Mayo Clinic comes out against the House health care reform proposal

Just a brief post – The Mayo Clinic has been touted by the President but the clinic has come out against the House proposal.

I don’t deny the need for rational health insurance policy but I am very nervous that the White House is pushing the process too quickly. Doing something bad could be much worse than doing nothing.

I appreciate readers who believe we need a single payer. However, all we are really talking about is who brokers the payments. The inefficiencies in the system and the incentives which drive costs must be addressed. Whether government can do this is an open question – one I am skeptical about.

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  • Mary

    I am afraid that if nothing is passed this time – I will be up the creek. I can’t get disability (because I am self -employed) and medicare and medical I can’t get either. My medical bills – and being depressed had made it difficult to manage my home budget. I’ve had to take in roommates, and cut many, many little delights out of my budget. No Netflix, no new books, housebrand hand lotions, toothpastes etc…. can only see my therapist 1 or two (if I’m lucky) times a month. I’ve not had my yearly mammogram check which is advised for women my age. I had to trade medical attentions and services for free loan and loan advise. Small price to pay …. but….why can’t I get insurance?

    I’m sorry I don’t care what the Mayo Clinic says. They are backed by very rich people. They live in a very different world than I do. And if I were at Mayo Clinic looking for grant money and other financial support – I would say anything my backers would want me to say.

  • Mary

    The link reads like a little advertsing for one side w/o much documentation to back up anything? Show me how it will lower patient outcome and results if we already have 24th in infant mortality rates, obesity, diabetes, heart disease etc…

    C;mon that was just a snippet of propoganda.

  • Lynn David

    I caught a break this last time I was in the hospital. Normally, a self-pay person gets 18% off their bill from our county hospital. But this time I went in complaining that I might not be able to pay my bill and pay my farm’s property tax at the same time. I pointed to one of the bursars/social workers (whoever?) that the hospital down in the big city south of me gives a 35% discount.

    .

    Now I don’t know if my complaining did anything or not. But I was told when I finally called to inquire about financial aid, which was a month after I got my bill for $34K for a 12 day stay ($27K with the 18% discount), that our county hospital (which makes money, btw) decided to reduce the payments for all private pay patients to that which Medicare would pay them. My bill went down to just a bit over $4,000. That was a savings of about 88% overall and 85% off the former discounted amount.

    .

    This was the hospital only, the doctors won’t give you a break. They want their money to help pay for their toys, like his racing car with which a local doctor was recently pictured in our local paper.

    Lawmakers have failed to use a fundamental lever – a change in Medicare payment policy – to help drive necessary improvements in American health care. Unless legislators create payment systems that pay for good patient results at reasonable costs, the promise of transformation in American health care will wither.

    And from a comment….

    Excellent article by Mayo’s Cortese and Korsmo in the Chicago Tribune about the need for a “value index” factor in Medicare payments.

    Value index? So is that like the government should create a outcomes table concerning what might work and what is not likely (though has a possiblity) and then hike up the payments on proven methods but deny your last resort?

    I went looking in the Chicago Tribune Health Section and a search found this article, “Bending the curve on health spending” By Denis Cortese and Jeffrey Korsmo.

    They had this to say…..

    Despite the fact that we strive to give patients the right level of care — everything they need, no more and no less — we consistently suffer huge financial losses due to the government price-controlled Medicare payment system, which financially punishes providers who offer higher quality care at a lower cost.

    ….

    A bill recently introduced by Rep. Ron Kind (D-Wis.) and others entitled the Medicare Payment Improvement Act (H.R. 2844) takes an initial step at rewarding value (a similar bill was introduced in the Senate by Sen. Amy Klobuchar (D-Minn.) and others). It is a simple concept: Insert a value “index” into the current Medicare payment formula to financially reward high-value providers and offer an incentive for low-value practitioners to improve. In this case, a health care value index is a basic indicator of “a great value” — a positive medical outcome and high satisfaction compared to the total bill that later arrives in the mailbox.

