The Poverty of Aging
Seligman, Ben B.
AMERICANS ARE PROUD of the fact that the nation is becoming young. Nearly half the population is now under 25 years of age and about a third under 15. While this may mean crowded...
...Wilbur Mills, offers benefits through matching grants to the disabled, ADC families, and to those who may have enough for other needs, but not for medical care...
...In 1965 it was estimated that 35 per cent of all social security recipients were poor and that another 38 per cent would fall below the Social Security Administration's poverty standard in the absence of social security payments...
...They prefer to deal with such matters as family counseling, leaving economic need to public authorities.17 So large is the bill for public assistance that on occasion a local authority gives up in frustration and simply closes down its program...
...on the average this represented three out of every four aged persons in the nation...
...Ordinary health insurance did not meet more than 7 per cent of the total cost of the aged's health requirements...
...While we do not burn the villages of the aged dead, or fill the air with cries of joy over the departed,' we do stuff our aged into institutions to let them await death slowly...
...While BEN B. SELIGMAN President Johnson specified in August, 1965, a many-sided crash program for the aged poor, only one of these, "Foster Grandparents," a program to train older persons to serve as "substitute parents" for neglected children, was in operation six months later...
...As in so many other societies, we would prefer simply to discard our aged...
...Some change in this regard is being sought by some civil rights groups...
...And the deductible corridors —that part borne directly by the insured— placed a substantial part of the cost on the policy holder...
...National Observer, Macch 7, 1966...
...As Gilbert Steiner says, farmers have their lobbyists, publishers express their views on mail subsidy to Congress, and trade associations speak for industry, but the aged—or for that matter, any recipient of public assistance— are not asked what they need...
...nues, not through social security, it provides for certain kinds of health care for the aged poor, but on a broader scale than Kerr-Mills...
...20, 1966...
...Yet more than half the states fail to make OAA payments sufficient to meet their own income tests...
...Boston Globe, June 5, 1966...
...24 24 New York Times, Dec...
...Yet there is no con 16 Senate Committee on Aging, op...
...Further, there was a prospect that some of the deductible corridors under Medicare would be covered...
...The aged are simply an embarrassment...
...Even congressmen who had expressed some doubts were pleasantly surprised at the results...
...Set against this record the mounting hospital costs—an increase of 27 per cent between 1960 and 1962— and it is patent that the health problem of the aged has been indeed serious 20 The demand for health insurance as part of the social security system grew without abatement...
...In 1959 hospital insurance coverage for the aged covered 46 per cent of that group as compared with 67 per cent in the total population...
...There is still some business they hope to get...
...In practice, there is no rational economic explanation for the sort of benefits the individual states bestow on their aged poor...
...The tax base was raised to $6600 a year and the tax rate stepped up to reach 4.85 per cent by 1973...
...Of course, social security encourages withdrawal from the work force...
...It was clear that much still had to be done if the country was to catch up with standards elsewhere in the West...
...but in 1960, 30 per cent of spending units with heads over 65 years of age had no liquid assets, and 20 per cent had such assets amounting to less than $1000...
...IT REMAINED FOR MEDICARE—medical aid through social security—to make the first sensible step toward an adequate health scheme for the aged...
...In any case, the usual commercial coverage offered fixed dollar benefits according to some predetermined schedule rather than in terms of need...
...Yet a large percentage of social security beneficiaries still require public assistance, mainly because the benefits are too small to maintain them at even low levels of existence...
...These changes do indeed offer some improvements, but whether they will take the aged poor out of poverty remains to be seen...
...Other agencies, insisted Shriver, had a greater responsibility for the aged...
...the illusion that he is among the living, al...
...Benefits were continued for children still in school up to the age of 22...
...Its impact will probably go far beyond the 10 per cent of the population for whom it has been devised...
...Financed by general reve 22 New York Times, May 29, 1966, June 13, 1966, and June 19, 1966...
...They hurriedly tried to amend the law, but it seemed too late—the welfare state had barged through the cautious legislative barriers with a resounding crash...
