Claude Pepper/On Health Care : President’s $2,000 Limit for Aged Criticized

After President Reagan hailed his Administration’s proposal to place a $2,000 annual limit on hospital and doctor bills for the aged as “a giant step forward,” Rep. Claude Pepper disagreed.

“It is not a giant step,” the 86-year-old Florida Democrat said during a recent appearance at a Los Angeles conference on aging. “It’s the step of a pygmy.

“In the first place,” the longtime advocate for the elderly said during a subsequent interview, “a lot of people don’t have $2,000 to spend. . . . The other thing is that it does nothing to help the people who have to go to a nursing home. . . .

“It does nothing to help you with home care . . . It does nothing to help people pay the $10 billion a year they spend for drugs. . . . or (to help with) eye care or hearing aids or dental care or foot care.”

The white-haired legislator, aided by a pacemaker, a synthetic heart valve and hearing aids on both ears, wore a gray plaid suit and royal blue tie while easily marshaling his arguments in a conference room at the Andrus Gerontology Center at USC.

The 12-term congressman said he supports comprehensive health care for the nation’s 30-million Medicare recipients and favors his own bill to that effect over the Reagan plan, which was first advanced by Secretary of Health and Human Services Otis R. Bowen and may soon be reported to the House floor.

Pepper said that Medicare patients currently pay 20% of physicians fees and $520 for their first day in a hospital. The law covers them for the next 59 days of hospitalization but provides that they must pay $130 for each day between 60 and 90, $260 for days 90 to 150 and all hospital expenses thereafter.

The Miami congressman would finance his proposal by expanding Social Security tax deductions. Currently the government deducts 1.45% of employee income up to $43,800 for Medicare. Pepper proposes to lift the $43,800 cap so that everybody pays 1.45% for all income.

“Mr. Iacocca, who made $14 million last year and will make $20 million this year, would have to pay 1.45% on his income just like you and I,” Pepper said. “Let him pay all the way up. It won’t hurt him. . . . Any of us can pay and it won’t hurt.”

Pepper said Congress would like to help but feels handcuffed. “They think: Well, Claude Pepper’s right. We’d like to do this, but it costs too much and they want to compromise on (something) just a little better than the Bowen bill. . . .

“Well, I tell them it won’t cost any less next year. It will probably cost more. . . . And what about these millions of people who go broke every year and some (who become) destitute trying to pay these bills. . . .

“We found out on my subcommittee on health and long-term care that a million people a year, including 700,000 of the elderly, became destitute simply because they tried to pay the cost of catastrophic illness. . . .

Simply Sitting Ducks

“There were tears in the eyes of an elderly lady of one of that group. She said: ‘Finally, after I had used up our savings and our liquid assets, there was nothing for me to do if I was gonna keep my husband in a nursing home except to sell our home.’ Which, she said, ‘I dared not tell him. It would have broken his heart.’

” . . . So the elderly people and the American people generally are simply sitting ducks to be stricken by catastrophic disease, and ordinarily only the rich are able without ruin to be able to pay the cost.”

“What I’m talking about is a principle of insurance applied to health care. We insure our homes. We insure our businesses. Why can’t we insure something that’s even more important to us, our lives and our health?”

Pepper thinks he has a good chance to get a comprehensive bill for senior citizens passed because 80 congressmen voluntarily support it.

He became interested in comprehensive health care when he came to Washington as a U.S. senator in 1936 and allied himself with the New Deal of Franklin Roosevelt, whom Pepper calls his political mentor.

Florida voters ended his Senate career in 1950 but elected him to Congress in 1962. Pepper wants Congress to pass his health-care bill this session because he recalls how slowly health-care legislation moved in the past.

First Bill Passed in 1938

“In 1938, Sen. Robert Wagner of New York introduced the first legislation to provide comprehensive care for people. Nothing was done,” he said.

“In 1945, President Truman sent a message to Congress asking for money for research for building hospitals and for comprehensive care. . . .

“Congress didn’t do anything until 1965. Finally we recognized the need to provide hospital care for the elderly ill. Then we decided to take care of the very poor, people who had less than $3,500 as individuals or a little more than that as a couple. . . .

“We thought at that time that if we did that, taking care of the elderly and the very poor, that would suffice. The rest of the people could take care of themselves. Now we found out they can’t. It costs too much.”

“We’ve waited 22 years since 1965 when we passed Medicare. What will be the advantage of waiting longer? A lot more people will die without the care that they could get. . . . What are we afraid of? Sure, they have to pay a little more taxes but . . . then they won’t have to pay all those big bills. . . .

“And to say to the elderly, you can only live, you can only be cared for if you’re rich, doesn’t seem to me to be the proper attitude for an American to take.

“The United States and South Africa are the only two industrial nations in the world that don’t provide some sort of comprehensive health-care program for their people. I don’t think that’s the company the American people want to keep.”