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medical care that was met by insur- dence of the spread of voluntary in- points a year, with the remainder of ance beneflts is shown for the total surance in these two fields. its growth dollarwise absorbed by in- and under five different groupings. In recognition of the fact that there creases in population and rises in the The benchmarks representing ex- are many items included in the Na- cost of medical care? Are improve- penditures have been calculated both tion’s medical care bill that are cov- ments in benefits, the newer forms of to include and to omit the expendi- ered by few forms of health insur- insurance-such as dental care, out- tures incurred in the purchase of the ance, the present report includes two patient services, benefits payable in insurance protection being measured, additional benchmarks, which have nursing homes, and the like-and the so that the reader may select the con- been prepared for each year in the broader forms of coverage repre- cept of expenditures best suited to series. The first of these-the amount sented by the establishment of health his particular needs. “currently insurable under existing centers and the sale of major medical Insurance was meeting 8.3 percent forms of health insurance”-omits expense insurance going to close the of the Nation’s medical bill in 1948 the services of dentists, nurses, and gap between actual and potential pro- and 22.6 percent ‘7 years later. Since other practitioners and nine-tenths of tection more rapidly than has been 1951 this percentage has increased the Nation’s expenditures for drugs the case in the past 8 years? about 2 points a year; 1955 was no and appliances. If prepaid dental The dollar volume of voluntary exception. care expands as much as it has in the health insurance benefits--which rose In the field of hospital care costs past year or two, this benchmark may 16 percent in 1955-must increase the peak year of growth in insurance need revision. Insurance benefits about 2 percent each year merely to protection was 1951 (6.9 percentage were equivalent to 30-33 percent of keep up with population growth. If points) ; for each of the other years this benchmark in 1955, and the in- the costs of medical care continue to in the series about 2 percentage dex was two and one-half times what rise, the volume must increase even points of growth have been registered. it had been in 1948. more if the same level of protection The rate of expansion in providing The final benchmark provides a previously afforded is to be continued. protection against the costs of physi- hypothetical measure of expenditures To cover a greater proportion of the cians’ services was more rapid in the that may be considered potentially medical care bill than in the immedi- earlier years of the series-with 1951 insurable; in this measure the items ately preceding year, there must be again a peak year (5.2 percentage of expenditure included are those an increase in the dollar volume of points)-but this rate too has lev- covered on a prepaid basis by some benefits paid over and above these eled off to about 2 percentage points comprehensive plans and under some two requirements. The 16-percent in- of increase a year. forms of insurance company policies ‘crease in 1955 in the dollar volume Since most of the health insurance -that is, major medical expense poli- of health insurance benefits was only available today applies to the costs of cies and comprehensive expense poli- sufficient to increase by 1.8 percent- hospitalization and physicians’ serv- cies. Today all forms of health age points the coverage of the na- ices, the measurement’ of the impact insurance are, by one or more ap- tional medical care bill. More rapid of insurance benefits on the expendi- proaches, meeting only 30 percent of closing of the gap will require that tures for these two items provides an this benchmark of potentially insur- the Nation assign still more of its index of the value of insurance where able costs. medical care dollar to the insurance it has been most successful. The What of the future? Is voluntary industry in return for prepaid pro- rise from 15 percent in 1948 to 36 insurance going to continue its net tection for those parts of the medical percent (or 39 percent, if the expense expansion in the protection it pro- bill inadequately insured at the pres- to obtain insurance is omitted) is evi- vides at the rate of 2 or 3 percentage ent time. lit income-maintenance program in June 1956. A6bte.sand Brief Reports