Mayo Clinic Blog Blasts Obamacare

[foginthemorn]

I heard President Obama praise the Mayo last week for its cost saving. But.....

http://www.informationweek.com/blog/main/archives/2009/07/mayo_clinic_blo.html;jsessionid=IRGUNV3V3LRRSQSNDLOSKHSCJUNN2JVN


Mayo Clinic Blog Blasts Obamacare

Posted by Paul McDougall on July 21, 2009 10:17 AM

No less a revered, tech-savvy institution than the Mayo Clinic has come out swinging against President Obama's national healthcare agenda. "The real losers will be the citizens of the United States," warns the clinic's official blog. The problem: The plan fails to employ data to gauge whether publicly-funded providers are earning their money or operating Dickensian patient mills.

The Mayo Clinic lauds the idea of healthcare insurance for all, but it believes that the current plan before Congress would simply extend Medicare's vast inefficiencies and failures to the wider public. "In general, the proposals under discussion are not patient focused or results oriented," states the Mayo Clinic, in a post on its Health Policy Blog that appeared last week.

A major shortcoming with Medicare and Medicaid is that, controlling for regional variations, they pay the same regardless of the level of care. That is, a hospital whose patients are likely to die within 30 days of a bypass gets equal reimbursement for the procedure as a hospital whose cardiac patients can expect to play tennis well into the next decade.

Obama's healthcare reform would continue to reward such medical mediocrity, but on a universal scale. The plan does envision so-called value-based payments, but not until 2012 or 2013. And the rewards for higher performance would be modest at best. "Lawmakers have failed to use a fundamental lever—a change in Medicare payment policy—to help drive necessary improvements in American healthcare," states the Mayo Clinic.............more......

....<**also some embedded stories at link>

[BlooInBloo]

1. And the battle is joined. This is why shitty Senators want a delay.

[nightrain]

2. The donors had already contaminated the health care reform field.

I think what we're seeing is more of a few patches put on the hemorrhage.

[WCGreen]

3. They have a point...

By paying less for inferior care would be an incentive to fix their daily operating procedures.

[FrenchieCat]

4. It ain't no fucking Obamacare,

its called AmericaCare!

[Spazito]

5. Oh, I love this...

"The plan fails to employ data to gauge whether publicly-funded providers are earning their money or operating Dickensian patient mills."

So says the institute known for the best care MONEY can buy but ONLY if you have the MONEY to buy it.

[kenfrequed]

11. Yeah

The moral gymnastics and contortion required to be able to speak of the Dickensian while defending privelage and attacking the principle of trying to help those that do not have the means is utterly astounding in its gall or absolutely ignorant hitorically or classically illiterate.

[Spazito]

13. Yes, what struck me when I read that sentence is...

the attempt to decry that which they profit from and want to retain using the old standard 'damning with faint praise' and assuming no one would see through it.

[Egnever]

18. I dont think its that hard to get into mayo

Assuming you can get there. My folks have been a couple times in the past when they had no health care I was aware of. Not sure how they pulled it off but I will ask.

[Spazito]

22. Did the Mayo Clinic treat them for free or did they walk out with a

sizable bill or have to pay upfront? It isn't a lack of access, in and of itself, that is at issue, for me anyway, nor the quality of care the Mayo Clinic offers, it is the outrageous costs for treatment which would limit who could/can access the care and the financial burden it places on many who DO get the care.

[kath]

21. You're wrong about Mayo - they are "among the highest-quality, lowest-cost health-care systems in

the country." See this very good article about health-care costs:
http://www.newyorker.com/reporting/2009/06/01/090601fa_fact_gawande?currentPage=1
The Cost Conundrum
What a Texas town can teach us about health care.

Excerpt:

The core tenet of the Mayo Clinic is “The needs of the patient come first”—not the convenience of the doctors, not their revenues. The doctors and nurses, and even the janitors, sat in meetings almost weekly, working on ideas to make the service and the care better, not to get more money out of patients. I asked Cortese how the Mayo Clinic made this possible.

“It’s not easy,” he said. But decades ago Mayo recognized that the first thing it needed to do was eliminate the financial barriers. It pooled all the money the doctors and the hospital system received and began paying everyone a salary, so that the doctors’ goal in patient care couldn’t be increasing their income. Mayo promoted leaders who focussed first on what was best for patients, and then on how to make this financially possible.
No one there actually intends to do fewer expensive scans and procedures than is done elsewhere in the country. The aim is to raise quality and to help doctors and other staff members work as a team. But, almost by happenstance, the result has been lower costs.

