Senior Citizens Program: Study Paper by Richard Nixon, Vice President, United States of America

No nation has made greater progress in meeting the human needs of all its citizens than has the United States in the past 25 years. Our standards of health care, of welfare services, and of economic security are equal to or higher than those of any other nation - anywhere, anytime.

In this development, we have consistently followed two traditional principles: the first, arising out of the heart of the Judaeo-Christian heritage, is that each of us is morally responsible for the welfare of his fellow men. We do not pay mere lipservice to this affirmation: we have made it the guide to private and public action. At the same time, we have adhered firmly, through most of these years, to the principle that government's primary role is to help provide the environment within which the individual can seek and achieve his own goals. Federal programs, over the last 8 years especially, have sought to support and strengthen individual, private, State, and local initiative.

In a sense, all our efforts and accomplishments in this area of human needs can be summed up in one historic event: the organization at the highest executive level, by this administration, of the Department of Health, Education, and Welfare. We have thus drawn together and focused all the more sharply a vast range of policies and programs, of knowledge and skills.

We are proud of our progress. But we are not satisfied. Much remains to be done.

I have already put forward, in previous papers and speeches, some specific programs that I vigorously support in the fields of basic research, education, health, housing, and urban renewal. All these are major sectors in the area of human needs. Now, let me direct attention to still another such sector - the problems of our senior citizens - and to some programs that will help us solve these problems and build solid national assets.

There are three major factors to be kept in mind as we attempt to devise an effective program to meet the needs of our senior citizens.

(1) The first arises out of a simple fact: there are more older people in our total population today than ever before. And in the years ahead, the ratio of advanced age groups to total population will continue to increase. In 1937, for example, the Social Security Board estimated that our 65-and-over age group would reach 20 million by the end of the century. Today - with 40 years still to run - there are approximately 16 million Americans 65 and over, and approximately 36 million between the ages of 45 and 65. Clearly, the more we do now to tackle and solve the problems of the aged, the better will we serve the immediate needs of this important group of Americans - and the better prepared will we be to cope with future needs before they swamp us.

(2) The second factor is the tremendous variety of programs and services - public and private, National and State and local - already in existence. Indeed, the very increase in the number of older people in our population is dramatic evidence of our progress to date. It is clear proof of our achievements in medical research and care, of our advances in education, of our overall social and economic growth. Not only are more of the American people now living longer than ever before, but. by and large they are living better. They have access to better medical and hospital care, they are better housed, they are better trained in a wider variety of skills, and they have more financial security than older people, as a group, have ever had before.

Such progress is no accident. It follows logically from prodigious and creative efforts of the greatest variety - by labor unions, by business and industrial groups, by the insurance profession, by our States and local communities - and, literally, by nearly every major executive department in the Federal Government.

(3) But - and this is the third factor - our total national effort needs still greater coordination and more efficient mobilization of available resources. Right now, it is a tragic fact that much specialized knowledge and many services exist of which those most in need either cannot or do not take full advantage. And as the numbers of senior citizens mount, as the manpower and brainpower needs of our economy grow, it, becomes all the more imperative to mobilize our resources and focus them on major targets. The real challenge, indeed, is to head off problems before they have a chance to become problems at all.

How then can we achieve our objectives in meeting the human needs of our senior citizens - in providing them with every possible opportunity for productive and satisfying lives? What role can and should the Federal Government assume in this effort?

I. The Federal Government must bring into play the full range of its resources in helping to solve the problems of our senior citizens

I am convinced that we will deal most effectively with these problems only by enlisting some form or degree of Government action - as a stimulant and an indispensable support and supplement to private efforts and to the programs of our States and cities and towns. In fact it is probably fair to say that, right now, there is hardly a department or agency within the executive branch of the Federal Government that is not somehow involved in the effort to help older people live more comfortable and more productive lives.

