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Mhm. Oh, okay. Oh, yeah. Mm. Mhm. Yeah. Yeah. You mhm. Yeah. Hello. I'm Lord Charles. And I'd like to welcome you to the Lord and Charles update this month. We're gonna look at two stories with special meaning for our state. Well, look inside the deadly business of designer drugs and some parts of the country.

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These drugs have become a cottage industry where people can ruin their lives and basement workshops. We'll see some graphic evidence of just how much damage these drugs can do. But before we look at that story, we're going to first explore what happens when Medicare is hit with a plan.

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Work slowdown. Medicare, the nation's largest health insurance program nationally, last year paid out more than $73 billion on 360 million claims. About 21 million claimants in Florida received $4 billion. Medicare is administered by the Health Care Financing Administration, headquartered in this building in Washington. D. C.

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Heck for, as it's called, employs 4200 people with an operating budget of over $1.2 billion. Of all the government programs, Medicare is among the most important. It's the key to helping our elderly pay their medical bills. It gives them peace of mind. Assurance and an illness won't wipe out there saving and make them dependent on society or their Children.

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Pick for runs Medicare by contracting out with private insurance companies, which provide the actual coverage for our senior citizens in Florida and in many other states, the program is administered by Blue Cross Blue Shield. Now, Blue Cross Blue Shield does a pretty good job in Florida.

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Last year, for instance, I had about 20 complaints about delays and Medicare payments, but this year it's been a totally different story. The complaints jumped from five a week in March to nearly 100 during one week in May, and each letter said almost the same thing.

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Medicare was suddenly and without reason, delaying its reimbursement payments. To find out why I held a hearing of the Senate Aging Committee in Jacksonville, where Florida Blue Cross is located. The numbers in Jacksonville confirmed the problems at the end of 1980 for Medicare had nearly 270,000 claims pending, and it normally took about one week to process that amount by the end of 1986 that backlog is expected to total 394 million claims, and that means that the people who process the paperwork will be running about seven weeks late.

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The source of the current problem is hip to they deliberately slowed down the process to make it appear as though they were saving money. Juggling accounts like that is wrong to start with. But even worse, it's worked some real hardships on a lot of elderly people in Florida.

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Mrs. Susan, Killer of the tone of Beach, told our hearing what happened after her husband died last year because of the Medicare slowdown. She's still involved in the painful settlement of her husband's medical bills. I have another bill pending for $650. It was filed the 26th of November.

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I have paid it. I'm entitled to receive it. I am the executive of record with the probate judge, and I haven't heard one thing, and it's sitting right in this thing. Uhh. I am not going to starve to death, but it gets might Ian handy to keep on paying the doctor bills.

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I have been frightened to file my own, which are now three or four or $500 worth since that time, because I'm so afraid they'll get mixed up and they won't pay my husband's bills. And I want that to be finished. And Mrs Keller's case, the slowdown created a lot of confusion, but the slowdown causes a lot of problems for doctors as well.

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In fact, it takes so long to process claims these days that a growing number of doctors just won't wait for payment from Medicare. Instead, more and more doctors are demanding that the patient pay upfront. That leaves the elderly patient waiting an inordinate period of time for Medicare to pay them back.

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Susan Sorensen works for a doctor in Jacksonville the past year since May of last year, I've seen the time progressively become stretched out from two months to three months and now six months, Uh, as a matter of fact, in April this past year, I finally received payment for a patient whose surgery took place.

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In April of 85. The claim was paid one year later, April of 86 we posted to her account. These people in most offices will end up going to the Credit bureau for non payment unless they have a physician that's willing to work with them and can understand what's happening in the Medicare system belong.

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The director of government programs represented Blue Cross at our hearing. We have been deeply involved in this program for the past 20 years since the Medicare program began, and we're proud of our association with this most important program. As a Medicare contractor, we serve over two million Medicare beneficiaries 250 part eight providers and 45,000 physicians and suppliers in Florida.

