The Mayo Clinic Diagnoses the House Health Bill
Although there are some positive provisions in the current House Tri-Committee bill – including insurance for all and payment reform demonstration projects – the proposed legislation misses the opportunity to help create higher-quality, more affordable health care for patients. In fact, it will do the opposite.
In general, the proposals under discussion are not patient focused or results oriented. 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. The real losers will be the citizens of the United States.
Why does this matter? Because the Mayo Clinic is so often cited by President Obama, and by health care experts, as the model for providing high-quality health care at a relatively low cost. You can read more about how they do it here.
UPDATE: So how is this criticism being received by the Obama White House? It is not being disputed there, in part because this argument is pretty much the same one that OMB Director Peter Orszag is making about the House bill.
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1
Somebody needs to tell the punks at Mayo that the House bill won't even come close to matching the final result that gets approval of the president and Senate moderates. Chill out!
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KT-You do realized that what you posted is the extent of what's at the link. 2 paragraphs with nothing to back up even the little that's there. What am I supposed to get out that? That a blogger at Mayo doesn't like the plan?
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2.1
This was posted on the Mayo Clinic's blog, and labeled as the "Mayo Clinic's reaction." Unless their bloggers are "going rogue," I think this is their effort to send a pretty pointed message. Interestingly, what they DON'T like about the bill --the Medicare payment policy -- is one of the main reasons that the AMA ultimately decided to support it. Pay attention to this issue (which I blogged about on Friday, when I linked to Orszag's blog making the same complaint about the House bill). Medicare reimbursement rates are an issue that looks like inside baseball, but they help explain why some pretty powerful interests are lining up as they are.
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"inside baseball" is right -- the comments from Mayo have nothing to do with providing Americans with health care, and everything to do with maximizing cash distribution to the Mayo clinics.
Mayo wants money distributed based on what is best for its integrated system. Of course, most of America doesn't have an integrated system, and the only way to achieve a nationally integrated system is with a single payer model.
Karen cites the Grunwald piece which goes to great lengths to avoid acknowledging that "more data" and has NOTHING to do with how Mayo saves money. Mayo saves money because all of its doctors work for the Mayo clinic -- its a mini-"single payer" system with strong central authority. ("more data" is complete BS, the current parasitical insurance system has all the data it needs, and uses it to deny treatment in order to maintain maximum profitability.)
As long as journalists insist upon lying to the American people about the true nature of the health care debate (i.e. especially by suggesting that places like the Mayo Clinic are 'impartial' and not looking out first and foremost for their own benefit) there will be no effective reform, just massive taxpayer subsidies to health care parasites.
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Take a look at the other items on that blog. They are basically press releases.
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"In fact, it will do the opposite."
Gunny has a good point. In fact, janej (if that's her real name) doesn't have an effing clue whether the proposed legislation will "help create higher-quality, more affordable health care for patients," or not. Sure hope that she doesn't practice medicine. Regardless, Mayo should have to explain why a bullsh*t propaganda statement like that appears under their name.
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4.1
I think the point it--and it is a criticism that a lot of experts, including Elmendorf, are making about the House bill--is that there isn't enough cost control in it, and not enough focus on improving health outcomes. Personally, I think this could end up being a healthy wake-up call. These are defects that can be fixed while this bill is still in the process of being written. And on that score, I recommend Jon Cohn's blog from yesterday. It explains very well why it is crucial to do this:
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Li' th' bullsh*t propaganda Congressional bills current under consideration be appearin' under th' name o' Democratic "reform"?
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6.1
Pirate
Not to digress, but you wished to discuss. I am more than willing and would certainly enjoy hearing your views on the matter. If you return to the Israel thread, I'll engage you in complete disregard to any side discussions that may be occurring.
Ci parliamo dopo...
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KT-The Mayo bloggers going rouge aside, it's still very thin gruel. It would also be nice to note that the Mayo clinic is against a public plan.
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Here's a link so people can put Mayo Clinic's agenda in perspective. Please note the paragraph where Mayo said it lost 840 million last year to Medicare.
http://www.mayoclinic.org/healthpolicycenter/pdfs/MC-Response-to-Expanding-Coverage-Final.pdf
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I think the point it--and it is a criticism that a lot of experts, including Elmendorf, are making about the House bill--is that there isn't enough cost control in it, and not enough focus on improving health outcomes.
