through the social security system, to protect themselves against the hazards of old age. This American tradition has been so successful that even its onetime enemies no longer dare openly oppose it. It commands the overwhelming support of the American people.

It would be a sorry choice if we were now to repudiate the 25 years of successful American experience. Yet that is just what we have been urged to do. When all the vague generalities are stripped away, nothing more is being offered by opponents of the Anderson amendment than an increase in the public assistance program to provide some increased medical care for the indigent.

The committee bill does improve our public assistance to the most needy. That is at least a gain over what they now have. But let me emphasize that it does not meet the needs and demands of our older people. These can only be met through the social insurance approach. Only that approach can provide the required protection in a satisfactory way.

Can there really be any doubt that systematic prepayment under the insurance system is to be preferred to the increased drain on general revenues?

Can there be anything but doubt about the ability of the States to raise money - especially when about half of the States now fail to match all the Federal funds at their disposal?

Can we really, in this day and age, say in all honesty that 50 different States with 50 different abilities to finance medical care are to be preferred to an orderly, nationwide system?

Can we really say that we favor social insurance for retirement, survivors and disability benefits, so as to avoid putting the relief tag on our citizens, and then make an exception when they become ill?

Mr. President, the answers are clear. I urge the adoption of the Anderson amendment.