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In fiscal year 1985 we processed over two million Medicare, part a hospital claims and 18.7 million part B physician and supplier claims, which accounted for a total payout of over $4 billion. Administration of the Medicare program is complex, and our responsibilities as a Medicare contractor include processing claims from both beneficiaries and physicians responding to in dealing with provider and beneficiary inquiries, controlling Medicare benefit payouts, implementing complex legislative, administrative and regulatory changes.

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We take seriously our commitment to provide service to the Medicare beneficiaries and providers in Florida. Well, no question, it's a big job, but it's one. Blue Cross has generally managed to do pretty well pretty well. That is, until Hick for decided to hold back money already appropriated by Congress, Part A and part B Medical and Utilization review and Medicare is secondary payer programs.

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Achieved program savings of over $109 million in fiscal year 85 and we estimated savings of approximately $113 million for fiscal year 1986. Severe funding cutbacks in fiscal year 1986 for contractors to process claims and answer inquiries. An increased number of administrative requirements. And the funding prospects for fiscal year 1987 All combined to seriously threaten our continuation of this record of success there for me a minute.

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Now you said three things there, I think you said severe funding, uh, cutbacks, increased screening requirements. And what was the third thing that you said and the the potential? We've potential funding for 1987 out years from there. All right, Are you telling me that you're given that you're provided less money and required to do more to do more in the way of screening and by heck for Yes, sir, we are.

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But you just told me that you were able to save $106 million by being able to screen uh, and to the work that you all were doing and taking out illegal claims are fraudulent claims or claims that were wrongfully processed. Ah, you're not going to be able to save that money if you if you're not giving enough money to do that job or you're not, that's true.

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Or does that just simply mean that the person that's filing their claim, uh, you know, just has to wait that much longer because you can't You're required to do certain things primarily, That's what's occurring now. Well, as hip for told you to slow down the processing of these claims.

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The health care financing innovation the electronic claims we have over the past couple of years received notice that it is the intent to gradually slow the claims payment times. How many claims do you think that you will have unprocessed at the end of this fiscal year, September 30th 1986 Based on our current rate of processing claims and are projected receipts of 20.6 million claims, we would have right at 2.1 million claims pending 2.1 million on in some stage of processing in our building.

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How many did you have of September 30th of 1985 512,000, I'm told. How many claims did he pay you for processing? Uh, in this year, our funding. Our budget this year is based on processing 19 million claims. Well, if you were paid for funding, 19 million claims and your processing, how many we we expect to receive 20.6 million.

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You didn't keep that a secret from Hick for what you thought you were going to process? No, sir, we did not. But while the delays have been getting longer, the number of Medicare claims nationwide has been climbing. They're expected to reach a record 394 million in the very near future.

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When Congress saw the number of claims growing, we appropriated money to deal with the increase. We took pains to make sure service wouldn't suffer. So Congress put in more money than you ask for, and you were cut back. Some and the administration tried to rescind more of that even after the after the cuts.

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I want to read you something that's in the, uh well, this this came out of the Appropriation Committee. The language says the committee believes that the adequate adequate funding level for Medicare administrative functions is essential to maintaining the integrity of the Medicare program and to assure the timely and appropriate processing of claims.

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Further, the committee believes that first priority should be given to claim payment functions, to reduce claim backlogs and to prevent any further deterioration in the quality and timeliness of claim processing functions. It went on to say the conferees put this in. The conferees want to urge that any cost cutting measures be implemented in a careful manner with the understanding that the processing of Medicare claims is an important function and that saving measures not undermine beneficiary services, professional relations, productivity, investment or program safeguards.

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The deliberate slowdown by Hector was clearly against congressional intent on every score, but at the last moment, the day before the Senate hearing, him tried an old trick and released some of the money. I asked the hick for regional director why they waited so long to release $14 million in back payments.

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That's a good question. We've we've had some real problems. I We were on the conference calls on this thing. The estimates were wrong. The total volume on claims has jumped dramatically. PPS came in and were Mr Hollande. I just wish like hell out of hell. The hell this hearing a lot sooner.

