Tag Archives: mayo clinic

New Health Care Law

ObamaCare is Off to a Bad Start

5 Comments

The Mayo Clinic, praised by President Barack Obama as a national model for efficient health care, will stop accepting Medicare patients as of tomorrow at one of its primary-care clinics in Arizona, saying the U.S. government pays too little.

This is stunning on so many levels: the President’s continuing push for a public plan, the belief that Medicare can be used to bend the cost curve, the claim that Washington knows best about what is efficient care and why, the notion that the federal government can use its purchasing power to make all providers as efficient as Mayo…etc.

Full report on the Mayo Clinic in Arizona.

Health Care Costs

An Argument for Pilot Programs

9 Comments

This is Atul Gawande, writing about the Senate health bill in The New Yorker:

Turn to page 621 of the Senate version, the section entitled “Transforming the Health Care Delivery System,” and start reading. Does the bill end medicine’s destructive piecemeal payment system? Does it replace paying for quantity with paying for quality? Does it institute nationwide structural changes that curb costs and raise quality? It does not. Instead, what it offers is . . . pilot programs.

Continue reading An Argument for Pilot Programs →

Medicare

Should Eligibility for Medicare Be Lowered to Age 55?

7 Comments

“The irony of this late-breaking Medicare proposal is that it could be a bigger step toward a single-payer system than the milquetoast public option plans rejected by Senate moderates as too disruptive of the private market.”  — Washington Post

“Any plan to expand Medicare, which is the government’s largest public plan, beyond its current scope does not solve the nation’s health care crisis, but compounds it. … This scenario follows the typical pattern for price controls —reduced access, compromised quality and increasing costs anyway. We need to address these problems — not perpetuate them — through health reform legislation.”                    — Mayo Clinic

“A Medicare buy-in…would add millions of more patients to a program where it is difficult for a new enrollee to get an appointment with a physician.”                       — American Medical Association

“Medicare pays hospitals just 91 cents for each dollar of care provided. …  Adding millions of people to these programs at a time when they already severely underfund hospitals is unwise and should be opposed.”  — American Hospital Association

Health Care Costs

Just How Low-Cost is the Mayo Clinic?

3 Comments

The idea that putting everyone into something like a Mayo Clinic will save oodles of money underlies almost everything being discussed in Washington. But it is based more on wishful thinking than on any real evidence. Now Peter Nelson at the Center of the American Experiment offers a paper that should put this fantasy to rest for a while.

Mr. Nelson agrees that the Mayo Clinic provides very high quality care. But he says if you look beyond the price controls of the Medicare program, it is by no means low cost. He writes, “In Medicare, the government sets prices and, as a result, the prices in the Dartmouth data reflect national Medicare policies and do not reflect the price of health care services negotiated between private health plans and providers more generally.” Indeed, “Relative to other Minnesota providers, most evidence pegs the Mayo Clinic as a high-cost provider.”

Continue reading Just How Low-Cost is the Mayo Clinic? →

Health Care Costs

Taking Another Look at McAllen

14 Comments

Atul Gawande published an article in The New Yorker about a month ago, laying out in great detail what he viewed as the inadequacies of the health care system in McAllen, Texas, and compared them to what he views as far superior systems in Grand Junction, Colorado and Rochester, Minnesota (home of the Mayo Clinic). He concluded that we needed to replicate the management systems (not-for-profit, salaried employees, team approaches to service delivery) of the Mayo Clinic in places like McAllen, and indeed, throughout the United States. Voilà! Problem solved.

Now comes the Texas Medical Association with a reality check, including some things Dr. Gawande overlooked about McAllen: Continue reading Taking Another Look at McAllen →

Health Alerts

It’s Still Not What I’m Looking For

10 Comments

Have you ever noticed how many people there are who (a) are not medical doctors, but (b) are firmly convinced they know how medicine should be practiced, and (c) are more than willing to tell everybody else about their ideas? On rare occasions (for example, here), I have succumbed to the temptation myself.

If you find that strange, be aware that there’s another industry where the exact same thing happens: education. In both fields, the people who pay for the service and the people who receive the benefits are different entities. Perhaps for that reason, one typically finds a sea of mediocrity punctuated by islands of excellence, scattered almost randomly. Invariably, someone asks: “Why don’t we look at what’s going on in the islands of excellence and copy it everywhere else?” Why not, indeed? In education they have been trying to do this for more than a quarter of a century with no success, whatsoever.

What brings all this to mind is a New York Times article in which Alain Enthoven, Uwe Reinhardt, Harvard Business School Professor Clayton Christensen and others seem to want to try the very approach in health care that has failed so miserably in education.

httpv://www.youtube.com/watch?v=Pb1XXs7e7ac

I have climbed the highest mountains…
I have run through the fields…
I have scaled these city walls…
But I still haven’t found what I’m looking for.

Continue reading It’s Still Not What I’m Looking For →