Friday, Sept. 6, 1985
University Daily Kansan
Nation/World
9
Unnecessary medical care may total $15 billion
United Press International
CHICAGO — Elimination of unnecessary medical care in the United States could save more than $15 billion a year, enough to pay for heart and liver transplants for everyone who needed one, a Boston physician said yesterday.
Dr. Marcia Angell, the physician and deputy editor of the New England Journal of Medicine, said burgeoning medical costs have prompted some economists to suggest rationing expensive transplants and other operations.
But that would be irresponsible when so much money is spent on useless medical care. Angell said.
"For the profession to take part in limiting benefits before dealing with waste is unseemly, at best," Angell wrote in the Sept. 6 issue of the Journal of the American Medical Association.
Angell pointed to three areas of unnecessary care: less complicated items such as X-rays, which are often of no benefit to a patient; more complicated items such as coronary bypass surgery, which may be unnecessary for a quarter of those
undergoing it; and aggressive treatment of the terminally ill.
More than $15 billion a year could be saved by curtailing such useless medical care, Angell said. By comparison, it would cost about $7.5 billion annually to provide heart transplants for every patient who needed one, and $1 billion for all the necessary liver transplants.
There is probably a large gray area between life-saving and useless medical procedures, Angell conceded, but there are some clear cases
Zealous efforts to keep dying
patients alive are perhaps the most tragic because they are both expensive and cruel to the patient, Angell said.
"These patients suffer greatly at the hands of high technology medicine." Angell said.
Such was the case of William Bartling, a lung cancer patient who, over his own protests, was kept alive by a mechanical ventilator for five months. The cost: $500,000.
Bartling's case is not atypical, Angell said. Last year in a large teaching hospital in New York, nearly 40 percent of the dying
"If this approximates the percentage throughout the country, then about $8 billion each year is spent on the final admissions of patients known to be dying," she said.
patients were known to be terminally ill when they were admitted.
"Treating these patients much less aggressively and directing the treatment toward their comfort would in most cases be kinder, and it would secondarily result in very large savings."
This money, combined with savings from eliminating other useless medical care, could be used to pay
for expensive operations that are truly beneficial, Angell said.
She said it should be easy to differentiate between Bartling's case and that of Jamie Fiske, a little girl who received a liver transplant last year after her father made a well-publicized appeal to a meeting of the American Academy of Pediatrics.
"The problem with liver transplantation is not that Jamie Fiske had one," she said, "but that others who need it do not."
EPA will evaluate 38 sites
United Press International
WASHINGTON — The Environmental Protection Agency yesterday proposed expanding the Superfund toxic waste cleanup program by adding 38 of the worst hazardous waste sites in the country to the list for priority attention.
The list now includes 850 final and proposed sites eligible for federal money that will finance most of the cleanup work.
The EPA action means that the 38 proposed sites, which include dumps, a mobile home park, a mining waste
site and part of the Sheboygan River in Wisconsin, will be evaluated to determine how contaminated materials could best be removed. While the reviews are in progress, the agency may authorize preparations to remove the hazardous materials.
hundreds of other hazardous waste sites now given priority attention by the agency under the Superfund cleanup program."
The EPA also will review public comments submitted over the next 60 days before deciding whether the sites will be given final places on the priority list. In the past, less than 3 percent of proposed sites have been rejected for the final list.
EPA Administrator Iee Thomas said, "These 38 sites now may join
The EPA's proposed expansion of the list comes three weeks after Thomas ordered a money-saving slowdown in planning and cleanup work at 57 Superfund sites already on the priority list.
Vastly different proposals have been approved by House and Senate committees, and both recommendations call for spending billions of dollars more than the administration's $5.3 billion request.
Airline to pay $900 million debt
United Press International
HOUSTON — Continental Airlines filed a reorganization plan in federal court yesterday that will fully repay more than $600 million in debts through the next 10 years and remove the carrier from bankruptcy.
Cash payments of approximately $121 million will be made to creditors when the plan is approved by a federal bankruptcy court judge.
The 145-page reorganization plan calls for much of the debt to be repaid in five years, but stretches some payments over eight to 10 years.
"A lot can change in two years and certainly a lot has," said Continental Chairman Frank Lorenzo. "The plan provides for full payment to creditors, which is an incredible accomplishment for any company coming out of Chapter 11."
is an agreement in principle for two groups of banks to provide $50 million in revolving credit and equipment financing for Continental.
The reorganization plan must be approved by a bankruptcy court judge and creditors. Although creditors can vote against the plan, the judge can overrule their decision if he believes the plan is fair. Final approval of the proposal is not expected until the first half of 1986.
Included in the reorganization plan
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Reagan touts tax plan in N.C.
United Press International
RALEIGH, N.C. — President Reagan, responding to charges that he doesn't care about protecting U.S. jobs from foreign imports, yesterday said tax reform would give America "a powerful boost ahead in world competition."
In the second of a renewed series of tax reform stumps, Reagan told students and faculty at North Carolina State University that the current tax system
Reagan altered his pitch on taxes to answer criticism of his opposition to protectionist legislation, an unpopular position in North Carolina, which has been hurt by textile imports.
of 14 brackets and multibillion-dollar loopholes is "dumb economics" and "a legal shakedown by Big Brother."
He said of his tax plan, "It will mean more jobs, bigger paychecks, and smaller taxes for those who now pay too much.
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