Cedar Rapids Gazette (Newspaper) - November 20, 1974, Cedar Rapids, Iowa
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Reducing High Medical Costs
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Cedar Rapids: Aisle Hor, Downtown Street Floor and Lindale Plata Iowa City: Mall Shopping Cantor on Sis at Sycamore
By Sylvia Porter
NKW YORK - ITEM: In New York City, I he average hospital room cost is now well over $185 a day and, by next spring, room rates are expected to rise to an average of $218 a day Nationwide, the average cost of spending a single day in a hospital room has crossed $110
I I KM In just the seven months since federal wage-price controls expired, physicians fees have been rising at a yearly rate of IO I percent and hospital charges, at a rate of 17 7 percent Hospital charges and doctor bills are now rising at almost twice the overall inflation rate.
ITKM Most of these added costs come directly out of your pocket, in the form of insurance premiums and cash payments for health services. And these zooming costs are on top of soaring costs for food, fuel, housing, virtually all other items.
An obvious area in which we must concentrate our aRti-inflation battle is in the health services cost spiral
Blue Cross plans the nation over have for years been urged to develop “utilization review" programs — to monitor length of hospital stays and other factors contributing to our fantastic outlays for hospital costs.
Some 17 Blue Cross plans are slated to launch computerized “Plan Utilization Review’’ schemes by next summer. But the vast majority of Blue Cross plans still have not put into action really effective utilization rev lew measures About 2.000 hospitals throughout the U.S. are now boasting that they offer some form of outpatient surgery. In many, if not most cases, a patient can be in and out of a hospital before dark The cost of same-day surgery is betwt‘en 20 and 50 percent of the cost of staying a day or two in a hospital.
In the words of Walter McNerney, president of the Blue Cross organization, “As many as three out of IO medical procedures could probably be performed as effectively, and certainly more economically outside the hospital or on an outpatient basis ” Yet, only a small minority of U.S. hospitals are using this cost-reducing measure to the fullest possible extent.
How many hospitals offer seven-day-a-week hospital care — reducing the high. cost of entering a hospital on Friday, among other obvious beneficial cost reductions?
How many actually offer self-care facilities for patients who aren’t very sick — who, for instance, are undergoing diagnostic tests, diabetes care, preparation for surgery, stroke rehabilitation — and who are perfectly capable of looking after many of their personal domestic needs and doing without costly nursing care?
How many hospitals have genuine consumer representation on their boards or effective consumer complaint mechanisms (ombudsmen) which might bring the people who are paying the hills and who could make valuable contributions into the system’’
Heme ( are
We still are paying only a pittance for home health services (visiting nurses and home health aides homemaker service agencies). Yet, it s a well-established fai t that home health care costs only a fraction <d hospital care and often is superior.
We still are paying only relatively small sums for preventive, outpatient services vs inpatient and acute care
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C»dnf Rapid* Downtown Second Floor and Lindale Plaza Iowa City Mall Shopping Center on St* at Sycamore
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forts lo promote occupational health and safety We still arc making far too small an effort to train and use assistants, nurse practitioners, family health workers and others who can assume a major part of the work load of a fully-trained physician Prepaid Services
We still have made only baby steps toward development of comprehensive prepaid health services and organizations and salaries for medical personnel and only baby moves
away from the costly fce-for-service system which encourages runaway costs
We still haven't made a real effort to promote the development and or application of standards of appropriateness of various types of care — for instance, elective and other surgery, lab tests, hospitalization, home care, visiting nurse care.
We still have done little to combat the irrational differences in aggregate fees and payments to family physicians
against pathologists, pediatricians and psychiatrists against neurosurgeons and general surgeons What is the justification for the giant difference in payments to surgical specialists and family physicians?
We must act now to control and cut our health care costs. And with the off-year elections behind us the insurers and those who administer Medicare and Medicaid no longer have any excuses for ducking the challenge
Tile Cedar Rapids Gazette: Wed., Nsv 21, 1174 5/^
We still are flagrantly underemphasizing physical exams, prenatal care, patient education, immunization, ef-