Newspaper Page Text
Medicare One Year Old
It’s Working
EDITOR’S NOTE: The Medi
care program, born in bitter
controversy, will be one .year
* old on July 1. EPI reporters in
all parts of the country have
tak?n a close look at how it’s
Operating. Their findings are
* reported below.
By LOUIS CASSELS
United Press International
WASHINGTON (UPD—
Medicare is working.
America’s old folks are
getting better medical care than
* ever before. Hospitals have not
been swamped with elderly
patients. And doctors are much
more enthusiastic about the
* program than they expected to
be.
These are some of the
>, findings of UPI reporters who
L conducted a nationwide investi-
gation of the massive program
f of prepaid government medical
care for men and women over
65. The program will be one
year old on July 1.
Some problems have arisen,
A
’ Imperial
Late Show
Saturday Night
Starting 11 P. M
ON STAGE — IN PERSON
Griffin’s Own
“THE BARON 5”
MOVIE FEATURE
“SUMMER
HOLIDAY”
%
With Cliff Richard
and the Shadows
• All Seats...sl.oo
Imperial
Today
LjggWjM
"wSF
OCULARS MOBS sS:« i ‘ skind!
CUNT EASIWDOftC ,Tr >nD
y zfcnsTs;
Friday Morning Show 10 A. M.
“The Boy And The Pirates”
All Seatslsc
Iris Drive-1 ii
Double Feature
Today- Friday and Saturday
O
“POOR
WHITE
TRAW j
ir - - .
This movie
was notmade W
for everyone > aMP .Jfal
jRSB&igl 1 RECOMMENDED / JflU
[_jojudult£] %1/
Hospitals complain that they
aren’t being paid enough for
treatment of medicare patients.
Doctors grumble about some of
the forms they ahve to fill out
The billing procedures for
outpatient services have proved
to be excessively cumbersome.
And many old people are
thoroughly confused about the
rules on what Medicare covers
and what they must pay
themselves.
Normal Troubles
But start-up difficulties are
Inevitable in a program of this
size. The consensus of physi
cians and hospital administra
tors interviewed by UPI was
that Medicare is off to an am
azing good beginning.
“We’ve been quite pleasantly
surprised.” said Grant Hurst,
executive director of the South
Carolina Hospital Association.
“All things taken into account,
Medicare is running very
smoothly.”
“I think Medicare is accom
plishing its purpose,” said Dr.
Louis F. Alfano of Melrose,
Mass. “We have seen it in
operation, and can say there is
very little interference between
doctor and patient.”
“Considering it’s a new
program, we’ve had good
experience with it so far,” said
Walter S. Shakespeare, adminis
trator of the Harrisburg Hosital,
Harrisburg, Pa. “We’ve had a
mild increase in occupancy, but
we certainly have not been
deluged with Medicare pa
tients.”
Outsp°ken Opponents
Although physicians as a
group seem to be far more
favorably disposed to Medicare
than they were before Its
enactment, there still are
outspoken opponents in the
medical profession.
“I disapprove of the whole
thing,” said Dr. Robert W.
Splettstoesser of Ashley, N.D.
"It’s socialism, you see, and I
despise socialism, not only in
medicine but the philosophy in
general.”
“It stinks,” said Dr. K. K.
Lawson of Knoxville, Tenn.
“The old people fail to
understand Medicare provisions.
And in some cases, the people
at home get tired of taking care
of their old folks and say they
belong in a hospital.”
The American Medical Associ
ation (AMA), which fought a
bitter-end battle against medi
care legislation, still is commit
ted officially to the position that
it is a bad law. But it is
reconciled to the fact that
Medicare is here to stay, and
now is worrying about future
expansions of the program.
Questions Future.
“The greatest danger in
medicare is not what the
program is today but what it
might become tomorrow,” said
Dr. Charles L. Hudson, AMA’s
president. He said here are
“persons, both inside and
outside the government, who
will not be satisfied until they
see it expanded into a complete
national health service.”
The man in charge of
Medicare, Social Security Admi
nistrator Robert M. Ball, is
delighted with the way it’s
working out.
