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About The Battalion. (College Station, Tex.) 1893-current | View Entire Issue (March 8, 1972)
Page 4 College Station, Texas Wednesday, March 8, 1972 THE BATTAUQ Auditors WASHINGTON GP) — Health insurance companies have misspent millions of Medicare dollars, federal auditors have found, because of business inef ficiencies and excess payments to doctors. Previously undisclosed audits by the Department of Health, Ed ucation and Welfare questioned practices ranging from the pur chase of 2,100 monagrammed golf balls to payment of $230 million to Florida doctors without assur ance that the fees were reason able. Spokesmen for the Social Se curity Administration and the insurance companies said many of the deficiencies disclosed by the audits have been remedied. Some insurers also challenge por tions of the findings, objecting to the HEW auditors’ statistical pro jections of misspending from an analysis of sample payments. The claims of corrective ac tion could not be verified. The audits run two years late, and the Social Security Administra tion won’t open current files to newsmen. A staff report of the Senate Finance Committee on the 33 Blue Shield plans, 15 commercial com- Air conditioning bad for patients, surgeon reports SAN ANTONIO UP> — A cold, air-conditioned recovery room may be among a hospital’s worst enemies, says a surgeon who has observed the effects of heat on patients. Dr. John A. Moncrief of Charleston, S.C., says most hos pital recovery room are kept cool for the benefit of medical per sonnel. “This is the worst thing in the world for patients,” he said in an interview, noting that the time immediately following surgery is critical. A patient fresh from surgery generally finds himself “thrown into a cool room,” and his body at once begins burning up energy just to keep warm, he said. “The body temperature is dissipated very rapidly.” It could be vital to some pa tients, he said. “If his heart isn’t able to pump well enough to dis tribute this energy, the patient can have cardiac problems very easily.” Moncrief, professor of surgery at the Medical University of South Carolina, says chilly hospi tal rooms also create problems for burn patients. The former commander of the burn center here at Brooke Army Medical Center, Moncrief said the healing process in burn patients requires tremendous amounts of energy. In other types of patients, the increase in energy demand may rise 50 per cent above normal for three or four days after surgery; in severe injuries such as a gun shot wound to the stomach, it may increase by 100 per cent, he said. But in the case of a seriously burned patient, he added, this de mand for energy may jump 200 per cent for six to eight weeks. “If you put a burn patient in a cold environment, he will lose heat by radiation—he’ll try to heat the room with his body just like a radiator heats a house,” Moncrief said. If the burn patient’s environ ment is warm, he said, his body will need less body heat to keep warm and can use its energy “for the more important functions of healing wounds and combating in fection.” Moncrief said this doesn’t mean the entire hospital room has to be warm. The patient needs only a “microenvironment” around him, such as heat lamps that the Army burn center here has used since 1964, he said. When the center first began using the heat lamps, Moncrief said, doctors noticed that a bum patient’s temperature would drop three or four degrees when the lamps were turned off. “When they turned the lamps back on, their temperatures float ed back up,” he said, so the lamps were kept on all the time until the patient healed sufficiently. The ideal temperature, he said, would be just below the “sweat ing point,” or about 93 degrees Fahrenheit. “Ideally, we’d like to have an environment in which the body is not expending additional energy to warm it or cool it,” he said. Although the heat concept is common knowledge at the Army bum center — the armed forces’ only burn treatment and study unit—it has not yet gained uni versal acceptance, Moncrief said. But he predicted it will eventually become part of standard practice. say insurance companies misspend millions on Medicare panics, and two independent in surers acting as Medicare pay ment agents for doctor bills had this to say: “Carrier performance under Medicare has in the majority of instances been erratic, inefficient, costly and inconsistent with con gressional intent . . . .” Thomas M. Tierney, who runs the Medicare program for the government, had a different as sessment. “I think in the over-all, they (carriers) and intermediaries have done an effective job in adminis tering a very complex program,” he said. “This is not to say there are not problems.” The insurance companies and “blue” plans funnel government money to health institutions and doctors who treat Medicare pa tients. They assume no risk, ad ministrative expenses are paid in full and no profit is allowed. The HEW audit findings, which will be aired this month at hear ings by the Senate antitrust and monopoly subcommittee, are serving as ammunition for pro ponents of government-run health insurance. “The weaknesses demonstrated in the audits should disqualify business from any role in new health-care insuring arrange ments,” said Max Fine, executive director of the Committee for Na tional Health Insurance. President Nixon, among others, proposes to funnel billions of dol lars into the carriers and an ex panded, government-required and subsidized health insurance. The federal auditors’ most com mon complaint involved over charges—failure by companies to limit physicians’ payments to “reasonable, customary and usual fees,” as defined by doctors them selves. “No one can say for certain how much money has been overpaid as a result of the failure to apply statutory limitations on ‘reason able charges,’ ” the Senate Fi nance Committee staff report said. But it estimated the amount at “many hundreds of millions of dollars.” The Social Security Adminis tration, under prodding from Con gress, has recently removed some companies from the program or cut their Medicare business. Cleveland Blue Shield lost its con tract. Thirteen counties in South ern California were taken away from California Blue Shield. Chi cago Blue Shield lost sixcoi The auditors also spotted expenses they said were chi improperly to Medicare. They included those golf country club and social mei ships, liquor, and leased caij| Virginia Blue Cross. In adition, 21 of 74 Blue plans have built new offices Medicare began, financed in with government money. The ernment considers this legitimate. EXTRA SAVINGS! GARDEN AND PATIO THERMOS COOLER AND JUGJ COMBINATION DELUXE 47 QT. COOLER PLUS 9 1 GALLON JUG VILLAGE BLACKSMITH EDGER-TRIMMER TOUGH RUST PROOF SEAMLESS LEAK PROOF CHROME PLATED HARDWARE WITH BOTTLE OPENER! MODEL NO. 9400 CHANGES IN SECONDS EDGE TO TRIM! 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