...Petersburg sin," couples living together to overcome loneliness, but in an unmarried state.'5 After some years of agitation, improvements were made in 1965...
...There may have been some improvement in the income position of the aged in re cent years...
...At the eleventh hour, private insurance companies sought to offer plans for aged health coverage within their underwriting perspective, but these were inadequate...
...In effect, funds would be made available to all medically needy persons under 21 and over 60 and to the blind or disabled and ADC cases between those ages...
...Besides, it was more difficult to get local communities excited about the aged poor...
...Budgeting outlays in OEO through 1966 for the aged were about 2 per cent of the total...
...Senators and congressmen were chagrined at their extraordinary faux pas and tried to scale down the generous program...
...In 1960 total payments to retirees from private pensions were about $1.3 billion, four times larger than a decade before...
...Despite the American Medical Association's crude effort in 1960 to demonstrate that the aged weren't suffering from sickness and could easily meet their health bills, the fact was that four out of five aged persons had chronic ailments as contrasted with two out of five for younger persons...
...moreover, the private agencies have developed their own specialized clientele and they are now reluctant to become involved in aid programs rooted in economic distress...
...In brief, the 1965 amendments to the Social Security Act provide hospital and medical insurance for beneficiaries...
...The program was small in scale, employing about 1200 elderly persons in March, 1966...
...Further, no matter what the base limit, a payroll tax remains regressive: with the present $6,600 limit, those receiving income under this figure pay proportionately more than those whose income exceeds $6,600 a year...
...In fact, Title 19, sponsored by Rep...
...In some private profit-making homes, the inmates ". . . suffer most from [a] sense of being dumped and lost...
...8 It was evident that little contact or understanding between the generations existed...
...Private insurers could not solve the problem of offering adequate benefits for a high-risk, low-income population, nor were they especially interested in doing so...
...21, 1965...
...As we have suggested, the nonmarried are worse off than couples: they tend to be older and poorer, so that one in six requires old-age assistance, as contrasted with one in 12 for the married aged...
...Thus, charges for rooms, x-rays, and medicines were expected to fall, whereas service costs for obstetrics and pediatrics might increase...
...Moreover, the states were not permitted to substitute Medicaid for existing welfare programs in order to prevent new federal monies from paying for old state welfare programs, thus encouraging liberality...
...Only 13 per cent of the respondents in this study saw virtue in some semblance of an extended family...
...Clearly, cutting the aged and other needy off the rolls was no solution...
...cit., passim...
...Delaware only 3 per cent...
...yet as late as 1962, 5 per cent of aged married couples and 44 per cent of 10 H. L. Sheppard, "The Povery of Aging," in B. B. Seligman, ed., Poverty As a Public Issue, New York, 1965, p. 98...
...It was predicted that Medicare would enforce vast changes in hospital administration...
...ante (OAA...
...An old person has a chance if he is still at work, but most of the aged do not work...
...Today only a third of persons 65 years of age or older are in the work force, as contrasted with two-thirds at the turn of the century...
...Numerous restrictions were instituted— means tests and family responsibility— which severely limited coverage...
...In any case, it was expected that the aged of the nation would flock into the 7,200 hospitals across the country and overtax already limited facilities...
...2 Often, the names of the inmates are not known to the staff that takes care of them...
...19 ONE MIGHT THINK PRIVATE PENSION BENEFITS would relieve the situation of the aged...
...There they are given care of a sort...
...The long-run decline in death rates, signifying greater longevity, coupled with the inability of older persons to compete for jobs, makes the problem of the aged more visible, despite a desire on the part of the rest of us to push them out of sight and out of mind...
...Unfortunately, as Jules Henry has revealed, such care is of the order that might be accorded to an inanimate object...
...Disability allowances were liberalized and the standards made less restrictive...
...Despite some improvement, stemming from the Welfare and Pension Disclosure Act, it is still possible for an employee to discover that he really has no pension...
...Quite simply, Kerr-Mills was a failure...
...13 C. D. Long, The Labor Force Under Changing Income and Employment, Princeton, 1958, p. 163...