One manifestation of this effort was the establishment by President Eisenhower, in March 1959, of the Federal Council on Aging. By this action, the President brought concern for the problems of older people into the highest councils of the Federal Government, at the Cabinet level. I will do whatever is necessary to do in order to make sure that this Council functions with maximum effectiveness.

II. We must encourage more flexible retirement policies and provide more job opportunities for older people who can and want to work

Our national attitude toward retirement is in a rut. We have tended more and more toward a system of compulsory retirement based simply on the criterion of age, a system that gives less and less heed to individual capacities and desires. We must reverse this trend. We must work toward retirement policies, public and private, that allow for greater flexibility, greater opportunity for adjustment to an endless variety of individual situations and capabilities.

To many people, retirement represents a welcome change. It enables them to do things that they have not had the opportunity to do during their working years. But to others, retirement comes as a sharp and unwelcome break with a way of life from which they derive their greatest satisfaction and sense of achievement.

As a nation, we must abandon the false notion that mental and physical deterioration suddenly set in when a person passes a certain birthday. We have mounting evidence that, in case after individual case, exactly the opposite is true.

Many of our present retirement policies are simply a lazy man's way of dealing with what is admittedly a difficult personnel problem. As persons become older it is necessary for the employer to recognize that some are no longer capable of discharging effectively the duties and responsibilities of a particular job. These are always difficult decisions and distinctions to make. We are no longer justified however, in saying that because it is difficult to determine who should and who should not continue to work at particular ages, we will arbitrarily cut off the employment of everyone at age 60 or 62 or 65.

By following such policies - and both public and private employers are guilty on this score - we are deliberately preventing capable men and women from continuing to be productive members of society. And we are not only hurting them - we are depriving the Nation of their services and invaluable experience.

The age barrier to employment - whether continued employment or new employment - can and must be broken through. Here are some of the ways in which the Federal Government can lead the attack

The provisions of the Social Security Act which reduce or even discontinue benefits if a person earns certain amounts of money after he reaches age 65 need to be liberalized - beyond the limited action taken by the last Congress. There is no question but that, even with these most recent changes, the so-called retirement test will continue to discourage many people from working who otherwise would not only help themselves but also make a contribution to the Nation's productive power.

Federal personnel officers should not engage in discrimination based on age - and Executive Orders should make that perfectly clear. Selection for the public service should be conscientiously based on qualification, and capacity regardless of age, in accordance with Federal law which prohibits the imposition of maximum age limits in civil service examinations.

The Department of Labor has made great strides in helping the State employment offices provide specialized advice and placement services for older workers. The funds to extend such services, and make them still more effective, should be increased.

Research by the Department of Labor on the problem of industry resistance to the employment of older workers should be greatly expanded, in cooperation with industry, with labor unions, and with other private groups. At the same time, intensive educational campaigns should be launched by the Departments of Labor, of Commerce, and of Health, Education, and Welfare to bring to the attention of both labor and management, and the public generally, the facts about older people and their capacities.

Vocational education programs should be expanded to provide opportunity for the training and retraining of older workers whose experience has left them ill equipped for present-day occupations but who want to go on working and could, with a little help, continue to be productive members of society. In our day of rapid and continual technological change, such programs take on special significance.

Industry should also be encouraged to broaden training opportunities for older workers to help them keep up with advancing technology. The Federal Government should make funds available to the States for demonstration projects to further this objective.

III. We must increase our investment in programs for the rehabilitation of the physically and mentally handicapped.

These programs are designed, of course, to serve all age groups. But they can play a major part in helping many of our older people to lead productive and satisfying lives.

Here is what the Federal Government can and should do in order to strengthen rehabilitation programs:

It should continue to increase its basic investment in the FederalState program of vocational rehabilitation.

A further Federal-State program should be inaugurated at once, designed to help rehabilitate handicapped persons who may never again be able to accept regular employment but who can be brought to the point where they need not be dependent on custodial care. Many older people in hospitals and nursing homes today could care for themselves in the proper setting, if the combined forces of medical care, social service counseling, and other resources were brought to bear on their handicaps.

