Eldercare v. Medicare

For years the American Medical Association has furiously fought the Democratic proposals that it considered steps toward socialized medicine, from Harry Truman's program for compulsory national health insurance to John Kennedy's $1 billion medical-care-for-the-aged plan. As taken over by President Johnson and incorporated into the Great Society, medicare seems a cinch for passage this year by the hugely Democratic 89th Congress. But the A.M.A. is determined, in the words of one top official, "to go down fighting." Meeting last week in Chicago, the A.M.A. House of Delegates endorsed an all-out national drive against medicare, along with an equally all-out push for its own program--which it calls "eldercare."

A Matter of Means. To the A.M.A. and its president, Dr. Norman A. Welch, eldercare's advantages over medicare are obvious. In a sense, eldercare would be an expansion of the 1960 Kerr-Mills law. Like Kerr-Mills, it would be financed from general tax revenues (not through social security, as proposed by medicare). It would provide federal funds matching state payments to pay for the premiums under existing private insurance plans of medical care. Like Kerr-Mills, it would set up a means test to determine whether elderly persons could afford their own medical care. Unlike Kerr-Mills, it would require only a simple sworn statement of inability to pay, not a full-scale welfare investigation.

Some A.M.A. officials estimate that eldercare would cost as much as $500 million a year less than medicare. It would pay all or part of medical-insurance premiums for some 11 million Americans aged 65 or over--as against some 16 million who would be covered, whether they needed help or not, by medicare. Eldercare, says the A.M.A., would preserve some freedom of choice, since the patient would be able to select any hospital or institution, not just one under contract with the U.S. Department of Health, Education and Welfare.

$1,000,000 Push. To push eldercare, the A.M.A. has set up a new "public education" program under which it may spend well over $1,000,000 in the next few weeks. The A.M.A. will send its lobbyists and Washington staff of 23 into action on Capitol Hill; it has already contracted for some $550,000 in newspaper, magazine, radio and TV advertising.* In addition, the A.M.A. has offered to aid state medical societies in their own local campaigns.

In the past, similar drives have been highly effective. In 1965, with that two-thirds-or-better Democratic majority in both branches of Congress, it looks like medicare over eldercare.

* The ads, however, will not appear on either the NBC or CBS television networks. Both have rejected them as "too controversial."

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