...Under the latter's program up to 40 per cent of its inhabitants could qualify for Medicaid...
...THERE HAVE BEEN IMPROVEMENTS, Of course, in the last few years...
...The administrative costs were inordinately high...
...Life might be meaningful if one's health were good, but most of the aged suffer from a large assortment of illnesses...
...9 Earn 7 Senate Committee on Aging, Developments in Aging: 1959 to 1963, Washington, 1963...
...Unnoticed for months, attention was called to Title 19 when New York State took advantage of its provisions by adopting enabling legislation in April, 1966...
...9 L. S. Epstein, "Income of the Aged in 1962: First Findings of the 1963 Survey of the Aged," Social Security Bulletin, March 1964...
...ALL TOO OFTEN AN AGED PERSON receiving benefits must ask local authorities for additional help...
...Much progress had been made in ten years...
...All too frequently the insurance the aged ,did have provided lower benefits at higher premiums.21 Furthermore, the shift from a community rating basis in setting costs to an experience basis tended to force up rates...
...The initial cost to the federal government was expected to be more than $350 million...
...Debt in the county rose 54 per cent in a 15month period, and evictions increased alarmingly...
...The foregoing data do not take into account more recent changes in Social Security...
...J. Campbell, The Masks of God: PrimitiveMythology, New York, 1959, p. 118 ff...
...MEETING HEALTH COSTS is a major problem for the aged...
...No one thought that the deductible corridors would provide some restraint.22 MOST OBSERVERS OVERLOOKED MEDICAID— Title 19 of the 1965 amendments to the Social Security Act—while plans for Medicare were being formulated...
...The aged stay in hospitals longer...
...Yet in December, 1964, the average social security payment was $79 a month...
...Worse yet, the state-run programs are frequently conducted in an irregular manner...
...For in the last analysis, the contract is between the employer or trustees and the carrier, and all too often trustees can escape penalties for negligence or misconduct...
...When Clermont County in Ohio cut off aid in 1961 because the voters rejected a tax levy for public assistance, the burden was simply shifted to landlords, grocers, doctors, and other agencies...
...Although most of the state plans were modest, California and Massachusetts had devised fairly ambitious ones, and their representatives in Washington made it known that they would not tolerate any changes in the law...
...For a family the maximum benefit may reach $368 a month...
...though awareness that he has been discarded by relatives, friends, and society is not uncommon...
...Wall Street Journal, July 11, 1966, and October 20, 1966...
...20, 1966...
...Business Week, June 25, 1966...
...Some children's institutions were horrified at the prospect of "caring" for older persons in addition to what they had to do: within weeks of the inception of the program they were asking for more "foster grandparents...
...THE POVERTY OF AGING counted for the decline...
...Mental, as well as physical illness, was a problem for the aged: first admissions in mental hospitals were two-and-a-half times greater than those for patients under 65...
...The largest proportion of aged married couples-79 per cent—derive their income from social security payments...
...While the lives of hundreds of rejected children were brightened for a brief time, a sizable group of aged men and women, all poor, were given a new interest in life...
...BEN B. SELIGMAN sistent pattern among the states: Louisiana reaches 49 per cent of its aged poor...
...But this doesn't mean that Delaware's level of aid is munificent— its average monthly payment is $63...
...Said some bureaucrats in justification of the policy: "We're a youth-oriented nation...
...The retirement test was altered, allowing earnings up to $1500 a year...
...All too often the public agency tends to blame his situation on the client himself...
...For the members of Congress had left the definition of "medically indigent" up to the states, and some of the latter were prepared to be as liberal as New York has been...
...Monthly cash benefits were increased by 7 per cent, so that the range is now from $44 a month to $136 a month, with the maximum scheduled to rise to $168 a month in future years...
...cit., pp...
...Nor did the Kerr-Mills Act in 1960 solve the problem...
...Less than 3 per cent of social security beneficiaries who receive un 18 Ibid., p. 84...
...Washington Post, May 13, 1965, and Jan...
...A similar attitude prevailed among the aged: older persons with incomes of at least $5000 a year expressed preferences for separate domiciles...