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It might have been the day before the hearing is held. A hearing six months ago we might have gotten the contingency fund six months. Mhm. Well, the hearing made it clear that hick for was at fault. But the evidence also made it plain that the administration of Medicare in Florida, with its large number of senior citizens, is a complicated job.

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This 20 story building is the nerve center of Medicare. In Florida. They've got 62 incoming watch lines, the toll free 800 number to handle as many as 10 calls a day. Indeed, the calls have become so heavy a caller gets a busy signal 60% of the time.

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Thank you for holding me, and he said that was for a shot of adrenaline, right? It was taking nice to get that back when I get that back. If that is a listed correctly, understand that that's true. To be reprocessed correctly, I'll send you a letter and let you know so the doctor can rebuild that with the correct Medicare code.

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Steve Davis, a Blue Cross vice president, explained how the claims are processed. Put it this way. We can just set a stack of envelopes in there. It brings it forward, sends it through a slicer that opens it up, and then the section cup opens it. Okay, there's the place you see right to see if there's anything left in the envelope.

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If it is, and give her a signal that there's something still an envelope that helps us be sure we don't under by the time it gets to the to these people, we have a couple of guys in the back. They bring it all in and the big buggies from the post office and sorted into thick and thin.

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These are mostly envelopes, large envelope from providers that may have 30 or 40 or 100 claims in one envelope. Well, there's no question that Blue Cross has a tremendous load, but when Hick for won't cooperate, you can see that makes the job even tougher. When I got back to Washington after the Jacksonville hearing, it was clear something had to be done about this slowdown policy and done in a hurry.

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23 other senators joined me in an effort to force him to reverse their policy. We held an aging committee hearing in in Jacksonville, and we found there the tremendous concern beneficiaries being afraid, not able to process their bills, not able to get payment as a tremendous after the loss of a loved one in a major illness.

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And then you can't get the money and people are beginning to done you. That's a that's a devastating effect on our seniors. Pictures now promised to try and set a goal of processing claims in less than a month, but that's not good enough. And so we've introduced another bill that would force them to pay bills within 22 days or pay the interest to the beneficiary if they don't.

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We've just looked at one health program with a problem. What we'll see next is a health problem period. For the next few minutes, we're going to look at the inside story of homemade death. It's a fairly recent development. It's deadly. It's called designer drugs. This is laboratory equipment at a major hospital, and it costs thousands of dollars.

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Skill. Medical experts use this equipment to help people live longer and better lives. In other words, this equipment can be a lifesaver. Here's another kind of lab equipment. It doesn't cost nearly as much. It's not run by scientists. It can be assembled in your basement, and it can cost you your life.

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With simple paraphernalia like this and a little research at the public library, people can alter a controlled drug and make it thousands of times more powerful than heroin. And the results can be tragic. The hearing in Washington focused public attention on what they are and what they do.

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The people who testified told the story of ruin and death. Mrs. Daniel Kinston and her family live in a suburban community just outside of Washington, D. C. It was here that her son, Barry, experimented with designer drugs. It's a difficult story to tell, but we feel that it should be told, and we're happy to have the opportunity that maybe this will help somebody else along the line, Mrs Kinston said.

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A car accident seriously injured her son, when he was about 14 and he was given Demerol to kill his pain. It was an encounter with a legitimate drug that took a bad turn. He was an intelligent young man. He had a great personality. Of course, I'm a little bias on that because he was my son.

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But I still thought a great deal of him, and he got along well with people. He liked to help people and do things. He was outgoing, but he then started a laboratory in our basement. Well, Barry had developed a drug problem, and he told his parents he was trying to develop a non addicting form of Demerol.

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And he set up his lab on top of the family dishwasher because he had he didn't even have as fancy of Billy Do is that thing is up there he had he had a little Edna burner. He had flasks and beaks, and he had one of those little glass trays that I see.