I think you have a disconnect here KT, because the Mayo clinics criticism and Elmendorf's are not equal or even on the same playing field. If any thing Mayo is looking out for their own bottom line.
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9.1
And yet, Mayo is cited more frequently than any other institution I can think of--cited, I might add, by Barack Obama--as an example of what a reformed health care system should look like.
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Pluk (see his comment earlier) is right: One big difference is that Mayo's docs work on salary. But the current Medicare reimbursement system, which is fee-for-service, does not exactly encourage that model. Again, it's inside baseball--but inside baseball that is worth understanding.
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Please note my update. The Obama White House is not disputing this criticism of the bill by Mayo, in part because it is very similar to the one that OMB Director Peter Orszag is making.
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12.1
Peter Orszag is saying that the proposed legislation will, in fact, do the opposite of helping create higher-quality, more affordable health care for patients? I don't think so.
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What is this, Groundhog Day? I seem to remember the same kind of responses when KT posted the item about Apostle Rahm being a board member of Freddie Mac when it had, ahem, accounting issues.
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http://www.powerlineblog.com/archives/2009/07/024096.php
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Another promise of St. Obama being broken. -
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I had some surgery at the Johns Hopkins Medical Center a few years ago. I got one of the top surgeons in the country -- and paid, mostly out of my own pocket, about three times the Blue Cross reimbursement rate. (To be fair, both BC and Hopkins told me how it would work, and BC did reimburse me their standard rate for the surgery.) It never occurred to me to go to another surgeon in order to save a few thousand bucks (which, thank God, I could afford without extreme strain). The money all went to Hopkins the institution; the surgeon is on salary.
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I'm not sure this is a model for anything, but it is worth noting that Hopkins, not the surgeon, opted out of direct Blue Cross reimbursement, and the surgeon was on salary. And it may also be relevant that this was a tricky operation and worked out just fine in my case. When you like the result, it's worth whatever price you're charged -- if you can afford that price and get the treatment.
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Wouldn't it be grand if everyone could afford Hopkins because their policy covered all the costs? All you'd need to do is persuade Hopkins to join up when everyone's insured. Just as the Mayo Clinic will. Oh, wait ... -
16
Is there a health care bill for dummies (or at least a colorful chart) some where, because I'm getting kinda of lost about who is supporting what and who is criticizing who and what for? And now Spob is throwing in Groundhog day and Freddie Mac into the mix. This is all way too much for my brain housing group to soak in.
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gunny, remember the Rahm was a board member of Freddie post? Basically, KT got lambasted for even posting it. Response is somewhat similar here.
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Sorry if that was opaque . . . .
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In any event, where's cincy? Seems he'd have something nasty to say.
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The health care bill for dummies would be the picture of many people, perfectly happy with their health care now, bent over, saying please sir, may I have another.
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In any event, Congress won't agree (and neither will Barack) to be subject to the same health care plan as ordinary Americans. Guess egalitarianism only goes so far.
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And as for Barack "Only Take One Test, Not Five" Obama, one wonders if he can sell this. -
19
I would prefer it if the press would just stick to reporting the news and stop trying to make it (present company excluded). The biggest problem in the health care reform debate is the press constantly trying to turn it into a political horse race.
Chuck Todd just admitted that the press is getting played because they keep focusing on Congress struggling to get something passed and wringing their hands, when in reality the last time we had a health care debate the industry spend millions to kill it and now of the $40 million being spent most is coming from advocates of reform.
The key enemies last time around are on board this time but yet the press story remains chicken little. And even when Todd admits the situation that the press is creating and through it making the public more nervous, he closes with the caveat, that well even if they get something passed, implementing it is going to be a nightmare. Give me a freaking break. The same nation that has done Medicare, Medicaid, VA, and tricare are now supposed to have a meltdown implementing health care.