...4 Ibid., p. 437...
...THE POVERTY OF AGING late the canon of self-help, and so we dishonor them...
...At the end of 1964, there were 13.7 million aged persons receiving such benefits...
...If one suggests an utter failure of imagination on the part of OEO in dealing with the aged, he would not be far from the truth...
...1G Ibid., p. 44...
...Recipients, especially those on OAA, cannot influence the level or administration of the programs that serve them...
...While Medicare, as passed in 1965, fell short of the original proposals, it was a significant advance, one that took 20 years to achieve...
...Federal tax regulations are so cumbersome that entrepreneurs in these industries are discouraged from even trying...
...The outstanding feature of such an effort as "Foster Grandparents" was the remarkable reliability and sense of responsibility of the participants...
...Says Rosow, the chances of a man over 65 having a favorable rating on all four counts is seven in a hundred, for a woman 65, one in a hundred...
...The Senate Committee on Aging noted numerous cases of local agencies reducing their aid when other sources were made available...
...12 Ibid., p. 211...
...New rental housing for the aged can be supplied through governmentinsured mortgages: by 1962, about 26,000 units had been built...
...YET THERE ARE NUMEROUS SERVICES the aged could be trained to perform—library assistants, recreation aides, school crossing guards, toll collectors, helpers to shut-in persons, and subprofessional social workers are just a few...
...8 Ibid., p. 407...
...Sentiment increased for recourse to the general revenues, although a sharp increase in the tax base—perhaps up to $15,000 a year—was not unthinkable...
...A query remains: will not those aged who do not buy private "dovetailed" policies continue to suffer a financial burden by virtue of the deductible corridors...
...Escape from poverty and hopelessness is possible if there is no loss of income, but the data show a drop of as much as 50 per cent in income after retirement...
...While this may mean crowded colleges or teen-age unemployment, the problems of senior citizens, who are increasing in numbers, do not diminish because older people become a smaller portion of the population...
...6 To be sure, there has been some improvement in institutional homes in recent years...
...But as Harold Sheppard has said, this reflects a curious reversal of logic, since the aged spend less only because they have less.10 The patent fact is that those aged who do not sustain a loss in income do consume as much as anyone else in their income level...
...Yet Congress made it clear in 1965 that OEO was to consider the special problems of the aged "wherever possible...
...While two-fifths of the total public-assistance burden goes for OAA, its distribution is quite unequal...
...The only way to help the aged seemed to be direct cash benefits...
...OEO could at best play a minor role...
...It is more than likely that private health insurance plans for younger persons will be altered and Medicare will no doubt affect proposals developed through collective bargaining...
...Private insurance companies, on the other hand, are cooperating...
...For months during 1965-1966 a bureaucratic battle raged in OEO on whether the aged poor should become a prime target group or remain a minor concern of the agency...
...Their job was done by March 31, 1966, the deadline for registering for Medicare...
...Wall Street Journal, June 15, 1966...
...Baltimore Sun, Dec...
...in the meantime, OEO's original allotment for this venture was cut back from $10 million to $5.5 million...
...National Observer, June 20, 1966...
...der $1,200 a year obtain any income from private pension plans...
...And older persons in states that provide higher Old Age Assistance appear to live alone more frequently than in states where OAA is minimal...
...Liquid assets are not available for the usual emergencies that afflict the aged...
...Widows could receive benefits at the age of 60 on an actuarially reduced basis...
...Irving Rosow has demonstrated that a secure position for the aged can exist only under conditions that cannot be found in a modern industrial society...
...22, 1965, and Jan...
...HOW DIFFICULT LIVING ALONE must be is underscored by the income data for the aged...
...The cost-benefit philosophy that had begun to infect many federal agencies, however, impelled some OEO officials to question the pay-off of investment in the aged...
...It was feared that Washington's Medicaid bill would reach $2 billion annually...
...When it was suddenly realized that New York's plan alone would cost over a billion dollars a year in combined federal, state, and local payments, the legislators in Washington were stunned...
