But we are very, very grateful. We have learned a great deal, I certainly have. I think the committee has. And we want to thank them for joining us.

Three weeks ago today, the citizens of Illinois, along with millions of Americans across the country, went to the polls. Since that time, analysts have been pouring over the results and have pronounced national health insurance a casualty of the election. I believe those analyses are wrong. The testimony we will hear today from Illinois families will effectively rebut those arguments. Health insurance is not dead-it cannot die while medical costs continue to escalate out of control it cannot die while parents all over America worry whether their child is $50 or $100 sick before seeking medical attention; it cannot die when the threat of financial ruin hangs over so many American families-poor, middle class, and upper middle class alike. It cannot die when our senior citizens are forced to pay more for their care today, even after adjusted for inflation, than they did before medicare was passed.

It cannot die because every American-every man and woman_in this country-knows the fear of illness. Everyone in this room today has felt it for yourself or for your loved ones. In America that fear has two parts: First is the fear of the illness itself, second is the fear of not being able to pay for the needed care or of not being able to afford the basic necessities of life after or while paying for care. How many Americans have lost their savings, their homes, their life insurance policies, in order to pay for care? And this in spite of having insurance; in spite of having a good job and a good income; and in the absence of an unusual medical problem. Common problems like strokes, heart attacks, intestinal ailments requiring surgery, can and do needlessly disrupt the economic lives of millions of Americans. I might say at this point often we think about the particular medical bills the families have and will hear about them-about those associated with really catastrophic situations I think the testimony we will hear today of very sizable medical bills that are catastrophic in terms of the incomes or savings of those particular families, but the important factor is from the economic point of view is that those illnesses, those sicknesses, those ailments are basically the type of everyday ailments that are affecting millions of American families. They are really not that unusual. They are not that distant from the types of health care problems that affect the average family in this country. They are catastrophic but they are more often typical than unusual.

What we really do in this country, I believe, is penalize people for getting sick. We penalize them financially for something over which they have no control. They have trouble getting insurance. They have to pay more when they do get it. It is a peculiar kind of American Darwinism-survival of the wealthiest.

No other industrialized nation in the free world except South Africa penalizes its people for getting sick. All of them have universal, comprehensive national health insurance. None of those systems is perfect-they have real and serious problems. But not a single political leader, not a single political party, not a single respected commentator, would turn the clock back and substitute our system for theirs.

National health insurance must come to the United States. If it does not, there will be no way to control runaway health costs. The choice is not, as critics would have us believe, between doing nothing on the one hand and enacting a national health plan on the other.

I might just say that this particular chart over here that has been developed by the Congressional Budget Office shows that if we do nothing at all, if we do not come to grips with the health care issues that face this country today, we are going to spend $252 billions by 1981; whereas, if we adopt a national health insurance program with effective cost controls, we are spending actually less than if we are doing nothing at all because of the growth of inflation in our current system.

In our health care area, it is almost double what it is for consumer price index. I think that is what is reflected to some extent with this chart here that shows the growth of the percentage that is of gross national product in the United States over the period of recent years in health.

In 1968, we were spending 6.5 percent. In 1978, 8.8 percent. This is without any national health insurance. That is without any effective kind of cost controls.

Any of our friends that look at what the record of the Congress was last year when we were trying to come to grips with the issue of cost containment and cost controls know that even a program that set a 14 percent increase in hospital costs for the first year, 12 percent the second year lost in the Congress of the United States.

What we have seen are enormous growth projections in terms of health care costs by doing nothing at all.

The question is whether we are going to be able to get effective handle on those costs over the period of future years and deal with the issues of equity and fairness and compassion in our health care system.

So if we do not do anything, we will see the explosions of the cost. It need not be that way. We will hear from families in Illinois and their counterparts in Canada, and one of the interesting points on the issues of cost is what the contrast has been with Canada. They were spending 6.8 percent of GNP in Canada on health in 1968 when they implemented their final aspects of national health insurance, and now they are spending effectively 7.1 percent 10 years later with prospective budgeting and effective cost controls.

It is going to be fair to ask with that kind of cost controls what the people of Canada feel about that particular program. Whether it is a program of humaneness and compassion and decency, and whether Canadian people feel that it is effective in meeting the health care needs of their particular families because we hear a great deal about that issue, we want to hear from our friends in Canada on that. We will move to our witnesses today. We are delighted to welcome our families from the Chicago area. We appreciate their joining with

us.