“A great deal of good has
been accomplished by Medicare
in its first year of operation,”
he told UPI. “Older people have
received from 15 to 20 per cent
more in hospital service during
this period than during the
years before Medicare went into
effect. The lives of many
elderly people have been
improved, and in some cases
prolonged, because of this
program.”
The statistics are impressive.
During its first 12 months,
Medicare paid out $2.4 billion to
provide hospital treatment for 4
million persons. It disbursed
$640 million in partial payment
of 25 million doctors’ bills. It
picked up the tab for home
treatment of 230,000 elderly
people by visiting nurses or
therapists.
Since nursing home benefits
became available last Jan. 1,
Medicare has underwritten ex
tended care for 200,000 patients
convalescing from ailments
which required hospitalization.
Hospitals Take Medicare in
Stride
It was widely predicted before
the Medicare program went into
operation on July 1, 1966, that
older people would rush to
hospitals for free care in such
great numbers that hospitals
would be unable to handle the
load.
That has not happened.
A nationwide survey by a UPI
reporting team showed that
there has been an increase in
hospital occupancy since Medi
care went into effect, but it has
been well within manageable
limits.
The only hospitals that are
seriously pinched for room
today are those which already
had more patients than they
could handle before Medicare.
One change, clearly attributa
ble to Medicare, is an increase
in the proportion of older people
in the average hospital’s total
patient population.
Patient Increase
In Chicago, UPI correspon
dent James M. Shanks found
Thurs. Night Only
ON STAGE
DR. EVIL
AND HIS
Terrors of the Un
known unlike any
thing oyu've ever
seen before.
SEE: A Beautiful
Girl's Head Chop
ped Off right before
your eyes.
SEE: The Mummy
SEE: King Kong
See: Frankenstein
Girls if you are scary, don’t
come without someone to
hold your hand.
Free shrunken head
to first 159 humans.
ON THE SCREEN
GODZILLA
vs.
KING KONG
Box Office Opens 7:00 P.M.
Stage Show Begins 8:30
ADM.: Adults 75c
Kids 50c
that “the percentage of hospital
patients over 65 has increased
from 23 per cent before
Medicare to 28 per cent
currently.”
Reporter Bob Weston was told
in Cincinnati that patients over
65 now occupy 32 per cent of
the hospital beds compared with
26 per cent a year ago.
There were comparable re
ports from other cities.
But hospital administrators
across the country emphasized
that there has been no “deluge”
of older patients and no
swamping of facilities such as
Medicare opponents had gloomi
ly forecast.
The big complaint which
hospitals have against Medicare
is not the extra business it has
brought them, but the formula
which Medicare uses to reim
burse them for the care of
elderly patients. The reimburse
ment formula is supposed to
cover “the reasonable costs of
services rendered,” but hospital
administrators insist it Is
inadequate.
“We lose money on Medicare
patients and have to charge
other patients more to make up
for it,” said a spokesman for
Methodist Hospital in Dallas.
Aware of Complaints
The Social Security Adminis
tration' is aware of these
complaints, and has promised to
take a close look at the whole
situation on the basis of the
first year's experience.
“If our formula fails to cover
fully the costs of caring for
older people, we will certainly
make adjustments,” Commis
sioner Robert Ball told a
reporter. “But so far I have
seen no convincing evidence
that this is really true.”
Bypassing Ball, the American
Hospital Association (AHA) is
urging Congress to amend the
law so that payments for
Medicare patients will include
an extra margin above actual
cost, sufficient to enable the
hospital to accumulate funds for
expansion, modernization and
other improvements.
“We believe non-profit volun
tary hospitals should be reim
bursed on a basis which will
insure them a healthy growth
and development,” explained
WOW! MA!
WE CAN GO ON OUR VACATION
AUTO-SAV VACATION SPECIAL
WILL HELP US. JUST THINK
NO DOWN PAYMENT I INF
UP TO 12 MONTHS TO PAY 4-Ply Nylon Cord The ULTISSMO
Ist PAYMENT DUE
AUGUST 10th
AUTO-SAV PREMIUM RETREADS
K S,ZE Salc l ’""' Sale 11 1 4 NYLON
CKa A Blackwall Whitewall
7.75x14 ~ ~21 SIZE Mohawk Sale Price F.E.T.