...For the non-married aged this ratio dropped to 24 per cent...
...Amendments to the Social Security Act have helped, and the beneficiaries now coming onto the rolls with better earnings records than those in past years have added to average benefits...
...By 1962 only one in every 200 eligibles was receiving aid through Kerr-Mills...
...surgical coverage was 37 per cent, a little over half of what everyone else had...
...they visit THE POVER TY OF AGIN G 'the doctor more often...
...Nevertheless, it was reported that some 20,000 physicians have decided not to participate...
...Set against the standards of "modest but adequate" budgets, these data suggest that at least 2 million couples and 6 million unmarried aged are in dire straits...
...The final stages of human existence can be a protracted period of human obsolescence...
...More important is the size of the income: the median for married couples was $2875...
...Low-wage industries, in which many of the aged poor have spent their working lives, have not instituted pension programs in any widespread fashion...
...The private proprietary institutions, though they are pro a I. Rosow, "And Then We Were Old," Transaction, Jan.—Feb...
...Further, because of the retirement tests, the law limits beneficiaries in supplementing benefits in any effective fashion...
...If the aged owned or controlled property on which younger persons depended, if they were transmitters of culture, in possession of key blocks of knowledge, if they provided significant links to the past, if the extended family were still central to our mode of life, if our society were tradition-oriented, and if the output of the aged were in any way economically useful, then they would still be honored.5 An older person has a chance for a fruitful existence if he is married and living with his spouse, but many of those over 65 years of age have no spouse, and widowhood increases with age at the rate of 20 per cent with each decade after 65...
...velop their own medical aid programs for the aged as a condition for obtaining federal grants...
...No doubt, the aged would be worse off were there no social security payments...
...the prices of other services would be reduced...
...Direct loans are also available to non-profit organizations sponsoring housing for the aged: by 1962, about 8,800 such units had been constructed...
...Nevertheless, the income derived from private pensions represented less than 6 per cent of the income of the aged...
...21 Ibid., p. 15...
...The sense of doom that the aged suffer hastens their passage through the vestibule to death . 4 THE AGED MAY BE among us, but they are not part of us...
...It is often argued that older persons do not need as much as younger ones, because the aged spend less for clothing, housing, food, and medicine...
...And most of the recipients could be classified as "higherincome aged...
...from] the . . . vacant routine, the awareness of being considered a nuisance and of being inferior to the most insensitive employee...
...Small firms are less apt to have pension arrangements than large ones...
...3 Soon ordinary human functions are distorted, so that the resident of an old-age institution undergoes a "pathogenic metamorphosis" akin to that experienced by characters in the tales of Franz Kafka...
...Congress proposed to bar able-bodied adults whose children were receiving assistance under other welfare programs, but the income standards were still open for aid to such adults...
...Many private plans have poor vesting—an absolute right to a pension—or none at all...
...Although survivor's insurance may lighten the widow's burden and help the orphans, no one anticipated that illegitimacy and desertion would in turn crowd the public assistance rolls...
...No doubt, it was their influence that resulted in all of Medicare's deductible corridors, for these allow dove-tailing private plans with government plans...
...Almost all of the latter had incomes under $3000 a year: this was also true for 54 per cent of the married couples...
...It was expected that Medicaid would eventually reach some 35 million people...
...and total OEO funds for aged programs were cut in half...
...Local housing authorities have available certain instrumentalities under the Housing Act to allow the construction of special facilities for the aged: by the end of 1962 about 8,000 such units had been built...
...prospect seems to be that social security benefits will come less and less from direct contributions to a special fund...
...1965...
...Medical practitioners BEN B. SELIGMAN are helping the government to set up the necessary standards, and the AMA, after spending almost $1 million in the first three months of 1965 to forestall the passage of Medicare, is now urging its members to cooperate...
...When this has been achieved, persons of sound mind and body can then withdraw from the aged without qualms of conscience...
...A resident of an old-age home must foster This, article is from the forthcoming book Permanent Poverty: An American Syndrome, to be published by Quadrangle Books of Chicago, © 1968, by Ben B. Seligman...
