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13A HEALTH/The Charlotte Post Thursday October 9, 1997 . J HEALTH Should Medicare patients pay cash? By Alice Ann-Love THE ASSOCIATED PRESS WASHINGTON - The issue of whether senior citizens on Medicare should have the choice of paying doctors’ hiUs out of their owh pockets has created a politi cal uproar. Because of a recent change in federal law, the nearly 37 million seniors with Medicare doctors’ ofiBce coverage would, for the first time next year, be allowed to pay to receive care from those doctors who don’t participate in the gov ernment’s health insurance pro gram for the elderly. But the nation’s largest doctors group and a number of conserva tives complain that the vast majority of doctors, who do take Medicare, would still be essential ly cut off finm taking on any pri vate-paying patients. That’s because under the change in law, doctors would have to choose between those private-payers and the! larger universe of people who do Want to use their Medicare coverage. “For some time now there have been certain patients who have said we’re willing to pay our ovm doctors’ regular fees - because of access or whatever,” said Dr. Thomas Reardon, chairman of the American Medical Association. ‘Why shouldn’t the physician be able to contract (with them) and stfil see other Medicare patients?” The AMA is lobbying hard for a bin sponsored by Sen. Jon Kyi, R- Ariz., and key Republican leaders that would let doctors who ordi narily accept Medicare name their price whenever older people are willing and able to pay. President Clinton disapproves. Repubhcans say to get it past him they may try to attach the mea sure to legislation Clinton badly wants, such as a free trade mea sure. “It’s critical that we get it done,” Kyi said. Tlie dispute does not involve services not covered by Medicare, such as some preventive health screenings and elective proce dures. 'These will continue to be available to any patient willing to pay private prices or find private insurance coverage. And seniors always have the option of not enrolling in Medicare; in such cases, the restrictions on doctors don't apply. Until the recent change, it had been illegal for any doctor to bill a Medicare patient at private rates for services that otherwise would be covered under Medicare's stan dard fees, which are generally lower. That rule, designed to protect seniors fi'om price-gouging, also had cut off Medicare patients fiom doctors who wouldn't take Medicare. That was especially a problem in cases of rare special ists or lone practitioners in isolat ed areas who wouldn't accept Medicare payments. Lawmakers seeking a solution to that problem got it changed as part of this summer's budget deal that was approved by Congress and the president. In return for that change, the Clinton administration demand ed and won a provision that would make a doctor give up all claims on Medicare for two years if the doctor saw Medicare patients who paid private rates. That provision, the administra tion officials said, would discour age doctors now accepting Medicare from in the future turn ing away new patients unless the patients paid privately. It also would prevent doctors finm refus ing certain treatments to those who want to use Medicare cover age. “We want to make sure that Medicare beneficiaries have the same access to high quality health care as those who choose private contracts,” Medicare spokesman Chris Peacock said. Letting doctors mix and match payment plans for Medicare patients also would make it hard er for the government to keep track of its share of fees, said the nation’s largest senior citizen’s group. “It really does begin to open up a whole new spigot for unscrupu lous operators to rip off beneficia ries and rip off the Medicare pro gram,” said Martin Cony of the American Association of Retired Persons. Yet, most doctors don’t want to and couldn’t afford to turn away the hordes of seniors who rely on Medicare, AMA officials said. Only about 5 percent of U.S. doc tors have no Medicare patients, and it is unclear how many of them are actually sought by and refuse seniors. Watch for the upcoming ‘98 car preview Wheel Appeal A MAM MO WHAT?" Get a MAMMoqRAM. 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The founda tion said child health care is getting better in 10 areas, including infant mortality, imfnunization rates among preschoolers and dental health. But the foundation said the United States is making little progress in five areas: enroll ment of eligible preschoolers in Head Start, motor vehicle deaths, mental disorders, child poverty and cholesterol levels. According to the report card, child health care has worsened in eight areas, including child hood obesity, physical activity in high schools and low birth weight. The report card covers both health behavior and health care, said Dr. Ernst L. Wynder, the foundation’s president. Good health behavior includes exercising, practicing dental hygiene and staying away from drugs and alcohol, he said. W.A.R. General Contractors CONTRACTING COMPANY This is the fourth year the foundation has issued its report card. It also designated Monday Child Health Day. “We say on Child Health Day, we ought to reflect on what we can do for our children’s health,” Wynder said in a tele phone interview. “We’re doing reasonably well, but we can do better.” “For example, if you asked how many children brushed their teeth last night, yOu'd find that many did not,” Wynder said. “To parents, that may seem a small item to deal with. But if children begin neglecting their teeth, they are more likely to begin to ignore other health-related things as well.’ Wynder said parents must lead by example if they want to improve their children’s health behavior. At a Monday break fast at the White House with First Lady Hillary Clinton, 80 children and their parents signed the “Healthy Family Practices Pledge,” a commit ment to better their daily health routines. Another way to improve chil dren’s health is to have compre hensive school health programs starting . in kindergarten, Wynder said. “When you go to kinder garten, you should also learn how to brush your teeth, how to exercise,” Wynder said. Complete Home Remodeling • Roo& • Elxtensions • Decks • Additions • Baths • Kitchens • Floors • Doors & More! Call Today For "FREE" Estimate Insured, Licensed & Bonded (704) 343-9123 616 Eastway Dr^ Chaiiotte, NC 28205 Diet key to surgery recovery 2115 E. Seventh Street Suite 102 Charlotte, N.C. 28204 (704)372-3126 701 E. Roosevelt Boulevard Suite 200 A Monroe, N.C. 28112 (704)282-8276 CAROLINA MEDICAL ASSOCIATES and Dr. AVINASH D. SHAH are pleased to welcome Dr. VTJAY K. JUN^A to our medical practice ACCEPTING NEW PATIENTS Participating in Medicare and 30 Managed Care Plans Specializing in Oncology/Hematology and Internal Medicine By Heather Lalley THE ASSOCIATED PRESS CHICAGO - What you eat may predict how well you recover from major surgery, a massive new study has found. Good nutrition is even more important than age or pre-exist ing medical conditions in deter mining which patients will devel op serious complications or die within 30 days after surgery, according to a study of 87,0()0 non-cardiac surgical patients that appears in this month's issue of the Journal of the American College of Surgeons. Before surgery, patients were given a cheap and readily avail able blood test that measures serum albumin, an indicator of protein levels in the blood. The test has been shovm in studies over the last several decades to be a good indicator of nutritional health. “We were quite surprised” at how well the test predicted the outcome of surgery, said Dr. Shukri Khuri, the study’s co- chairman and chief of surgery at the Veterans Administration Medical Center in West Roxbury, Mass. “It allows us to calculate expected mortality rates for a variety of sub-specialties in surgery, and that form of risk adjustment is what surgeons have been hying to develop for years.” The next most important pre dictor of surgical outcome was the American Society of Anesthesia classification, a ranking of patient health as measured by anesthesi ologists. Also important was whether the operation was emer gency or elective, whether the patient had cancer and the patient's age. Nutrition experts say the study’s findings should make peo ple more aware of what they eat before undergoing surgeiy. “Tbo often people are thinking about what nightgown and tooth brush to pack, and they don’t think about being well-nour ished,” said Chris Rosenbloom, an associate professor of nutrition at Georgia State University.”Make sure you’re eating well. This is not a time to diet. It’s not a good time to think about weight loss.” Sufficient levels of protein in the blood are important in helping woimds heal and guarding against infections, Rosenbloom said. Besides potentially saving fives, nutritional therapy can also be cost-effective, said Helenbeth Reiss Reynolds, spokeswoman for the American Dietetic Association. Reynolds pointed to a recent ADA survey that foxmd that more than $8,000 per patient can be saved if they are properly nom-- ished before surgeiy. “It puts them in a better situa tion for having a better recovery and a better survival rate,” she said. “That means a reduced hos pital stay and reduced hospital costs.” The VA study was conducted at 44 veterans administration hospi tals around the countiy from 1991 to 1994. It is part of a large, ongo ing study to determine a compar ative assessment of the quality of care within the VA system, Khuri said. He said the researchers are now considering launching a study to determine how to raise serum albumin levels and improve patient outcomes after surgeiy. IMPORTANT NOTICE RESIDENTS OF EASTSIDE AREAS GRIER HEIGHTS • WENDOVER MONROE ROAD • BILLINGSLEY GOTSWOLD • McALWAY DR. WATTS Chiropractic Physician IS NOW ON YOOR SlOE WITH HIS NEW OFFICE AT 901-B WENDOVER PLAZA
The Charlotte Post (Charlotte, N.C.)
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Oct. 9, 1997, edition 1
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