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Show Page 6 The Utah Independent December 2, 1976 The Paper That Dares To Take A Stinfij . of the agreement which on December 5, 1973: slipped through, and I can assure you that probably 90 of the members of the U.S. Congress today havent the fuzziest idea what a PSRO is. They dont understand the concept they dont even know that they cast a vote on it. CHAPTER V FEDERAL REGULATORS' similar activities otherwise required under or pursuant to any provision of this Act." In other words, a unilateral decision by the chief federal medical The PSROs became operational on regulator. Illustrating the power of the PSROs, January 1, 1974. At present, the law is applicable only Landgrebe revealed: to medical care which may be paid in whole or in part by the federal government. The PSROs.. .have the authority November the an to in in article regulate both institutional and However, personal providers of health care 1973 issue of National Health Federation by declaring their services medically Bulletin, Willadean Vance stated that if necessary or unnecessary, of good a national health insurance or when or poor quality, and fairly or unfairly cover will which enacted probably plan is priced.... If any practitioner, or any and PSRO rules the regulations everybody, facility, hospital, or other health-car- e will .be applicable to every doctor in his or organization violates the agency, care of every patient." regulations, the local PSRO is reCongressman John R. Rarick in his quired to report him or it to the to had 1974 this of Statewide Professional Standards Renewsletter say: May 1 CONTROL OF AND HOSPITALS When Medicare and Medicaid were adopted back in 1965, assurances were given that these programs would not lead to government control of medicine. Indeed, that guarantee was written Professional Standards Review Organizations (PSROs) establish a network of interlocking committees reaching from the offices of local doctors all the way to" the Secretary view Council which in turn is required to report to the Secretary (of HEW)." . into the legislation. ' The bill explicitly of Health, Education, and Welfare. said nothing in its language shall be They are responsible for establishing construed to authorize any federal officer national standards of diagnosis, treator employee to exercise any supervision ment and care of Medicare and or control over the practice of medicine Medicaid patients. The medical or the manner in which medical services history of some 50 million patients and 10 million hospital admissions are provided.' This had a pleasantly are presently subject to PSRO soothing sound, and people who had warned monitoring." against potential government takeover The excellence of America's medical were dismissed as cranks. in large measure In this connection, an editorial in the profession has resulted trust and candor which INDIANAPOLIS NEWS of April 8, 1974, stated: from the mutual has always existed in the heretofore Those early warnings of governrelationship. But sacred doctor-patie- nt ment coercion are all in the process PSROs place a third party directly beof coming true. The bureaucrats of a tween a patient and his physician the Department of Health, Education, and Welfare (HEW) are deploying a medical bureaucrat appointed by, and Professional network of massive subject to, the Department of HEW. Standards Review Organizations PSRO examiners have been given (PSROs) to control the private power to: practice of medicine down to the last detail. And the pretext, exactly Search, without a warrant, a doctor's files, including his most privileged and according to the crank scenario, is that such control has become essential confidential records; because of Medicare and Medicaid." In its report of September 26, 1972, on the PSRO bill, the Senate Finance Second-gue- ss a doctor's pro- fessional decision; Overrule his decision to the degree Committee began by citing the financial that he may be ordered not to perform debacle of Medicare and Medicaid: an operation he deems necessary; According to recent estimates Countermand his order to hospitalize the cost of the Medicare hospital a patient, or not hospitalize him, and insurance program will overrun ,the Penalize him by denying him payment estimates made in 1967 by some $240 billion over a costs are also 25-ye- ar period....Medicaid rising at precipitous rates." (Emphasis added) Supposedly, PSRO was designed to stem the fiscal disaster of Medicare and Medicaid by curbing abuses by doctors, patients, and hospitals. However, as will be shown in this chapter, the PSROs are a vast bureaucratic monolith controlled by the Secretary of HEW for the purpose of federally regulating doctors, patients, and hospitals. . Professional Standards Review nizations were established as Orga- legally-recogniz- ed, government-relate- by Public Law 92-6- 03 d established them as a PSRO.. To accomplish this, the Secretary of HEW is authorized to waive any or all of the review, certification, or This was the deceptive way PSRO DOCTORS federal regulatoi the federal monster THE FEDERAL r agencies passed by the 92nd Congress and signed by the President on October 30, 1972. The law establishing regional PSROs as well as a national PSRO within HEW was crowded into the for his services. Citing the law establishing the PSROs, Walter Donway in the November 22, 1975, issue of human events , stated: The law directs the Secretary of HEW to divide the country into regions.. .and in each region to designate some medical or other organization as the local PSRO Professional Standards Review Organization. Each PSRO will set up and run review committees staffed by local doctors who, under the law, will have access to all the pertinent records of doctors and hospitals treat patients under Medicare, who and Maternal and Child Health programs. Using these records, plus other sources of information, the local review committees will pass judgment on the medical decisions of doctors Medicaid, and hospitals..." Landgrebe further disclosed that if a practitioner" or health-ca- re orders or provides health-ca- re services which do not conform to the standards and regulations of the PSROs and the Secretary, the violator may be fined an amount not in excess of the actual or estimated cost of the medically improper or unnecessary services." .In his newsletter of January 23, 1974, Congressman Bill Scherle pointed out that beginning in January 1974, the PSROs can be composed of non-medi- cal insurance carriers. State personnel health department officials, or anyone satisfactory to the Secretary of HEW. Thus are persons given the to make medical judgments. responsibility non-medi- cal H.E.W. CHIEF SETS GUIDELINES FOR MEDICAL TREATMENT The Secretary of HEW is authorized to establish norms" of health care. These standards, all based on average situations, relegate the judgment of the physician to a distant second place in importance. One sure effect of PSROs is rapid standardization of medical care and a coming era of medical mediocrity. These federally-decre- ed norms" are then used to determine the necessity of hospital admission, length of stay, nature and number of medical tests, type of treatment, and what pharmaceuticals a physician may prescribe. Little wonder that this has been angrily denounced by some doctors as cookbook medicine" and medicine by averages. These norms" allow little room for treatments. Woe to patients suffering from ailments not cured by normal means Here is what can happen under the federal norms": Envision a situation where a Medicaid patient is examined by a private physician and despite the absence of certain symptoms described in the norms," the doctor has a that the. patient is seriously ill. He admits the patient to the hospital. The federal regulations require all Medicaid admissions to hospitals to be reviewed within 24 hours by a review committee." , The patients doctor cannot be a member of that committee. The patient is then expelled from the hospital because at the time of the review" the total symptoms prescribed in the norms" still have not appeared. The patient is sent home and dies non-standard- ized Congressman Earl F. Landgrebe in the January 5, 1974, issue of HUMAN EVENTS , discussed the power wielded by the chief federal regulator of the PSROs. According to Landgrebe, the Secretary of HEW has the power to review the actions of the Review Organizations and to terminate their status as official Review practically no publicity. As Congressman Philip M. Crane put Organizations, if he decides that the it in a speech before the American Medical organization is not substantially comAssociation convention in Anaheim, Calif., plying with or carrying out the provisions" the next day. very complex Social Security Amendments Act of 1972. The PSRO section, at the last minute, was pushed into the bill which consisted of 989 pages. Consequently the PSRO section was not given proper study or hearings and was given institution 1 gut-feeli- - ng |