...al., Income and Welfare in the United States, New York, 1962, p. 158, ff...
...aged nonmarried persons had incomes of less than $1000 a year.'1 While the proportion of all families and individuals in dire poverty has decreased since 1900, the proportion of the aged in such circumstances has not decreased markedly.12 Nor do they have accumulations of savings on which they can fall back...
...Families headed by older persons represent one-third of all poor families, a ratio substantially higher than the one in seven for the total number of aged in the general population...
...and only 10 per cent of the aged had insurance for doctors' visits, as contrasted with 19 per cent for the general population...
...14 Curiously enough, social security is structured in such a manner that the income transfers flow from lower-middle-income groups to lower-income groups, with upper-income groups contributing very little...
...In one study two-thirds of the persons interviewed were opposed to having aged parents live with their children...
...23 For all these improvements, social security remained inadequate...
...The industry failed to convince anyone—not even itself —that it could do the job...
...Yet by THE POVERTY OF AGI NG October, 1966 some 41 states and Puerto Rico had taken advantage of Title 19...
...This was underscored by the Senate Committee on Aging in 1962, and despite existing legislation little genuine progress has been made...
...Moreover, since most of the states had failed to provide even adequate general assistance to the aged, it was unlikely that they would assume the added burden of Kerr-Mills...
...69-70...
...Other government retirement programs, such as railroad retirement systems, provide income for 12 per cent, while private retirement schemes lend support to 16 per cent...
...1963, p. 391 ff...
...If" he reaches pathetically for reality, the inmate is apt to be rebuffed by a staff member: the latter do not want reality, for the transformation of their charges is the only reality available to them...
...Confidentiality requirements may be flouted or recipients classified on some arbitrary basis other than need...
...S J. N. Morgan, et...
...They are poor, unable to provide medical care for themselves: they vio 1 Cf...
...Furthermore, widows must surrender part of their benefits if they marry another beneficiary, leading to "the St...
...In the final analysis, proprietary homes are commercial enterprises and generally isolated from community health services.' Living with relatives has not been a viable solution either...
...They were almost all hospital-oriented and did not deal with other medical needs, i.e., they were not comprehensive...
...To rely on private pension income to relieve the condition of the aged poor would be disastrous...
...And for the aged poor who do not have recourse to the federal program there is no alternative to Old Age Assist 14 M. Gordon, The Economics of Welfare Policies, New York, 1963, p. 35...
...The various plans cover over 20 million workers, or about 43 per cent of the employed private work force, almost double the ratio in 1950...
...New arrangements might be worked out for staff doctors, and it was hoped that Medicare would speed up integration in Southern hospitals...
...18 The eligibility standards usually mean emotional agony for the recipient who is willing to run a bureaucratic gauntlet to obtain aid...
...It was obvious too that the structure of social security taxes, which provided the "trust fund," could not be expected to do the whole job...
...But neither does increased aid make the problem disappear...
...The only program for the aged to which OEO gave any priority was "Medicare Alert," under which older persons were given temporary jobs at $1.25 an hour to brief other aged on the benefits available under Medicare...
...Perhaps in our society this may be the only way—give the aged poor money and let them stand aside, silent and unseen...
...And more than half the home equities were worth less than $10,000...
...19 Ibid., p. 153 ff...
...for non-married persons, $1130...
...Even in the one agency primarily concerned with poverty—the Office of Economic Opportunity—the aged have been relegated to secondary status...
...A large number of social security beneficiaries receive the minimum benefit: women who select "early" retirement get even less...
...One problem was the erosion that resulted as prices continued their upward drift...
...All Sargent Shriver could do was to tell a Senate Committee that little could be done for the aged: older persons, said Shriver, have low educational levels, are in poor health, and cannot compete for jobs...
...In effect, support of the poor comes from those quite close to them in the income scale...
...The aged may have homes with mortgages fully paid, some insurance, and some liquid assets...
...A higher proportion of the rural aged are reached through OAA than the urban aged...
...16 As with all forms of public assistance at local levels, OAA is conditioned by the perennial clash between proponents of low taxes and those who express a concern for the poor...