First will be Mrs. Loretta Wilson, from Chicago, and Mr. and Mrs. Iain Troup, from Windsor, Ontario.

What I am going to do is ask some questions, first of Mrs. Wilson, and then we will go down and hear from our other families, Mr. and

Mrs. Louis Steinbrecher, from Chicago, and Mr. and Mrs. Gerald Clancy, from Windsor, Ontario; and then Mrs. Reifsterk, from Lena, Ill., and Mr. and Mrs. Gerard Beneteau, from Windsor, Ontario, and Mr. and Mrs. Kemo Biondi, from Chicago, Ill., and Mr. and Mrs. Archie Kinberg, from Hamilton, Ontario.

Then we will hear from Mr. and Mrs. Bjarnason, from Buffalo Grove. Ill., Mr. and Mrs. Agnew, from Windsor, Ontario; Mr. and Mrs. Moss, from Chicago, Ill., and Mr. and Mrs. Mieyette, from Manitoba, Canada.

We will start with Mr. Steinbrecher, from Chicago.

Mr. Steinbrecher, I believe you are 58 years old?

Mr. STEINBRECHER. Yes. I was born the same day as Stan Musial, November 21, 1920.

STATEMENTS OF MR. AND MRS. ARCHIE KINBERG, HAMILTON, ONTARIO; BELLE BIONDI, CHICAGO, ILL.; MR. AND MRS. PAUL (GLORIA) MIEYETTE, WINNIPEG, MANITOBA, JOHN MOSS, CHICAGO, ILL.; MR. AND MRS. IAIN TROUP, WINDSOR, ONTARIO; LORETTA WILSON, CHICAGO, ILL.; MR. AND MRS. GERALD CLANCY, WINDSOR, ONTARIO; LOUIS STEINBRECHER, CHICAGO, ILL.; MR. AND MRS. GERARD BENETEAU, WINDSOR, ONTARIO; MARGARET REIFSTERK, CHICAGO, ILL.; MR. AND MRS. SAM AGNEW, WINDSOR, ONTARIO; AND MR. AND MRS. CHARLES (GERALDINE) BJARNASON, BUFFALO GROVE, ILL., A PANEL

Mr. STEINBRECHER. I would preface my remarks with a thanks, a deep thanks for the staff of the Swedish Covenant Hospital because without them and their heroic actions, quick actions, their facilities, their patience and their love and their kindness, I would not be here. I would have died 4 years ago.

And also thanks to modern medicine, the medicine, that if it had happened about 10 years prior to that, they would have let me bleed to death. We are making progress in medicine.

I would also like to say these people at Swedish Covenant are of the highest caliber. They are kind, good, sincere, dedicated, and knowledgeable. I also want to express my thanks to the chaplains who gave me the spiritual strength to survive this ordeal. I never will forget it as long as I live.

I will say they are a victim of the system. I have asked one of our assistant directors what the problem was. He explained to me, but they are victims as well.

Senator KENNEDY. I think that is very true just as doctors are and as consumers are. That is why it is essential we deal with the total systems approach rather than just sort of Band Aid approach. I agree with that.

Let me just ask you some specific questions.

As I understand it, 4 years ago, with your illness, you were taken to the hospital and you were given a series of transfusions, is that correct?

Mr. STEINBRECHER. Yes: I was given 19 pints of blood.
Senator KENNEDY. You had surgery?

Mr. STEINBRECHER. Yes; it was really a rough situation. I had really practically everything in the book.

Senator KENNEDY. Collapsed lung, is that correct?

Mr. STEINBRECHER. I had the same as one of our Presidents had. I had a collapsed lung. I had a blood clot on my lung. I had 105° temperature. My blood pressure was 50/40.

Senator KENNEDY. You were a very sick man?

Mr. STEINBRECHER. Not only that, but I also developed an infection. And I was unable to work for about 2 or 3 months later. Then I became anemic. Thank God I pulled through.

Senator KENNEDY. You had some medical insurance?

Mr. STEINBRECHER. Yes. I had Blue Cross and Blue Shield.

