European Stars and Stripes (Newspaper) - September 27, 1985, Darmstadt, Hesse                                Page 4 the stars and stripes Friday september 27. 1935 Pentagon attacks Star wars7 analysis denies . Needs perfect defense to defer nuclear War by Norman Black Washington a the Pentagon responding to a critical analysis of president Reagan s Star wars program argued wednesday the United states does not need a perfect defense to help lower the threshold for nuclear War. We seek a thoroughly reliable defense said Penta gon spokesman Robert b. Sims. A perfect defense would not be necessary to significantly enhance deter rence. We would argue that deterrence would be enhanced by an effective strategic defense that the uncertainty of the opponent would be increased if he was not sure now Many of his missiles might get through Sims said. The president s Star wars program known formally As the strategic defense initiative is a research Effort to design lasers and other weapons thai could be used to automatically shoot Down nuclear missiles fired at the United states. The congressional office of technology assessment released a 324-Page study tuesday that concluded such a system could never completely protect the United states from nuclear attack and although defensive in nature could spark a new offensive arms race. The study said the United states would need great technical Success with the program coupled with a change in the soviet Union s strategy to push both coun tries toward Reliance on defensive systems instead of offensive missiles. The Star wars program carries a risk of starting an entirely new arms race and could also create severe instabilities by making the soviets think the United states was Bent on a first strike capability the report added. The soviets May fear that with a workable Star wars system the United slates could strike first and then Ward off soviet missiles fired in retaliation. Any . Defensive measures would undoubtedly prompt soviet offensive activity thus guaranteeing that some attacking missiles would make it through the american shield the report said. Sims while describing the report As a real contribution to the dialogue said the administration was concerned by the study because there is a question As to whether their analysis of our goals is  the Pentagon is Well aware of the technical problems that would have to be overcome to construct any Type of defense system much less a perfect shield he said. How Ever that docs not support an Assumption that the Sovi ets could overcome any defensive system simply by building More offensive missiles he continued. While nuclear offensive forces have traditionally had the advantage Over defensive forces we believe that emerging defensive technologies May change hat Equa Tion Sims said. Sims said a defense system would not be built and deployed unless the United states was convinced it was survivable and Cost effective. He said that Means it would have to be a system that would create a powerful incentive not to respond with additional offensive  Senate May bar Early discharge of medicare patients Washington not the sen ate s special committee on aging is con Vinced that legislation is needed to prevent hospitals from prematurely discharging elderly medicare patients. Reporting on a four month staff investigation the committee concluded wednes Day that there is substantial evidence that seriously ill medicare patients Are inappropriately and prematurely discharged from  it said hospitals have new financial incentives to shorten the time medicare patients spend in their care. Under a payment system that began in late 1983, hospitals Are paid the same amount for each medicare patient with a particular illness regardless of How Long the person is hospitalized. Medicare is serving 30 million elderly or disabled people this year at a total Cost of $71 billion. About two thirds of the Money is used to finance Hospital care most of the res pays for physicians services. The average length of Hospital stays for medicare patients has declined by 19 per cent in the last two years to 7.7 Days from 9.5 Days according to the department of health and human services. Many patients especially the terminally ill and their families Are being Given false and incomplete information about their right to Appeal decisions to discharge them from hospitals the report said. The report said Congress should pass a Law authorizing medicare officials to deny reimbursement for care deemed to be sub Stan  such assessments Are made by medical peer review organizations which include Doc tors and other health care professionals who evaluate the Quality of medicare services. The committee headed by sen. John Heinz r-pa., was to hold a hearing thurs Day to investigate the effect of the new pay ment system on the Quality of care received by medicare beneficiaries. The staff report recommended that con Gress change the Law to allow medicare to pay for extra Days that patients spend in the Hospi Tal when there is no appropriate place to Send them at the proposed time of discharge. In addition it said Congress should promptly revise the medicare payment sys tem to reflect differences in the severity of illness among patients classified in the same diagnostic category. Each patient is Classi fied in one of 468 categories and the pay ment is based on this classification. Richard p. Kusserow inspector general of the health department said in a recent report that evidence is mounting to Sug Gest abuse of the new medicare payment system through the