If the press would stop trying to be political pundits we will be a lot better off because unlike real political consultants who are in this game because they are basically optimists and look for ways to succeed, reporters are ill suited because they are basically cynical and are only looking for ways to prove a negative, ways that mean failure, frustration, and create adversaries.
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Dee, do you honestly think that "implementation" is going to be smooth? Hasn't CPSIA tought you anything?
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So guys, is Tapper a big meanie fighting health care for all?
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http://www.weeklystandard.com/weblogs/TWSFP/2009/07/obama_loves_mayo_but_mayo_does.asp
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I know; I know, no fair asking Gibbs a hard question. -
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"The biggest problem in the health care reform debate is the press constantly trying to turn it into a political horse race."
I'm starting to come over to pluk's view: no article about health care reform legislation should appear without noting the fact that Max Baucus has pocketed at $3.4 million from the pure generosity and patriotism of the insurance lobby.
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This Drum post, touching on Max Sawicky, springs to mind.
"Pitchforks and Torches"
Fri July 17, 2009 10:23 AM PSTI miss Max Sawicky. But he's back temporarily this week, and today's sermon is about the origins of bubbles and other economic catastrophes. Is fundamental irrationality the wellspring of financial chaos? Nope:
[Sawicky] "What's missing from the meliorist framework of my fellow bloggers is the concept of Power. We're getting progressivism when we need populism.
....Let's recapitulate. Big finance ('BF') systematically dismantles regulation of its activities. BF takes taxpayer money and lobbies against the interests of taxpayers. BF shovels money to politicians. BF offers the sunny side of the revolving door to high-level officials in public agencies. BF provides a haven for its minions to make one-way/heads-I-win-tails-you-lose bets with other peoples' money. BF alumni construct new policies, in the wake of the meltdown, to make new one-way bets, with taxpayer money. BF luminaries walk away from this debacle with personal fortunes intact, if not larger, as well as high public office, followed by further personal enrichment. Even the former chief economist of the IMF thinks that government policy has been captured by the bad guys."
I won't pretend to have settled views about whether the financial industry owns the United States government lock stock and barrel or merely has a controlling interest. It's at least the latter, and after the events of the past year it wouldn't take much to convince me of the former. But whichever it is, I agree that irrationality just isn't a key factor in what happened — at least, no more than it normally is for any kind of organized human activity. At every step of the way during the Bush-era bubble, virtually everything that financial actors did was either (a) outright fraudulent or (b) cold-bloodedly rational in the short run even if it was disastrous for the rest of us in the long run. Where are the pitchforks and torches when you need them?
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"no article about health care reform legislation should appear without noting the fact that Max Baucus has pocketed at $3.4 million from the pure generosity and patriotism of the insurance lobby."
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I actually agree. But then I'd like to see exploration of the fact that campaign contributions can be considered protection money too. KT? -
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KT & Commenters:
Lawmakers have failed to use a fundamental lever – a change in Medicare payment policy – to help drive necessary improvements in American health care.
Regardless of the authority or agenda of the Mayo Clinic, is this a true or false statement of fact?
If it's true, then, at least in terms of:
A) causing the proposed policy to fail (as someone at Mayo asserts)
B) the stated and unstated reasons why lawmakers have not included said change in Medicare payment policy
C) the policy's failure extending to degrade even further the health care system as a whole , i.e. "the proposed legislation misses the opportunity to help create higher-quality, more affordable health care for patients. In fact, it will do the opposite." and "The real losers will be the citizens of the United States. " (as someone at Mayo asserts)
, what is the meaning of that fact?
Is it not possible to say "Yes, that's true." or "No, that's false." about this claim without first evaluating the authority of the Mayo Clinic (or appeals to its authority by the Obama Administration)?
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24.1
"I regret that in our attempt to establish some standards, we didn't make them stick. We couldn't find a way to pass them on to another generation..."
Walter Cronkite on his greatest regret.
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Given SW's OT comment, here's one of mine:
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Carolyn Maloney, not ready for prime time . . ..http://www.weeklystandard.com/weblogs/TWSFP/2009/07/maloney_steps_in_it_1.asp
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Now if a Republican used the "n-word", we'd see an orgy of press coverage--a Dem, not so much.
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