Additional Federal funds should be made available for research and training in the field of rehabilitation, with special emphasis on rehabilitation of older people. There have been many forward steps in the rehabilitation of the physically and mentally handicapped as a result of money invested in research. There is much more that remains to be done. And as we make discoveries growing out of our research activities, we must have trained personnel available to apply the results. We are faced with serious manpower shortages in this area. The Federal Government has made some funds available to accelerate the training of professional personnel, but we must raise our sights. We will get a very substantial return - in both humanitarian and economic terms - on any such investment.

IV. We must make it possible for our senior citizens to receive adequate medical services

As a nation we must do a better job of providing adequate medical services for our senior citizens - to prolong their period of productivity, to reduce the likelihood, of dependency, and above all to prolong the period during which hey obtain joy and satisfaction out of living - quite simply, to make sure they will live out their lives in decency and dignity. Here are some steps the Federal Government can take in working toward this objective:

Additional funds must be made available for medical research in those areas directly related to the problems of the aged. Medical research makes a tremendous contribution, of course, to the welfare of all our people - as I have pointed out in an earlier policy paper. But the aged are confronted with cumulative problems, and we need to concentrate a higher proportion of our funds for medical research in this special area of concern.

Additional Federal funds should be made available to accelerate our progress in the construction of adequate hospital and medical facilities.

The Federal Government and the States must work together to provide greatly improved nursing home facilities. This will have the desirable effect of taking some of the pressure off our overburdened hospitals. Many nursing homes today are model institutions and give the best of care, but in far too many communities they are little more than devices for profiting from human misery. Both the buildings and the services are often shamefully inadequate. We should have just as much concern about these nursing homes as we do about hospitals, and the Federal Government can take the lead in correcting this serious national deficiency.

Medical care under our old-age assistance program needs to be improved. The Congress in its last session took an important step in the direction of providing more medical care for the neediest. But we cannot assume that the problem is solved. The Federal Government should keep in close touch with developments in the States and, if there is not marked improvement throughout the country, then we should consider additional steps to bring it about as soon as possible.

The Federal Government should use every means at its disposal to encourage the States to put into effect the new Federal-State program which safeguards persons of small income - but who are not on the public assistance rolls - from becoming impoverished by the costs of medical care. This program gives the States great latitude in determining both eligibility and benefits, and the Federal Government will help by paying from 50 to 80 percent of the costs. This program promises to be of great benefit to many of our older people, but we must watch it closely in its early stages; if it proves to be inadequate, then it should be strengthened.

All senior citizens who can and wish to protect themselves in advance against the costs of illness should be provided with every opportunity for doing so. Private groups have made substantial progress in providing such protection at reasonable cost. It is clear, however, that private programs will never be able to take up the whole burden. Government must supplement private efforts - without turning to compulsory health insurance. The time has come for decisive action. It is surely possible to develop a sound voluntary insurance program that will greatly eliminate the fears of illness that now hang over the heads of so many of our senior citizens. It is imperative for those who truly believe in the voluntary principle to set aside their differences and develop a program that will attract maximum support. Unless the existing vacuum is soon filled by an adequate voluntary program, pressure for a compulsory program will become almost irresistible.

V. We must continue to improve our old-age, survivors, and disability insurance program

During the past 25 years, we have made amazing progress in making available to our citizens a sound program of old-age and survivors and disability insurance. Wet must not be content, however, to stop at present levels of achievement. There is still much that remains to be done in providing an adequate floor of income for the aged, for the disable and for widows and their children. Here are some of the goals for Government action in the years immediately ahead:

A soundly financed plan should be developed to make benefits available - at least as large as the minimum payable under the social security system - for the 2.6 million persons 65 and over who are not now eligible for benefits under social security or one of the other public retirement systems. Most of these persons were simply in the unfortunate position of not working, or not having husbands working, at a time when their employment was covered under the system. Their continued exclusion from benefits is indefensible, and the time has come to take effective action. For many such persons, inclusion under the benefit structure of the social security system would enable them to face the remaining years of their lives with a greater sense of independence and well-being.