“When doctors put their heads together in a room, when they share expertise, you get more thinking and less testing,” Cortese told me.

Skeptics saw the Mayo model as a local phenomenon that wouldn’t carry beyond the hay fields of northern Minnesota. But in 1986 the Mayo Clinic opened a campus in Florida, one of our most expensive states for health care, and, in 1987, another one in Arizona. It was difficult to recruit staff members who would accept a salary and the Mayo’s collaborative way of practicing. Leaders were working against the dominant medical culture and incentives. The expansion sites took at least a decade to get properly established. But eventually they achieved the same high-quality, low-cost results as Rochester. Indeed, Cortese says that the Florida site has become, in some respects, the most efficient one in the system.

Lengthy article, but well worth the read. Discusses the HUGE variation in healthcare costs in different parts of the country.
Mega-thanks to whomever posted it here on DU a month or so back!

[Spazito]

23. Excellent article, thanks for the link as it has very interesting information...

but I don't think it negates the point I was making in that the Mayo Clinic is a revenue-generating institution. In 2007, annual revenue at Mayo Clinic grew 10%, to $6.9 billion, the increased revenue came from, primarily from it's patients. If you do not have enough MONEY, you cannot access the wonderful, high-quality care offered by the Clinic. I don't know the % of Medicare/Medicaid patients they have treated versus the number of patients who are able to afford the care on their own but, given their revenue increased 10% in 2007 while the number of patients treated was unchanged, I suspect the percentage of the latter is much greater than the former.

Link to the article re the 10% increase in revenue to 6.9 billion:

Mayo Clinic reports 2007 revenue grew 10%
Income from patient care rose 5 percent for the year, though the number of people being treated was unchanged.

Revenue at the Mayo Clinic grew almost 10 percent in 2007, to $6.9 billion.

In 2007, income from patient care went up by 5 percent, to $294 million. Patient numbers were flat, at 520,000.


As a not-for-profit organization, the famous clinic plows profit back into its practice, education and research.

snip

Mayo officials have complained in the past that Medicare has cut payments across the board without taking quality into account. Through its new health policy center, Mayo is proposing a formula for Medicare payments that weighs outcomes and cost over time, two measures that Mayo scores particularly well on nationally.



http://www.startribune.com/business/16684991.html

[ericgtr]

6. The same may clinic where rich Canadians pay over $100,000 to deal with non-life threatening cysts?

That mayo clinic?

[masuki bance]

7. Obama on the Mayo Clinic-

“I think what’s important is to say to the American People that you should get the best possible care to make you well. And that the measure of the quality of care is not quantity, but whether or not it is making you better. Now, what we’ve seen is that there’s some communities and some health systems that do this very well. Mayo Clinic, a classic example. In Rochester, Minnesota. People go there. They– spend about 20-30 percent less than some other parts of the country, and yet have better outcomes.”

http://abcnews.go.com/Politics/Politics/story?id=7910304&page=1

[Laf.La.Dem.]

8. Obamacare

Get your head out of your ass - we do NOT have anything called Obamacare:mad:

[kenfrequed]

9. The disgusting doubletalk and bullshit!

"... The plan fails to employ data to gauge whether publicly-funded providers are earning their money or operating Dickensian patient mills."

The disgusting, disreputable, deceptive, double-speaking, dip-shittery of this hack of a two bit dot com diatriber. Charles Dickens would beat this maggots rich-loving butt to death with his laptop for using his words in such a backwards, self serving, manipulative way.

Honestly Why didn't Paul McDougall just write: "Are there no free clinics? Are there no student hospitals? Are there no sliding rate community healthcare centers?" The absurd moral contortions and abstract justifications are pure Scrooge in their intent and effect so perhaps Dickens should indeed be enlisted from wherever his soul resides to speak to this.

Patient-mills indeed. Far better I suppose to consign those cursed by being both sick and poor to collapsing into an ER somewhere and dying than to get in line for proper treatment. Nowhere in his self serving, insurance friendly, name dropping, unattributable mess does he actually stake out anything resembling a real solution to either the uninsured or the underinsured.