Senator KENNEDY. What part of the medical bills were covered? Mr. STEINBRECHER. Roughly costs totaled about $11,000, and out of that I was reimbursed $7,000, and then I had to go over to our savings and loan association and pull out about roughly $3,900, plus I had a few other payments in the following year.

Senator KENNEDY. So they covered a little better than half?

Mr. STEINBRECHER. Roughly about 60 percent. Thank God I was able to go to my savings. I feel sorry for the people who are unable to do this.

Senator KENNEDY. You have a daughter who, several years ago, fell off a sled and broke her elbow, is that correct?

Mr. STEINBRECHER. She tried to make a sled run out of a slide. She dislocated her elbow. She was in intensive care because they were afraid that the artery might be punctured or she might have a nerve that might be pinched and give her paralysis. She came out very fine.

Senator KENNEDY. She was covered by some of the insurance, but you had to pay some of that as well, did you not?

Mr. STEINBRECHER. It is like going to bed and having your feet stick

out.

Senator KENNEDY. Do you remember how much approximately that was?

Mr. STEINBRECKER. Certainly. That was $2,300. She was in intensive care because of this condition.

Senator KENNEDY. The insurance paid part?

Mr. STEINBRECHER. Yes. They paid roughly about $1,600. I paid about $650 in all.

Senator KENNEDY. You were one of the people in our system who actually recovered with health insurance, probably a good program that exists today, and still you had those kinds of financial payments for your own health and for your child's health?

Mr. STEINBRECHER. Yes, sir.

Senator KENNEDY. Mr. Clancy, how old are you?

Mr. CLANCY. Fifty-one.

Senator KENNEDY. You are about the same age, about 6 years difference. You are a member of the Auto Workers, is that correct?

Mr. CLANCY. UAW.

Senator KENNEDY. You have diabetes?

Mr. CLANCY. Yes.

Senator KENNEDY. Has that ever required hospitalization?

Mr. CLANCY. On about four occasions. I was confined about 3 weeks to where I could leave the hospital.

Senator KENNEDY. You spent some time in the hospital for a chronic condition?

Mr. CLANCY. Yes; I have.

Senator KENNEDY. How long would you say you spent in the hospital?

Mr. CLANCY. Over the period of my life, at least 6 or 7 months. Senator KENNEDY. And in 1977 did you not have a swimming pool accident?

Mr. CLANCY. Yes.

Senator KENNEDY. Would you tell us a little bit about that?

Mr. CLANCY. I was getting out of my pool and I fell back in and ripped my heel, which became infected. I was put in isolation for 3 weeks in the hospital, and for 6 months I was an outpatient and had to go in every week.

Senator KENNEDY. Now, at sometime Mrs. Clancy had some surgery, as I understand, as well?

Mr. CLANCY. She has had three major surgeries, kidney operations. Senator KENNEDY. Over a period of recent years, last several years? Mr. CLANCY. Yes.

Senator KENNEDY. You have children as I understand, five children? Mr. CLANCY. That is right.

Senator KENNEDY. You have had your fair share of broken bones, I understand, with them.

Mr. CLANCY. Two boys were great football players. After the game, they were in the hospital every weekend.

Senator KENNEDY. So your children have been hospitalized. Do you have any idea about how many times?

Mr. CLANCY. Not that often.

Senator KENNEDY. A fair number of broken bones?
Mr. CLANCY. Yes.

Senator KENNEDY. How did you pay for yours? We heard now from Mr. Steinbrecher about his hospitalization and the amount going down to his savings account and taking out approximately $5,000 for his own hospital bill, and approximately $600 a few years ago for his children.

You have been in the hospital several times in the last few years. Your wife has had three major operations, and your children also have had broken bones.

Can you tell us how much you had to pay?

Mr. CLANCY. Nothing whatsoever. Nothing that was laid out of my own pocket.

Senator KENNEDY. Who paid for the program?
Mr. CLANCY. OHIP.

Senator KENNEDY. That is what?

Mr. CLANCY. Ontario Hospital Insurance plan.

Senator KENNEDY. Were you satisfied with both the medical treatment that you received

Mr. CLANCY. I was in a semi-private room and we got the best of care and choice of doctors.

Senator KENNEDY. Did you have choice of doctors that you wanted? Mr. CLANCY. Oh, yes.

Senator KENNEDY. Could you have gone to a different hospital if you had not been satisfied?