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In fact, I have a little note about that being washed in my dishwasher, not realizing what was being washed, but he bought chemicals from mail order houses. Her son's experiments were more than basic chemistry. He was making designer drugs for his own use, and he continued to do so until Labor Day weekend in 1978.

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Last I have a very is as he walked out the door through the carport, smiling and waving goodbye about 10 o'clock that night earlier in the afternoon, about 6 30 or seven, we had a call from it, says the Naval Hospital was very our son. We said yes, and I said Why?

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And they said, Well, they were checking records. And then about 10 o'clock or nine o'clock or an hour later, they and I age called wanting to know if Barry was our son. I said yes, Why And he said, Well, they were retiring records. By 10 o'clock that night, the front doorbell rang and there were three gentlemen there.

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One was from the coroner's office, and the one was from the FBI and the other was from was a state trooper, and the FBI was involved in it because Barry had been found under a tree dead on the NIH grounds. Ironically, the NIH that Mrs Kissed unmentioned was the National Institute of Health is located near their home.

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Her son had died of an overdose spawned by his work with designer drugs. A tragedy, no question about that. But even for those who survive, the balance of their lives can be tragic in themselves. What you're about to see shows what designer drugs can do, and this isn't very pleasant.

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But I hope you'll watch. And remember, you're looking at the aftermath of the nation's first designer drug disaster. She can't even make a sound. She's a prisoner in her own body. That's the way she was described by Dr J. William Langston, the chairman of the neurology department at Santa Clara Valley Hospital in San Jose, California She looks like she has Parkinson's disease, but she doesn't.

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She's a casualty of designer drugs now. Medicine can relieve her symptoms, but not for long. And she'll never return to normal. This man is a victim, too. He took a Demerol look alike, but it was slightly altered. That alteration made it legal, and it also made it poison.

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The drugs that reduce this man to near paralysis was made in Southern California. It wasn't very hard to make a raid on a California laboratory uncovered a Xerox copy of home instructions. 15. Do it yourself steps to slow suicide. Dr. Langston testified that designer drugs like the one at fault here kill the same cells that die in Parkinson's disease.

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Designer drugs. They are altered for profit. But man, they're designed for disaster. The man you're looking at is trying, but his body just won't respond. He's trying to stick out his tongue, and here is still another victim. According to Dr Langston, his tremors are about as bad as Parkinson's disease ever gets.

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Drugs like the one that turned these people into chemical wreckage can be made in a basement setup. Some of the drugs are 3000 times more potent than heroin. So with $300 worth of chemicals and a few $100 worth of machinery, these basement chemists can work black magic.

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For a total of $2000. A person can make as many as 200 million doses of this high potency killer. That's just about as much as a handful of salt, but it could yield profit in the billions of dollars. What an ideal target for organized crime loose on the streets of San Diego or a city in Florida.

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These drugs could spell tragedy for thousands of people. The man picture here can't even get out of bed. He used designer drugs for about two weeks. Dr. Langston called his condition living death only worse. This man would have starved if his mother hadn't stopped by for a visit and called an ambulance.

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We've got to stop this plague before it hits the mainstream of American life. It's going to take stiffer criminal penalties, strict monitoring and cooperation between the medical community, our law enforcement of people and our schools. But if we don't act now, we'll be chasing a problem that we might not be able to catch.

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The people you'll see next were helped, but they can never be saved. This is the same woman we saw at the beginning. She's been treated with L dopa, the same drug that's used to treat Parkinson's disease. In her case, it worked, but only for about five minutes.

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Now you see, she's already starting to twist and lose control. These are side effects of the treatment in Parkinson's. The side effects might show up in five years. Hers developed in three weeks. Once your own designer drugs, you're damned if you do, and you're damned if you don't.

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If the treatment medication wears off your back where you started, too much medication and your condition is different, but hardly better. In this last scene, we're looking at a man who once was an athlete. He's now a victim of designer drugs. 2.5 hours after treatment, he seems all right.

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But 20 minutes later he starts faded, and a few minutes after that, he's immobile. The treatment has worn off. He's gonna need treatment every hour and 45 minutes to be active, Dr Langston told us. The human body can't last very long that way, and that's the main point.