[Thrill]

10. Obamacare? Stop reading these RW sites

[kevinmc]

12. Wash. Times, Fox Nation falsely suggest Mayo Clinic critical of Obama health proposal

http://mediamatters.org/items/200907210034

In a July 21 article, The Washington Times reported that the Mayo Clinic is "joining the growing chorus of critics the Obama administration is trying to fend off as the debate intensifies from Capitol Hill to Main Street" and that "White House aides did not have a response to the criticism from the Mayo Clinic, which Republicans exploited." The article later stated: "Sen. John McCain, Arizona Republican, used his Twitter feed to spread the Mayo Clinic statement, adding: 'They are right.' " A Fox Nation headline also falsely claimed, "Mayo Clinic Rebukes Obama's Rationing," and linked to a NewsBusters post, as well as the Times article. In fact, in the statement to which the Times and NewsBusters referred, the Mayo Clinic did not criticize Obama's health care proposal. Rather, it criticized the House bill for "fail to use a fundamental lever -- a change in Medicare payment policy -- to help drive necessary improvements in American health care," and the Obama administration has itself proposed reforms to Medicare payment policy.

In a June 2 letter to Sens. Edward M. Kennedy (D-MA) and Max Baucus (D-MT), President Obama listed several proposals to reform Medicare, including "reducing overpayments to Medicare Advantage private insurers; strengthening Medicare and Medicaid payment accuracy by cutting waste, fraud and abuse; improving care for Medicare patients after hospitalizations; and encouraging physicians to form 'accountable care organizations' to improve the quality of care for Medicare patients." Obama also proposed "giving special consideration" to the Medicare Payment Advisory Commission to "identify and achieve additional savings." Obama said the commission "could be a valuable tool to help achieve health care reform in a fiscally responsible way."

Subsequently, White House budget director Peter Orszag stated in a July 17 statement that "one of the most potent reforms is a change in the process of health care policymaking: empowering an independent, non-partisan body of doctors and other health experts to make recommendation about Medicare payment rates and other reforms." And in a July 17 letter to House Speaker Nancy Pelosi (D-CA), Orszag proposed creating a nonpartisan Independent Medicare Advisory Council (IMAC), which would "have the authority to make recommendations to the President on annual Medicare payment rates as well as other reforms.".........................

[joeglow3]

14. They may be right (to an extent)

I don't know enough about the issues to really say. However, my wife is an RN at an OB/GYN clinic. She only works in the office one day a week, but they let her do just about anything from home the rest of the week, including billing. She says they only get $35 for an annual exam (I assume from Medicare). At this amount, they lose money.

The practice is a private practice owned by a husband and wife (who are both OB/GYN's). While I agree they make more money than they need to, it should also be noted that they lived in abject poverty until they were well into their 30's and still have about $500,000 in student loans. Thus, I don't have a problem with them making SOME money.

Thus, I think Mayo is over-blowing this, but I think there is some truth to their word.

[kenfrequed]

15. Seperate issue

Student loans are complete bunk. They are welfare for the banks and the greed of these bastards has created greater noise-signal ratio with regard to access to education. The result is to either make debtors of us all or cut of education from all but the most well heeled.

However I Don't think that there is anything right about this. The mayo clinic system is not designed to understand day to day clinic needs of the uninsured or underinsured, their wonderful system notwithstanding.

Also, false targeting here. Doctors are not what we are discussing in healthcare reform, it is the insurance and administration that is making all the damned money. Please do not prop up untennable and absurd arguments.

[joeglow3]

16. I agree that insurance companies need to be dealt with

All I am saying is that if all their payments were the same as Medicare and Medicaid, they would most likely have to drastically cut back on staff or close up (at least, this is based on the financial information my wife works with). I don't think this bill is addressing only insurance companies, as the fees received by the Doctors and hospitals HAVE to be at least enough to not lose money.

[scheming daemons]

17. Ummm.... welcome to DU?

FUD, eh?

That's your style?

[Sparkly]

19. Here's the blog, without the commentary.

http://healthpolicyblog.mayoclinic.org/

Not quite as drastic as the "information week" person suggests.

[Politicub]

20. Wow - they f-ing suck

After Obama compliments them, they attack. What assholes.

[Rosa Luxemburg]

24. Mayo is a business reallly