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How Much Security? President Eisenhower, as he told his press conference last week, is "utterly opposed" to any compulsory insurance. At first, conservative Republicans in Congress prevailed upon the President to hold out for no legislation at all. But a liberal wing pressed for action. It was led by Vice President Nixon, who back in 1949 co-sponsored a bill to subsidize private health insurance for the aged. Ike and Nixon agreed to search for a modest plan that would be voluntary instead of compulsory, and administered less by Washington than by insurance companies and local medical boards.
Many Congressmen in both parties fear that any health insurance program for the aged hitched to social security would be only the first step to broader demands on the social security system. Widows and orphans would start hammering for admission. So would veterans and low earners. The American Public Welfare Association is already demanding that the Forand bill's benefits be extended to cover routine doctors' visits and home-nursing care. Says Thomas Pitts, A.F.L.-C.I.O. secretary for California: "Federal protection for the elderly is only the first step to pave the way for universal coverage"—meaning comprehensive federal medical subsidies for every U.S. citizen.
The U.S. is moving faster than it knows toward universal coverage. Social security coverage and benefits have been extended every election year since 1950. Social security taxes have jumped from 2½% last year to 3% this year, will rise steadily to 4½% (paid by both employer and employee on the first $4,800 of earnings) in 1969. And the taxes are falling behind the benefits. The social security program ran about $1 billion in the red in fiscal '59 and again in fiscal '60. In addition, the U.S. spends about $5 billion a year on other welfare programs, including veterans' benefits, medical and relief grants to the states. Next to spending for defense, spending for welfare is the fastest growing item in the federal budget.
But fiscal arguments are likely to carry little weight when placed against statistics of rising human need.* Morally, the idea of some kind of medical aid for the aged is laudable. Politically, it is expedient. Practically, it is complex, especially in the highly paid, highly individualistic U.S. Instead of rushing for a cure-all in an election year, Congress would do well to act like a doctor who knows his patient is ailing but is unsure of what to prescribe: the problem is there, the solution should be thought through with care.
* The U.S. is the world's only major industrial country without some form of national medical insurance for the aged. Belgium offered voluntary national old-age annuities as far back as 1850. now foots up to 75% of the medical bills for its aged. Bismarck's Germany instituted the first mandatory national health insurance plan in 1883; in modern West Germany, workers and employers alike are compelled to contribute 12% to 14% each to various welfare schemes—which is the main reason why workers get free vacations in mountain resorts when they are ill, and rock-bottom wages when they are not. Among the 30 other countries with governmental health insurance plans for the aged: Britain, France, Canada. Mexico, Japan.