O 7-60x14 $14.88 i $16.88 List I Whitewall |
2 for 2 for 2 for 18.25x14 j . 6.50x13 I 63.57 | $20.88 I 1-80
8.00x14 I $17.88 | 2.38 | '
1590 1790 1990 |ET puicr 82218
. ... .. . . ~ J JLI VIIILI 8.25x14 85.05 COC fifi 2.38
Any Size Listed Any Size Listed Any Size Listed uvinw 8 00x14 s£v.oo
Blackwall plus tax and Blackwall plus tax and Blackwall plus tax and 4-rLY NYLON CORD J
recappable tire. recappable tire. recappable tire. 8.55x14 90.52 $27.88 2.56
SIZE Fed. Tax SIZE Fed. Tax SIZE Fed. Tax B ' s °* U -
Per Tire Per Tire Per T,re r 8.15x15 85.05 2 .33
* ■ 710x1 s JZu-00
6.33x13 35c 7.50x14 46c 8.50x14 55c ■"'WW
6.50x13 36c 8.00x14 51c 9.00x14 61c L’S’i $27.88 2JB
,staM ™ 8:8115 *' ;wtls » £»iis “SST- -JS"
5.60x15 35c 7.10x15 51c 8.00-8.20x15 62c 8 00x15 s£o.oo
7.00x14 37c 6.50x15 42c 9.50x14 62c JvSr 9.15x15 101.58 ~~C9Q OO 2.89
FACTORY TYPE RETREADS—WHITEWALLS SI.OO EXTRA PER TIRE
SIZE Blackwall Whitewall
USED ’ -
TIRES $?oo «p — T “ " ia 0M Tlr,! '
X . | 8 A. M. to 6 P. M.
FLATS st °p Tail Drag 0™ 6 DAYS A WEEK
rivrn flnd Front End Sa S «.
™ MONROE AUmJAV
I ■ f fW HCVSrATINTOH
3UC SHOCKS T,s " ’ 5 “
803 W. Taylor St. Phone 227-0661
Dr. Edwin L. Crosby, executive
vice president of the AHA. He
said this would require a
“significant increase” in the
present Medicare payment for
mula.
Ball Agrees
Ball agreed that some way’
must be found to meet the
needs of hospitals for additional
funds to modernize and upgrade
their facilities. But he said this
should be done through federal
grants or in some other open
and direct way, rather than as
a hidden charge in Medicare
bills.
Medicare was expected to put
an even greater strain on
nursing home facilities than on
hospitals. Again, however, the
dire predictions have not been
borne out by events.
Nursing home benefits (avai
lable only to convalescing
patients who’ve spent at least
three days under treatment in a
general hospital) took effect
last Jan. 1. To qualify for
participation, a nursing home
must meet high standards.
Among other things, it must
have registered nurses on duty
around the clock. To date some
3,800 nursing homes, with
265,000 beds, have qualified.
That is about 40 per cent of the
nation’s total capacity of skilled
nursing homes.
Social Security officials said
that on a nationwide basis, the
total number of beds available
in qualified nursing homes is
more than adequate to meet the
demand resulting from Medi
care. But they acknowledged —
and the UPI survey demonstrat
ed—that local shortages exist in
some areas.
Medicare did not cause, but it
has evidently aggravated, a
nationwide shortage of trained
nurses. Every hospital adminis
trator interviewed said his
institution needs more nurses.
In New York, the situation is so
serious that the state legislature
recently voted funds to double
the number of nursing scholar
ships.
What Doctors Like
And Dislike
Ab°ut Medicare
Since Medicare went into
effect a year ago, doctors have
been paid for the care of many
elderly patients whom they used
to treat free or for sharply
reduced fees.
A nationwide survey by UPI
reporters showed that this is
one aspect of the new program
that is very popular with the
medical profession.
But doctors are not so pleased
with the procedures by which
they collect for treatment of
Medicare patients. At present,
they have two alternatives, and
each has disadvantages from
the physician’s point of view.
