Newspaper article THE JOURNAL RECORD

Are Physicians Willing to Roll the Dice with Sullivan?

Newspaper article THE JOURNAL RECORD

Are Physicians Willing to Roll the Dice with Sullivan?

Article excerpt

In his new book on the health care crisis in the United States, Joseph Califano, the secretary of Health, Education, and Welfare under former President Jimmy Carter, insists that a quarter of all the money this country spends for its health care is wasted.

If his estimates are anywhere near correct, Americans are wasting about $100 billion a year. It would buy a lot of expensive toilet seats at the Pentagon.

Califano arrives at his expenditure conclusions by analyzing what the money is spent for. At the top of his list: unnecessary surgery.

The former Cabinet officer points an accusing finger at doctors who, at his judgment, order unnecessarily too many hysterectomies and far too many expensive and invasive diagnostic tests. And, he goes on to fault the American people for living dangerously - smoking, overeating, ignoring the need for exercise.

When it's all added up, he argues, we're being forced to lay out too much money for health care.

Now comes one in a string of successors in the top Cabinet health post, Dr. Louis W. Sullivan, to complain that physicians are paid too much. Especially, he says, are doctors paid too much under the nation's Medicare program for elderly retirees.

As secretary of the Department of Health and Human Services (formerly HEW), Sullivan is in a unique position to tighten the purse strings, and he seems bent on doing just that.

With a little help from Congress, he is offering what he describes as a reform package. First on his list is a new fee schedule that takes into account geographic differences in the prices of physician services.

Presumably, a rural doctor doesn't need as much for a particular service as one who practices in a high-cost urban area. That, in any case, is the way rural and small city physicians are likely to interpret it. …

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