European Stars and Stripes (Newspaper) - November 11, 1992, Darmstadt, Hesse                                Wednesday november 11,1992 the stars and stripes i Page health care fees Likely to keep rising by Ray Rowden staff writer Washington a civilian employ pcs can expect further increases in health care charges at military hospitals and clinics Over the next few years but not As big As the one levied oct. 1. Changes made in this fiscal year in the Way medical rates Are computed in creased the Cost for an outpatient visit to a military medical facility from $72 to $94. The Price of inpatient care also Rose sharply. The rates apply to All patients in military facilities but Only defense department civilian employees who Are authorized to receive care actually pay the fees themselves. Pentagon officials anticipate moderate increases Over the next two years based on inflation pay raises for health care professionals and a shrinking patient base that requires fixed costs to be recovered from fewer people. The rates set for this year reflect the inclusion of some medical costs that previously were not used to compute fees according to Pentagon responses to written queries from the stars and stripes. Analysts in the office of the Pentagon comptroller who set rates each year now Are Basing costs on meeting the payroll of medical personnel in the system. That move added the costs of a special medical pays a which arc paid to military doctors dentists and nurses whose skills Are in Short Supply. One such incentive can boost a doctor s income a and a clinics operating Cost a by $36,000 a year. The higher outpatient fees reflect the new accounting methods. And inpatient costs which previously Cost a Flat $657 a Day now vary with the Type of care. For example charges for psychiatric care and substance abuse Are less than the old Flat rate this year while a Day in surgical intensive care will Cost More than $1,600. The Pentagon analysts said they were following requirements of the office of management and budget. However they added that the changes also matched the military s goal of a establishing patient level  though far less precise than itemized charges at civilian hospitals the analysts said the new accounting method provides better estimates of actual health care costs. An bomb analyst estimated the Pentagon is accounting for 80 percent to 90 percent of the actual Cost of providing health care helping ensure that Federal budget Money is properly spent. The bomb has been trying to make Federal agencies account for their spending with a actual Cost Quot information instead of estimates he  will resist any brightest coup Yeltsin tells britons London apr president Boris n. Yeltsin warned tuesday that right Wing forces want to stage a coup in Russia but he vowed that his government would not allow a the ghosts of the past Quot to Triumph. The russian Leader hinted that he would assume emergency Powers if necessary. It Yeltsin addressed russians political and economic problems during a speech to both houses of parliament the first by a non Westem Leader and a recognition of his commitment to democracy and capitalism. He later had lunch with Queen Elizabeth ii at Buckingham Palace and invited her to visit Russia. He told reporters the Queen accepted the invitation. Yeltsin was led into the soaring gothic chamber of the Royal gallery at the Palace of Westminster to the accompaniment of a trumpet fanfare. The 500 lawmakers and Peers including prime minister John major and his predecessor Margaret Thatcher gave him a two minute standing ovation when he declared that Russia and Britain were now allies. A we must directly recognize there Are in our country forces interested in a Revan Chist coup Quot Yeltsin said. He identified the potential coup plotters As remnants of the former communist party and state elite As Well As militant nationalists traditional communist economic managers and a a political  a fall these forces have come to life in recent times. They Are trying to switch to open massed attack taking advantage of the difficulties which russian citizens Are experiencing Quot he said. A but i am convinced such plans Are not destined to succeed. A the majority of russians oppose them. And Are not falling prey to panic and  despite predictions of widespread unrest after he began economic reforms last january he said Russia is quieter now than it was 10 months  of shame two men build a new Wall in front of Berlin s Brandenburg Gate on monday the third anniversary of the opening of the Berlin Wall. The stunt was a test by a German television Channel to gauge the reactions of passers by to the Wall. Most people found the event to be in bad  services to be curbed at shape Center by Rosemary Sawyer Brussels Bureau Casteau Belgium a army officials have approved a plan to discontinue inpatient care and specially services such As obstetrics and orthopaedics at the shape medical Center by Spring or Early summer. The move to close the 196th station Hospital will Force . And Allied personnel and their families to go to local belgian hospitals or other military hospitals in Europe for the curtailed services. Although driven by . Troop reductions in Europe the closure also makes sense medically and economically said or. Col Roger v. Carol the medical Center commander. A we really came to the conclusion that As an International Hospital it is be coming More difficult to justify a cont Uco a i my c an  it Hospi Tal Quot with a reduced patient Load and with care available nearby in belgian facilities Carol said tuesday. The army run Hospital is just one part of an International medical Center serving the supreme Headquarters Allied Powers Europe nato Headquarters and other units in the area. Medical officials have been working for some months on a plan to provide the curtailed services through three area belgian hospitals. The plan was approved Friday by Gen. John m. Shalikashvil supreme Allied commander Europe. As the 26-bed Hospital closes doctors in family practice will staff a clinic that can handle up to 90 percent of patients without referring them to specialists. The clinic will be open around the clock but not for major emergencies lab services and service in radiole�?T., a Quot vhf str ,  uni ophthalmology will continue to be provided Carol said. In addition local doctors will be contracted to Back up family practice doctors in paediatrics and internal Medicine. Obstetrics and gynaecology and orthopaedic services will be Cut. The future of physical therapy and preventive Medicine services is still being discussed. Dental services for . Personnel also will be Cut Back with specialists in orthodontics a endodontics periodontics and prosthodontics being replaced by two general practitioners. The hospitals that have been coordinating with shape officials include am Broise pare Hospital in Mons Hospital Erasme in Brussels and Soignier Hospital in Soignier where most obstetrics cases is ill be referred. 1 lie Ambrose Bate Hospital which 1 a e t1 a a i Quot it 1�?T  in 1 i is i e c already been training some of its staff in English said or. Daniel Desir the hospitals chief executive officer. A with this announcement we will go into another phase a Desir said. A we will have bilingual personnel in our information desk on a 24-hour  in addition Hospital officials have identified staff members who already speak English Desir said noting that at least 20 of the hospitals doctors have studied in the United states. The move will Cut 90 jobs at the medical Center 30 of them held by americans. It also Means increased medical costs As patients pay for deductibles and services not covered by the civilian health and medical program of the uniformed services. Officials Are exploring solutions to that problem. In the meantime Carol recommends that service members pick up Applei Enlal insurance politic