premature discharge and subsequent readmission of patients needing Hospital care. Medicare officials said they did not have data to document the extent of the problem. But last month they instructed medicare peer review organizations to deny payment in cases where there was an inappropriate medical practice such As the premature discharge of a patient if it leads to the readmission of the same person to the same Hospital. Jack w. Owen the director of the Washington office of the american Hospital association said the Shorter lengths of Hospi Tal stays were an expected byproduct of the new payment system. In part he said they reflect the operational efficiency of hospitals. But also he said they expose a deficit in health care that eventually must be filled the Lack of facilities and programs in Many communities for convalescent and Long term  Heinz said the committee staffs report was based on interviews with medicare beneficiaries physicians and nurses University researchers Hospital administrators and Federal health officials. The report said that some hospitals Ore pressuring physicians toward quicker Dis charges by publicly ranking and comparing doctors to Snow which ones generate profits and which ones generate losses for the Hospi Tal. Many people see physicians As the con science of the medicare program As those who will defend the patients interests and resist pressure for premature discharge the report said. However it said Hospital hold Many strings that Are directly connected to the physician s livelihood and they Are becom ing More bold in tugging on those strings when doctors forget the institution s Finan Cial  patients at some hospitals have been told they would be discharged on a certain Date because medicare would not pay for Hospi Tal stays longer than the average Federal officials said there were no such limits in the medicare Law or regulations but they acknowledged that some Hospital employees might be misinformed. A Rah con fro clinic of d by school officials Chicago a a clinic criticized for giving contraceptives to teen agers at the High school with the City s highest teen age pregnancy rate survived a Stormy school Board hearing wednesday. But after nearly two hours of Public debate the Board called for guidelines for the Pilot program at disable High school clinic and other in school clinics that follow. We have a problem with babies having babies said the Board s vice president William Farrow and As Long As we have the problem we ought to be flexible enough to Deal with  the clinic at the South Side school has drawn fire for its free family planning activities since it opened last june. So far 169 students have requested and received contraceptives from the clinic. According to census statistics As Many As one third of the school s female students about 300, gave birth in 1984, the highest rate among the City s schools. Half the clinic s $225,000 annual operating Cost is paid for by the Illinois department of Public Aid and the balance is covered by a coalition of four private foundations. Several other cities including Dallas new York Kan Sas City Cleveland san Francisco and St. Paul minn., have such clinics. Another is to open soon at Chicago s Orr High school and More Are Likely Board members said. Much of the opposition to the disable clinic on wednesday came from members of right to life groups and individuals opposed to family planning. The people who distribute contraceptives ought to be charged with contributing to the delinquency of a minor and sent to jail said Gregory Morrow a member of help for women. You re spreading 30 kinds of venereal disease through out the school Morrow told the Board to a chorus of catcalls and jeers. Louise Mccurry a nurse practitioner and manager of the disable clinic said students cannot receive birth control pills or condoms without a consent form signed by their parents. They also must admit being sexually Active. Board member Patricia o Hern said she was concerned that parents might not be aware that the consent form gave permission for their sons and daughters to obtain contraceptives. We Don t just pass out birth control pills and con Doms Mccurry said in an interview. Family planning is just one of 10 health functions we  she said six previously undetected cases of diabetes and 23 cases of venereal disease have been detected by doctors at the clinic. Clink figures indicate 75 percent of clinic visits Are unrelated to birth control we have a situation Here where the dropout rate is a Ais a a curl id of the dus Oble High school area which Borders the Robert Taylor Homes Public housing project we have a situation where somebody had to do some thug she said. The right to lifers have never done any thing. Most of them have never been  some opposition to the clinic has come from religious leaders. Cardinal Joseph Bernardin of Chicago has spoken out against the dispensing of birth control devices to teens. And Eileen Dolehide read a letter to the Board from Mother Teresa s missionaries of Charity urging that the practice be curtailed. The ready availability of contraceptives simply encourages promiscuity which a an aberration of human dignity destroying the family which is the Basic unit of society the letter said. But students at the meeting said the clinic would help ensure them a better future. K the question is not just How Many birth control de vices Are Given out said Johnathan Moore a 17-year-old disable senior. It also fulfils its role As a clinic giving i health care. Our bodies it it unless a Toke care