Author and doctor Atul Gawande writes an interesting article on the current state of our healthcare mess and questions whether otr debate is really discussing the foundational issues of our nation’s healthcare problems. Being at Mayo Clinic I’ve had a chance to hear a lot of Mayo’s ideologies and it makes a lot of sense to utilize a pay-per-value system to decrease healthcare costs–but obviously it comes into contention with the self-interest of physicians who don’t want to ‘leave money on the table.’ The counter-point is, that if all our physicians in the nation keep snatching the money off the table, soon there won’t be anyone putting money on the table. Regardless, this issue will be very pertinent to everyody in America in the near future, so it’s worth your read to offer at least some expanded perspective.
Read Full Article: The New Yorker – Annals of Medicine – The Cost Conundrum
Additional Coverage: Post Bulletin: Mayo Clinic model is a hot topic, but is it sustainable?
McAllen… it is one of the most expensive health-care markets in the country. Only Miami—which has much higher labor and living costs—spends more per person on health care. In 2006, Medicare spent fifteen thousand dollars per enrollee here”
Rochester, Minnesota, where the Mayo Clinic dominates the scene, has fantastically high levels of technological capability and quality, but its Medicare spending is in the lowest fifteen per cent of the country—$6,688 per enrollee in 2006, which is eight thousand dollars less than the figure for McAllen.
The long-term proposal, tosses out the pay-per-service plan completely to be replaced with something like a bundled care method. That means a heart attack would be covered with one fee for all related treatment and that encourages a hospital “to do things right the first time,” he said.
The more money Medicare spent per person in a given state the lower that state’s quality ranking tended to be.
As America struggles to extend health-care coverage while curbing health-care costs, we face a decision that is more important than whether we have a public-insurance option, more important than whether we will have a single-payer system in the long run or a mixture of public and private insurance, as we do now. The decision is whether we are going to reward the leaders who are trying to build a new generation of Mayos and Grand Junctions. If we don’t, McAllen won’t be an outlier. It will be our future.
(Mayo’s) practice model is closer to the quality and cost we want, though we have a financing system that doesn’t make it sustainable,” wrote Gawande in an e-mail. “My conclusion is that it’s the financing system that has to change, not the medical system.
Mayo Clinic, which lost $840 million on $1.7 billion in Medicare treatment last year, agrees.
[Mayo] sees a short term fix and a long term one.
The short term one stays with the per service model, but it adds a “value index” calculation to different Medicare reimbursement level for each region.
The long-term proposal, tosses out the pay-per-service plan completely to be replaced with something like a bundled care method. That means a heart attack would be covered with one fee for all related treatment and that encourages a hospital “to do things right the first time,” he said.
In the end, our national healthcare system doesn’t need to pay more across the board, it needs to use its resource to reward systems that optimize value to minimize cost and reduce waste that is currently dragging our our system as a whole.
Related posts:
- Week 2: Scrubbed, Gloved, & Inside an Abdomen
- So Where’s it Gonna Be? It’s Mayo not UCSD!
- Mayo Family Week
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Mayo Clinic is Going Bankrupt Saving America’s Money
This is an entry for me as much as it is to my medical colleagues who have probably run into the dreaded spell check for any medical manuscript that you are trying to proof. The good news is there is a 5 minute fix that adds 50,000+ medical words from the open source project 
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