...THE AGED NEED DECENT HOUSING as well as adequate income, yet the limitations from which they suffer in income impose severe restrictions on what they can purchase in shelter...
...Institutions for the aged are likely to be tombs for those still alive, and as in a tomb, silence prevails...
...13 The proportion of the aged who work appears to have fallen sharply in recent years, although it is conceivable that illness or changes in attitudes toward retirement may have ac 11 H. S. Gordon, "Aging and Income Security," in C. Tibbitts, ed., Aging and Society, Chicago, 1960, p. 212...
...The most serious problem is the lack of air-tight legal protection for pensioners...
...liferating, rarely set up responsible lay boards to review both policy and day-to-day operations...
...Benefits include a maximum of 90 days hospitalization for each illness, post-hospital extended care for 100 days, and outpatient diagnostic services...
...The 23 New York Times, May 29, 1966...
...Chicago Tribune, May 1, 1966...
...Ordinary human dignity would represent too serious a chal-lenge to the apparatus of the institution, the main purpose of which is to create hopelessness...
...The law also stresses the need for community health planning...
...The recognition that the aged need to have a choice in living arrangements has been growing, and some better homes have been provided by religious denominations and fraternal organizations...
...The hospital plan is financed by a separate earnings tax and separate fund...
...BEN B. SELIGMAN iigs were a source of income for somewhat more than half the aged couples...
...and in the absence of portability—the transfer of pensions from one company to another—a feature conspicuous by its rarity, workers lose years of accumulated rights when they change jobs...
...Opponents apparently have accepted Medicare as a fait accompli, and indeed are geting on the bandwagon...
...Enrollment in the medical plan is voluntary, paid for by a monthly premium of $3 to be matched by the federal government...
...they need more home care and more drugs...
...It has been argued that the steep increase in payroll taxes that this entailed would generate resistance, and discourage firms from increasing their work force because of rising costs...
...Admittedly passed as a sub stitute for health care through the social security system, it asked the states to de 20 Senate Committee on Aging, op...
...AMERICANS ARE PROUD of the fact that the nation is becoming young...
...New York Times, July 19, 1966...
...By mid1966 seven states had obtained approval for their programs and a number of others have applied for approval...
...Many refused to utilize the "service" when they discovered that they would have to pauperize themselves...
...Fees for some services provided by hospitals would be raised...
...Nearly half the population is now under 25 years of age and about a third under 15...
...Somehow social security benefits would have to be tied to a "cost of living" formula if the retired were not to lose ground...
...Quite significant too was the marked easing of eligibility rules, residence requirements, and family responsibility regulations...
...2 J. Henry, Culture Against Man, New York...
...Yet assistance to the aged, as well as other categorical forms of aid, has become much too severe a problem to be handled by private charity, as is frequently suggested by low-tax advocates...
...yet few of these institutions tie their services to a medical care system or rehabilitation effort that would minimize the "disuse syndrome" among their clients...
...After eight months one could detect no demonstration, no dropouts, no absenteeism in the project...
...The brutalizing habits of the larger society seemed to have undermined what would appear to be the moral obligations of an agency concerned with poverty...
...In fact, in an industrial society the position of the aged tends to worsen...
...Only $80 million would be cut from the estimated half-billion-dollar federal cost in the year beginning July, 1967: the original estimate for federal contributions had been $238 million a year...
...The lower the income, the less coverage: only a third of the aged with incomes under $2,000 a year had hospital insurance...
...With social security payments as a base, the aged poor can turn to private services when no others are available...
...This amendment is a liberalized and expanded version of the 1960 Kerr-Mills law...
...The higher the educational level, the more undesirable did joint living appear to be: educated persons were less likely to provide a home for their older relatives...
...p. 21 6 Rosow, ibid., p. 25...
...It seems obvious that these programs have provided a tiny fraction of the need...
...17 G. Y. Steiner, Social Insecurity: The Politics of Welfare, Chicago, 1966, p. 11...
Vol. 15 • March 1968 • No. 2
