Library Collections: Document: Full Text

To the Congress of the United States:

The American people are not satisfied with better-than-average health. As a Nation, they want, they need, and they can afford the best of health:

-- not just for those of comfortable means.
-- but for all our citizens, old and young, rich and poor.

In America,

-- There is no need and no room for second-class health services.
-- There is no need and no room for denying, to any of our people the wonders of modern medicine.
-- There is no need and no room for elderly people to suffer the personal economic disaster to which major illness all too commonly exposes them.

In seeking health improvements, we build on the past. For in the conquest of ill health our record is already a proud one:

-- American medical research continues to score remarkable advances.
-- We have mastered most of the major contagious diseases.
-- Our life expectancy is increasing steadily.
-- The overall quality of our physicians, dentists, and other health workers, of our professional schools, and of our hospitals and laboratories is unexcelled.
-- Basic health protection is becoming more and more broadly available.

Federal programs have played a major role in these advances:

-- Federal expenditures in the fiscal 1965 budget for health and health-related programs total $5.4 billion -- about double the amount of 8 years ago.
-- Federal participation and stimulus are partly responsible for the fact that last year -- in 1963 -- the Nation's total health expenditures reached an unprecedented high of $34 billion, or 6 percent of the gross national product.

But progress means new problems:

-- As the life span lengthens, the need for health services grows.
-- As medical science grows more complex, health care becomes more expensive.
-- As people move to urban centers, health hazards rise.
-- As population, which has increased 27 percent since 1950, continues to grow, a greater strain is put on our limited supply of trained personnel.

Even worse, perhaps, are those problems that reflect the unequal sharing of the health services we have:

-- Thousands suffer from diseases for which preventive measures are known but not applied.
-- Thousands of babies die needlessly; 9 other nations have lower infant death rates than ours.
-- Half of the young men found unqualified for military service are rejected for medical reasons; most of them come from poor homes.

Clearly, too many Americans still are cut off by low incomes from adequate health services. Too many older people are still deprived of hope and dignity by prolonged and costly illness. The linkage between ill-health and poverty in America is still all too plain.

In its first session, the 88th Congress made some important advances on the health front:

-- It acted to increase our supply of physicians and dentists.
-- It began a Nation-wide attack on mental illness and mental retardation.
-- And it strengthened our efforts against air pollution.

But our remaining agenda is long, and it will be unfinished until each American enjoys the full benefits of modern medical knowledge.

Part of this agenda concerns a direct attack on that particular companion of poor health--poverty. Above all, we must see to it that all of our children, whatever the economic condition of their parents, can start life with sound minds and bodies.

My message to the Congress on poverty will set forth measures designed to advance us toward this goal.

In today's message, I present the rest of this year's agenda for America's good health.

I. HOSPITAL INSURANCE FOR THE AGED

Nearly thirty years ago, this Nation took the first long step to meet the needs of its older citizens by adopting the Social Security program. Today, most Americans look toward retirement with some confidence that they will be able to meet their basic needs for food and shelter.

But many of our older citizens are still defenseless against the heavy medical costs of severe illness or disability:

-- One-third of the aged who are forced to ask for old age assistance do so because of ill health, and one-third of our public assistance funds going to older people is spent for medical care.
-- For many others, serious illness wipes out savings and carries their families into poverty.
-- For these people, old age can be a dark corridor of fear.

The irony is that this problem stems in part from the surging progress in medical science and medical techniques--the same progress that has brought longer life to Americans as a whole.

Modern medical care is marvelously effective -- but increasingly expensive.

-- Daily hospital costs are now four times as high as they were in 1946 -- now averaging about $37 a day.
-- In contrast, the average Social Security benefit is just $77 a month for retired workers and $67 a month for widows.

Existing "solutions" to these problems are (1) private health insurance plans and (2) welfare medical assistance. No one of them is adequate, nor are they in combination:

-- Private insurance, when available, usually costs more than the average retired couple can afford.
-- Welfare medical assistance for the aged is not available in many States -- and where it is available, it includes a needs test to which older citizens, with a lifetime of honorable, productive work behind them, should not be subjected.