The Salina Journal Monday January 27,1986 Page 12 Reviewer criticizes Medicare reforms WASHINGTON (AP) - The first hard look at quality control under recent Medicare reforms has found "serious deficiencies" in procedures that are supposed to protect America's elderly from incompetent, indifferent or greedy doctors and hospitals, a senior government investigator says. The review of more than 4,700 cases that were flagged by watchdog Peer Review Organizations as suspicious uncovered a few striking examples of physician ineptitude or hospital indifference to patient health — and a general indifference by the PROs to policing those abuses. The results prompted an unusual "early alert" by Inspector General Richard Kusserow to the Health and Human Services Department, privately warning that the review was uncovering serious problems in the Reagan administration's heralded reform program. "The early findings of our inspection have disclosed serious deficiencies," Kusserow said in his Nov. 25 memo to C. McClain Haddow, the acting head of the department's Health Care Financing Administration. "We have found numerous cases of substandard care in which there was "The early findings of our inspection have disclosed serious deficiencies." —Richard Kusserow little or no action by the PROs. We are deeply troubled by the ineffectiveness of the existing procedures used by PROs to review cases of substandard care." Haddow, in his response, told Kusserow he was surprised by the inspector general's conclusions and disagreed with the assessment of their severity. Kusserow said recently that he stood by the assessment in the "early alert." "You will never get the inspector general of this department to say there isn't a big problem out there," Kusserow said. "There is a problem." But, he said, the cases reviewed covered a period from October 1983 through May 1985, a period when the reforms were new and review organizations still were feeling their way. Kusserow's inspection involves the potent political question of whether quality health care for the elderly is being sacrified in the drive to reduce the federal spending. C'mon America, Drive Over To Tirestone Firestone TM Firestone i intirw-^^-- _^^® MasterCare Bargains for Cars and light Trucks. 1 90 Days Same as Cash! Get 90 Days Same as Cash on revolving charge at Firestone stores and many dealers. Minimum monthly payment required. Finance charges refunded when paid as agreed, we also honor Visa, MasterCard, Diners Club. Carte Blanche and American Express. Prices and credit plans shown are available at Firestone stores. See your independent dealers for their prices and credit plans. Stores and dealers are listed in the Yellow Pages. MasterCare brand service is available at Firestone stores and participating dealers. Faced with soaring Medicare costs, the Reagan administration in 1983 launched a "prospective payment" system for Medicare that dictates in advance how much the government will pay for a specific ailment. The system controls medical costs by putting hospitals on a budget. Quick, efficient care means profit; dawdling means losses. But critics charge the system sabotages quality, pressuring hospitals and doctors to discharge patients before they are ready. The adminstration has denied any quality problem, pointing to its network of 54 PROs, which monitor Medicare cases for quality assurance. But it is there where Kusserow found the problems. The inspector general said he started with 4,724 cases flagged by PROs as suspicious discharges. Files could not be found for about 1,000 of the cases, despite the review organizations' stated suspicion, Kusserow said. Of the remaining 3,700, about 2,900 raised questions of whether the patients received proper care. Of the 2,900, Kusserow said, 74 were so outrageous that they would justify disciplinary action by HHS, such as exclusion from the Medicare program through Kusserow's office. But none of the 74 was referred to him for action, Kusserow said, and the watchdog agencies generally did not aggressively pursue the 2,900 cases of suspicious discharges. Some of the abuses were flagrant, but still not pursued, the inspector general said. In one case, a woman was admitted to a hospital for surgery but found to be so unstable from gangrene that she could not undergo the operation. For five days, doctors worked to stabilize her condition. Then, as they wheeled her to an operating room, they noticed on her file that her Medicare benefits for the procedure had just run out. The operation was cancelled, and the woman discharged, Kusserow said. The case is particularly appalling, he said, because the woman's physician simply listed the lack of further Medicare money as the reason for her discharge. —Coming Wednesday— City-Wide COUPON POWER Clip the coupons from the Salina merchants coupon insert and save $. Coming — / Sunday, February 2nd Fewer colleges offer free course catalogs EXTRAUFE FLUSH &FILL BATTERY SAIL' Save S4Q95 $20! "§y 88 OH«r «nd» February 1,1B8B Pow<vlul [.troMe oO 1 " e.ceedi o«girxjl equ.pmp speciiicoliom toi mosl vehicles Otter ends February 1,1986 FRONT END ALIGNMENT LUBE, OIL & FILTER We'll lubricate your vehicle's chassis, drain the old oil and install up to 5 quarts ot new oil and a new oil filter Most American cars and light trucks and most Datsuns. Toyotas, VWs and FRONT DISC BRAKE SERVICE Restore handling re- iponie and sleeting comfort to your vehicle Firestone Ride * ittock absorber 1 - nave 40% more ea ttion mait new car vhocks STEEL-BELTED RADIAL SALE'. Prices reduced lor o limited time Buy now and save an these strong, long mileage radials with two steel belts and whitewall styling By The Associated Press Free college catalogs, those fat listings of detailed information about a school and every course it offers, are fast going the way of the free lunch. In the past, high school students could get free college course catalogs by writing for them. Now, a prospective applicant most often will be sent much slimmer, flashier "viewbooks," promotional brochures with general information about financial aid, admissions requirements, the school's philosophy, and life on campus — but little on specific courses. Nearly all colleges still send thousands of free catalogs to high school guidance offices. And students will almost always get a free catalog after they are admitted. But if high school students trying to decide which colleges to apply to still insist on having their own catalogs, a growing number of colleges will charge them a fee, because of rising costs of paper, printing and mailing. Public colleges with budget problems began the trend in the 1970s, and the practice has spread to private schools. 1985 1986 SALINA LOOKING BACK... ...LOOKING AHEAD The SALINA JOURNAL takes a look at 1985 and the developments for 1986 Our annual PROGRESS EDITION SALINA AUTO SALVAGE If we don't have it we can get it Telephone Service to 65 cities 1 Vt Miles North on Highway 81 827-5686 We're Moving To Coming Sunday, February 23rd Something old... Something 1986 L Salina Journal S* Bridal Edition Journal I Proud Parents & Grandparents Example (Actual Size) « Remember your favorite little ones on Valentine's Day with their photo on the special "Cupid's Kids" page in the Journal's classified section. Children's Names Parents or Grandparents Daily 7:30 a.m.-6 p.m., Sat. 8 a.m.-5 p.m. Only V Prepaid Name cry Deadline Is 12 Noon, Friday, Feb. 7th (For good reproduction, photos must be clear & no more than 3 children per photo please.) Send or Bring Photo with Payment To... THe"Journal's Classified Ad Dept. P.O. Box 740, Salina, Ks. 67402-0740 Please Note: Ads must be pre-paid. If photo is to be returned by mail, self-addressed, stamped envelope must be sent with order.
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