    .

    Over time, we believe that a value index has potential to put downward pressure on the cost curve by rewarding high-quality, efficient providers with payment increases over the standard Medicare rate. When a portion of their payments is based upon value, doctors and hospitals will begin to seriously weigh the benefit of ordering more tests because additional medical spending that does not improve outcomes reduces overall value — and consequently would reduce their Medicare reimbursement. Health care professionals also will begin to understand the value they can add by working in teams to improve care and reduce costs.

    .

    And also from the Mayo Clinic blog comments….

    Exactly! These Medicare payment “formulas” are helping to drive up costs in the first place. So they want to apply similar policies across the board to help lower costs? I guess that only makes sense to people in Washington.

    Gee…. makes sense to me. I’ll let you figure out what it is that makes sense to me though…..

  • Pathia

    I already have two bankruptcies under my belt, both medical related. I’m only 29. The only time I can reliably get care is when I go to the ER. Private insurance companies deny me coverage, and when I can work enough to get insurance through my employer, they’ll use my transsexual and intersex status to deny just about everything possible. (They denied my appendicitus for being transsexual awhile back for example).

  • http://www.wthrockmorton.com Warren

    Pathia – I am not sure that government coverage will be any more generous. Medicare for instance is a patchwork quilt of coverage. The prescription drug has a gap in coverage that is very confusing. It covers some expenses too generously and other things not much at all. Some things are not covered that seemingly should be. Medicaid has a 5 year look back that prevents elderly from giving any money away (prior to applying for Medicaid long term care) lest the government think the person was shielding income from the government. You can only have 8k in assets and be covered by Medicaid. If Medicaid thinks you gave away too much then your eligibility is delayed. Where do you go then?

    The system is not a free market now, so criticizing it as a failure of the free market is a straw man argument. The market is incredibly regulated now by the government, we are talking about a progression from a relatively free market prior to the 1960s to a much more regulated one then and to the present. In my view, government plans are not much better than the private ones. My guess is that people who have been denied coverage by private plans will think a public plan will be better and those who have had much experience with public plans and programs are in dread at what is coming (I know I am).

  • http://www.wthrockmorton.com Warren

    Lynn David – You are putting up some good stuff there. The trick has been defining value.

    Normally this involves patients who get well quickly. In my field, it means curing folks in the shortest period possible. So what happens to folks who don’t get over things quickly? They get referred to other providers, you know, the low value providers. Measuring value without taking into account diagnosis severity, social context, etc., places incentives to move certain patients to levels of care which are not paid at optimal rates. Voila – Fewer race cars for those docs; more for the high value providers.

  • Pathia

    Warren: So, having coverage with holes, is worse than having to use the ER exclusively for my health care needs…how?

  • http://www.wthrockmorton.com Warren

    I don’t know if it is worse. It may be better but then again perhaps the ER care is better than what you might get from the government. It is a crap shoot, in my view. I think it depends practically on what the holes are and whether you need what is in them.

  • Pathia

    Warren: Most are chronic conditions that would be much cheaper and easily controlled with medications and regular checkups, instead of waiting until they progress until I have to be hospitalized.

    I get bronchitis often for example, but it will develop in pneumonia just as easily. If I could afford to get the bronchitis treated, I wouldn’t have to even go to the ER.

    Treating my conditions as they hit the ER level are astronomically higher than treating them earlier on, I’d wager they’re 10% the size, if not less of the ER costs.

    I need access to basic pharmaceuticals, a PCP, very basic simple stuff that everyone takes for granted. That’s all I need.

  • Mary

    Nonetheless, these are just theories or fear tactics. Nothing has been proven and we know what we have does not work. I have no doubt that whatever is put in place will need to be tweaked but the overall health of america is deteriorating. We’re priced out. And the more people that are selected out of health insurance – then the premiums will rise for those who do have it. If you sell to fewer people you will have to sell at a higher price. Basic economics – not theory.


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