The first alternative is to bill
the patient himself in the
customary way. It is then up to
the patient to pay the doctor,
and send the receipted bill to
Medicare for reimbursement.
But some elderly patients live
on such tight budgets that they
can’t afford to pay the doctor
out of their own pockets and
then wait two to three weeks
for reimbursement.
Find System Confusing
Others find the whole proce
dure terribly confusing. They
don’t know how to file a claim
for reimbursement. And they
don’t understand the rather
complicated rules, which pro
vide that a patient must pay the
first SSO of his doctors’ bills in
each calendar year, and there
after may claim reimbursement
for 80 per cent of all additional
bills.
The biggest problem I have
with Medicare is explaining to
old folks how it works,” said
Dr. John B. Howell of Canton,
Miss., voicing a sentiment that
was heard from many other
physicians in all parts of the
country.
The American Medical Associ
ation (AMA) says the problem
could be alleviated by dispens
ing with the requirement that
patients send in receipted bills.
It has asked Congress to amend
the law so that Medicare will
reimburse patients on the basis
of a doctor's bill that has not
yet been paid.
The Social Sercurity Adminis
tration is opposed to this idea.
It believes the best way to curb
increases in fees is to give
doctors every possible incentive
to use the other method of
collecting which is available to
them. That is to accept an
“assignment” from the patient,
and send the Dill directly to
Medicare for payment.
Mu s t Do Paperwork
If a doctor accepts an
assignment, he must do the
paperwork involved in filing a
claim rather than leave it to the
patient. And, more important,
he must agree to accept what
the Medicare “carrier” for his
community (usually a Blue
Shield or private health Insur
ance firm) has determined to
be a “reasonable charge” for
the particular services ren
dered.
The AMA has urged doctors
to reject the assignment method
as an infringement of their
right to set their own fees. An
analysis by Social Security of
first year operations show that
about 40 per cent of the nation’s
doctors are refusing on prin
ciple to accept assignments
from any patients, regardless of
circumstances. The other 60 per
cent, however, are accepting
assignments at least some
occasions.
The UPI survey indicated that
the majority of doctors have
settled on the practice of billing
patients directly whenever pos
sible, but accepting an assign
ment when the patient would
have serious difficulty in paying
out of his own pocket and filing
a claim for reimbursement.
Incre a sed Fees?
Has Medicare led to increases
in hospital charges and physi
cians’ fees?
The UPI survey showed that
hospital charges have risen
rather sharply in nearly every
community during the past
year. The average increase was
F LICHT... an aid to sight
‘X Good lighting cannot cure visual de-
\ Z sects but can do much to prevent eye*
\ [ strain and fatigue which help produce
1— „ J visual problems. Have enough light,
eliminate glare, have light distributed
about room and eliminate shadows.
Members of The American
Optometric Association
Girffin Daily News
Thursday, June 22, 1967
in the neighborhood of 15 per
cent.
But hospital administrators
were virtually unanimous In
attributing the increase, not to
Medicare, but to higher wages
for nurses, maids, kitchen
helpers and other hospital
personnel. Medicare officials
say the wage boosts were
justified and even overdue.
Hospital personnel still are one
of the lowest-paid occupational
groups in America, with a large
percentage receiving the bare
minimum wage.
As for physicians’ fees, UPI
reporters found no evidence of
any sharp rise since Medicare
went into effect. There has been
a steady uptread in fees for
several years and this continued
during the past year, but it does
not appear to have accelerated.
It is true, of course, that
doctors are now charging
elderly patients their regular
fees instead of the reduced fees
they used to accept, and this
may give some oldsters the
impression that there has been
a general rise in medical costs.
PAINFUL BITE
PITTSBURGH (UPD—Frede
rick Russell, 18, charged with
malicious mischief, resisting
arrest, intoxication by a minor
and assault on a police officer,
said Sunday he did not
remember knocking over two
beehives while being chased.
“If I ruined those beehives,
why didn’t I get stung?” he
asked the judge.
“You did get stung—by the
police,” the judge replied.
13