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How long could the nation stand Terrible chemistry like this, where one drug ruins and the relief is either too awful, too short or too late? You can see how designer drugs stop people. The question now is what can the people do to stop them? Well, there is the key question.

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How do we stop designer drugs? The Florida Department of Law Enforcement tells me that we've got to have a joint effort between the medical and the crime labs as a first line of defense and detecting these drugs. And here in Congress, I'm working with the Justice Department to see how the federal government can help.

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It's interesting how sometimes things work, how often they're interrelated. It was at a meeting with community and law enforcement leaders in Fort Lauderdale that someone told me designer drugs were popping up in the rock, cocaine, trade, rock, cocaine. I said, What in the world is that?

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We're going to take a closer look at it in a future update. We talked earlier about how many complaints that I had received in the mail about Medicare. That's how that problem came to my attention. Many times when you write we members of the Congress letters, that's the first time that we find out about a problem.

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I think that's very important. My mail is always very helpful to me and and getting into areas I received. Here's a letter I received from a military retiree in Tampa. He said, Dear Senator Child's. I'm very upset about the possibility of my not receiving a cola again next year.

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Senator, it's not fair. I don't understand why one group of government retirees can get a cola. Why others do without. Can you explain this to me? He's right. I couldn't explain it to him. And yet that's what happened last year. This year, when we put together our budget, Senator Domenici in ourselves myself put in provisions to show that there would be no change with the way we treated retiree Social Security, military civilian retirees, and they all would be entitled to get a cola again.

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That's why it's so important that we try to get a budget that starts us on this path to a balanced budget. And then we won't be fighting every year about where we have to make these kind of cola cuts. Here's another letter that I received from a lady and Naples.

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It says. I saw your show on TV, the one about the budget. You talked to Senator Domenici about how things were going and that you hope you could get both parties to agree. So far, I haven't seen any agreement. What's the problem? Well, we have had a problem.

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The house passed a budget, uh, similar to ours in that it met the targets of the Gramm Rudman Hollings. We got down to the 144 billion but they're playing like ours had some revenue in it. You heard Pete talk about the fact that revenue is going to be or new taxes, revenues, a term we we like to use up here when we don't want to talk about taxes.

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But he talked about the fact that some revenue was the glue that was gonna hold this package together, that we couldn't get down to reduce the 30 to $40 billion taking it all off the spending out of domestic programs or cutting the defense down to that that we'd have to have some revenue.

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The president had about $6 billion of new revenue in his plan. We had to put in about 11 billion more in our plan to make it work. The House had sort of a similar figure. So far, the president has said no. If there is any new taxes, I'll veto the bill.

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Now. We had a bipartisan group in the Senate that said, Well, we've got to pass this budget, it's necessary. We need to try to get towards the balance so we'll do it together and we had 70 senators vote for that. A majority of the Republicans and a majority of the Democrats.

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The House. It's a little different. The Democrats, uh, can't get any help from the Republicans over there. So right now they're saying, Why should we put in revenue If the president is going to be to us and then say that we're the tax and spend party So we're trying to get beyond that.

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And one of the things we're trying to do is to set up a reserve and say, Mr President, we know that you want an adequate number for defense. We do, too. But in order to have an adequate number for defense, we have to be willing to pay for it.

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And we think the people in this country are willing to pay for it. So we're going to say a number that we can have under our existing money that's going to come in, and we're gonna put aside a reserve and say This is the mouth that we think that we should have for defense.

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But the only way that we can get it is if we're willing to pay for it. We help. The president will to say it's better to go ahead and ask the people if they want to pay this additional money, which won't be that much. And for us to be able to have a budget that covers defense as it covers other things adequately.

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So that's what we're going to be pressing on. I'm delighted to have a chance to visit with you again. I look forward to seeing you again next month. Okay? Okay. Okay. Mhm. Okay. Yeah. Mhm. Yeah, yeah.