page 6
daily nebraskan
friday, november 13, 1981
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-4 Years txpenence in Medical weseaicn-
Private money pays for Medicare cuts
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By Laura Garrison
Lincoln hospital officials agree that private paying pa
tients will pay the difference made by Medicaid and Medi
care budget cuts that Reagan administration officials have
proposed.
According to a copyrighted story by The New York
Times Sunday, Richard S. Schweiker, secretary of health
and human services, gave details of the proposed changes
that include strict new limits on federal payments for hos
pital care and physician services for the elderly. Also rec
ommended was a new way of financing long-term institu
tional care for welfare recipients and other poor persons
receiving Medicaid benefits.
Reimbursements limited
Some of the changes include imposing limits on federal
reimbursement for laboratory tests, drugs and other ancil
lary hospital services. Limits currently apply to routine
costs such as nursing service, room and board, radiology
and pathology services.
Medicaid benefits to the poor for long-term care, which
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accounts for 47 percent of total Medicaid expenditures,
would be converted from an open-ended entitlement to a
block grant - a fixed sum appropriated to the states by
Congress for broadly defined purposes, the Times report
ed. Schweiker said in the report that the proposals
would save the Department of Health and Human Ser
vices more than $4.1 billion in fiscal year 1983.
John Davidson, assistant administrator for Lincoln
General Hospital, said the Nebraska Hospital Association
has already met and talked about the proposals. Some
welfare programs may be eliminated in order to contain
costs, since hospitals have the option to offer many of the
services. The association is working on a list of welfare ser
vices that may be cut, he said.
Davidson said welfare Medicaid patients pay on the
average of 10 to 12 percent less than private paying pa
tients, therefore hospital Medicaid discounts are paid back
by the private paying patient.
Davidson said rising hospital costs could be contained
considerably if people would not abuse the emergency
room facilities at hospitals.
Emergency room overused
"Many persons come in to the emergency room for
treatment when a visit to the doctor's office would suf
fice," Davidson said. "Emergency services cost more to
the hospital and to the patient because we have a doctor
on call 24 hours a day, seven days a week. We can only
control our costs if people try to control their costs."
Davidson added that some medical insurance is "per
verse" since it will pay for everything. One method of
holding down insurance costs would be to have insurance
companies pay 80 percent of medical bills and have indi
viduals pay 20 percent.
Ron Jensen, vice president of St. Elizabeth Community
Health Center, said that although the impact on the pri
vate paying individual is not known yet, the gap between
providing good hospital care and balancing out the cost is
usually filled by private paying patients.
Jensen said a Medicare proposal that would require pri
vate insurance coverage for people who continue working
beyond the age of 65 would cause a disincentive for em
ployers to hire older workers.
Jensen said St. Elizabeth will increase its effort to re
tain hospital costs.
Del Lembrich, administrator of provider services for
the Nebraska Department of Welfare, said all individual
patients will be responsible for more of hospital costs.
He said the Nebraska Legislature will have to decide
about funding for the Medicaid program, but added that
last year the Legislature voted not to use state money to
make up the difference on federal cutbacks.
i
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