Benefits now being paid under social security should be subjected to a close and continuing study to determine whether or not they are achieving the objectives of the system. We must never allow this benefit structure to become frozen. We know, for example, that the benefits paid to many aged widows are inadequate. Whenever it is determined that benefits should be increased, we must, of course, hold to the sound policy that has been followed throughout the history of the system - that is, providing additional revenues to cover the cost of additional benefits.

The strict requirements in the law for determining eligibility for disability benefits should be modified for those over 60. Persons in the 60 to 65 age group who are prevented by disability from engaging in the kinds of work to which they are accustomed, and their dependents, should still be able to qualify for monthly benefits.

VI. Constructive steps should be taken to provide more of our senior citizens with housing adapted to their needs

Much of the housing available to our senior citizens today is ill adapted to their special needs. And it is often located in the wrong place for maximum use and convenience.

Additional research is required to determine what older people want and need in the way of housing. Such research should not be confined to determining what kind of living quarters are most desirable for our senior citizens - it should take into account the whole living environment. Funds for such research should be made available to the Housing and Home Finance Agency.

In addition we should reexamine our existing housing programs to make sure that they are making a real contribution to meeting the needs of our older citizens and also to make sure that they can be readily adapted to the results that flow from an accelerated research program.

VII. We must develop adequate counseling and guidance programs for our senior citizens

When we think of counseling and guidance programs, we normally associate them with children and youth. Today these programs are every bit as necessary for many of our senior citizens who simply do not know where to turn for responsible advice and assistance - even though there may be adequate services available close at hand.

There is no doubt that many hundreds of thousands, perhaps millions, of elderly men and women could be given real help by competent specialists attached to information and referral services in our major population centers. Such persons could become the link between many of our senior citizens and the "outside world".

The Federal Government should inaugurate a grant program designed to help States and local communities develop demonstration projects of this kind. A relatively modest outlay might bring incalculable returns.

VIII. The Federal Government must do everything in its power to maintain the purchasing power o f an "honest" dollar

The effects of inflation are of course a burden on all of us, but they are most severe for those living on limited fixed incomes - and this is precisely the case for millions of older people. The Federal Government thus has a special responsibility where they are concerned to combat inflation, and its disastrous effects, in every way that it can.

Unless the Federal Government maintains constant vigilance against inflationary pressures, the potential benefits of many of its own activities in behalf of older people will simply be eaten away.

IX. The Federal Government can also help middle age groups to plan ahead

All the above proposals will, in my view, get us well on the way to helping our present senior citizens realize more of the benefits of our phenomenal progress in the fields of health, education, and welfare. These proposals are designed to meet the most pressing problems confronting many of our older people right now.

But our efforts must not begin and end there.

"Preventive medicine" is far more effective - and far less expensive in the long run - than cures deferred to the last minute. And so we must assist all our citizens - especially the present group of approximately 36 million between the ages of 45 and 65 - to plan ahead for their old age.

Many of the proposals put forward earlier in this paper would have the dual effect of both attacking the problems confronting our older people today and helping to prevent these problems from arising in years to come. Vocational training and other educational programs are prime cases in point, where we can buy invaluable lead-time against the problems of the aged by starting with persons of middle age.

One of the most important preventives of all would be to accelerate the use of private medical care insurance programs which would enable people of working age to take adequate action to safeguard their health. I think we should give immediate consideration to allowing tax deductions for the cost of health insurance, designed to protect them against catastrophic illnesses that place crippling burdens on our families.

In all these ways, then, and by means of an effective partnership of government and business and labor unions and many private groups, we can surely mount a successful attack on the problems of aging and the aged. There is in this rich nation no lack of resources and no failure of will. But there is a lack of fully coordinated, well-focused effort - and it is in this area that the Federal Government has a unique and an urgent job to do. The program I have proposed here will, in my view, do that job - if we support it generously and take action as soon as possible.