Almost all the married women had Money Income Sources ceiving public assistance are taken income from one or more of the for Persons Aged 65 and into account, it appears that sub- sources under consideration, either in stantially all the 6.7 million aged their own right or as wives of earners Over, June 1956* men in the United States and more or of beneficiaries. Most of those By mid-1956, it is estimated, 9 out than four-fifths of the 7.8 million without any money income of the of 10 aged men in the United States women aged 65 and over had some types specified were widowed before and 2 in 3 of the aged women had earnings or money from a public in- their husbands had been able to earn some money income from employ- come-maintenance program (table insured status under old-age and sur- ment, social insurance, and/or a pro- 1). Since women outnumber men in vivors insurance: some of them had gram for veterans. When those re- the aged population, with about 116 income from private insurance poli- women to every 100 men, one-tenth cies, some were supported by rela- *Prepared by Lenore A. Epstein, Dlvieion of Program Research. Omce of the Commis- of all aged persons were still without Wves and some were maintained in sioner. income from employment or a pub- institutions. Bulletin, December 1956 13 These estimates relate to all aged Table 1 .-Estimated number of persons aged 65 and over receiving money persons living in the continental income from specified sources, by sex, June 1956 1 United States, Alaska, Hawaii, Puerto Number of persons Percentage Rico, and the Virgin Islands1 whereas (in thousands) distribution Source of money income r estimates presented in previous notes / and articles in this series related to Total Men women Total Men Women the continental United States only. --- -___-~ -__ _- Total aged 65 and over ’ .._._. .___. ___._.... 14.550 6,720 7,830 100.0 100.0 100.0 Since aged persons in these four Ter- __- ritories and possessions number only Emnlovment .._.. _. __.. .-_ _. .__ ___ __-_ .._._ 4,260 2,570 1,690 29.3 38.2 21.6 Earners....-.--..-......---.--.--..-..-...---.. 3,310 2,570 740 22.7 38.2 9.5 about 122,000, the findings on income Earners’ wives not themselves employed.. _. 950 6.5 _. 12.1 sources are essentially the same for Social insurance and related programs 4 ._ .~ 8.E 4,150 3,940 55.6 61.8 50.3 Old-age and survivors insurance.. .- __-. ._ _. 6.640 3.390 3,210 45.4 50.4 41.0 the total as for the continental United Railroad retirement insurance.... ___. ._ ___ _ 520 270 250 3.6 4.0 3.2 Clovernment employees’ retirement programs. 480 290 190 3.3 4.3 2.4 States.? Most of the differences are Veterans’ compensation and pension programs.. 710 450 266 4.9 6.7 3.3 Beneficiaries’ wives not in direct receipt of within the margin of error of the es- benefits ____ ____-_-___-- .____... __.....____. 220 220 1.5 2.8 Public assistance 5__.._._. -.. _. .-. _. _-. .__ 2,570 1,000 1,570 17.7 14.9 20.1 timates. The number of aged old-age No money income or income solely from other and survivors insurance beneficiaries sOU~C~S..........~~..~~.......~.....~.~....~.... 1,520 70 1,450 10.4 1.0 18.6 per 1,000 aged population is slightly Income from more than one of specified sourcesw 1,890 1,070 820 13.0 16.9 10.5 higher for the continental United Employment and social insurance or assistance 1,340 760 580 9.2 11.3 7.4 Social insurance and public assistance.-. _. 550 310 240 3.8 4.6 3.1 States than for the total, however, and the old-age assistance recipient 1 Persons with income from sources specified may Virgin Islands. also have received money income from other sources, 4 Persons with income from more than one of the rate is slightly lower. Puerto Rico such as interest, dividends, private pensions or annu- progrsms listed are counted only once. In addition and the Virgin Islands, which account ities, or cash contributions from relatives. to the programs shown, unemployment insurance 2 The sum of the persons shown under the 4 cate- programs provided beneats for some 65,000 men aged for almost three-fourths of the aged gories exceeds the number in the population by the 65 and over and 15.000 aged women. Workmen’s estimated number with income from more than 1 of compensation snd temporary disability insurance population in the four Territories and the 3 main sources. The estimates of persons with programs also provided income for some, but infor- income from more than 1 source, developed from sur- mation is lacking ks to the number.

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