Health Reform News 5-12-08

May 12, 2008 – 10:01 am

Recent health reform news highlights:

The Wall Street Journal’s Health Blog covered the story of Wisconsin Congressman Steve Kagen (D), the only member of the U.S. House to refuse health insurance coverage. He introduced a bill this year, says the WSJ, that “would bar insurers from denying coverage or raising rates because of pre-existing conditions. He’d also require companies to disclose all of their rates.” Jacob Goldstein also wrote about IBM’s consumer-driven health care project in Georgia.

The Associated Press ran a background piece yesterday comparing the leading presidential candidates’ proposals with the systems in Great Britain and Canada.

The Kaiser Family Foundation also issued a Background Brief on Health Care as a 2008 Election Issue.

The Pittsburgh Post-Gazette ran an article on employer-sponsored wellness programs aimed at cutting insurance costs.

On HealthPopuli, Jane Sarasohn-Kohn analyzes reports from Watson Wyatt on factors that will influence retirement timing and a Zogby poll for the American System for Advancing Senior Health. Here are some of the most relevant statistics:

One in 3 older Americans said they need more help with their health decisions, and 71% said they want to be able to find more information about their own health care. 9 in 10 older Americans want to be in control of their health decisions.

One-half of older people believe they themselves are in the best position to help improve the quality of their health.

Read the rest of Jane’s post for additional background and her analysis.

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Overview Presentation on Health Policy Center Activities

April 28, 2008 – 8:28 pm

Denis Cortese, M.D., the president and CEO of Mayo Clinic, and Mayo Clinic Health Policy Center director Jeff Korsmo, who also is chief administrative officer for Mayo Clinic Rochester, began the LaCrosse Leadership Luncheon on Health Care Reform with a presentation that highlighted Mayo Clinic’s health reform efforts. Their slides are embedded below, and you can read more about the presentation here, or you can view the webcast of the entire event.

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Questions and Comments

April 28, 2008 – 3:09 pm

Here are the questions and comments, submitted via laptops at each table, from the LaCrosse, Wisc. community leaders who attended the Leadership Luncheon on Health Care Reform on Monday, Apr. 28. Please feel free to add your input and contribute to the discussion in the comments below:

Questions and Comments
LaCrosse Leadership Luncheon, April 28, 2008

Dr. Cortese asked us whether we would want to be a patient tomorrow or go to a hospital, and we all answered no.  This is because we see receiving medical care as being a negative thing.  We only seek medical care when we are sick.  However, if the healthcare system put as much emphasis on proactive, preventive, wellness-based care, I would be happy to go to a hospital tomorrow and be their patient in an effort to live a healthier life.
Read More »

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Community Panel on Health Reform

April 28, 2008 – 12:32 pm

After the scene-setting from Dr. Cortese and Korsmo, a panel discussion ensued, in which they were joined by Congressman Ron Kind, who represents western Wisconsin in the U.S. House; Mary Jo Werner (with the Wipfli accounting firm), and Rusty Cunningham (Publisher, LaCrosse Tribune).

Congressman Kind raised concerns about IT innovation, which is exciting, but said proprietary interests are being built into competing systems. The systems need to be interoperable…they need to talk to each other, making information available to patients but also protecting their basic privacy.

Read More »

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Overview of Health Policy Center Activities

April 28, 2008 – 11:51 am

Denis Cortese, M.D., Mayo Clinic president and CEO, and Jeff Korsmo, the Chief Administrative Officer for Mayo Clinic Rochester and Director of the Health Policy Center, followed the participant voting with an overview of the HPC activities from the last couple of years.

Why is Mayo Clinic engaging in this? Demographics alone will force Medicare reform, and how Medicare is reformed will affect Mayo and its patients. Dr. Cortese alluded to a quote from Jerry Garcia:

“Somebody has got to do something, and it’s just incredibly pathetic that it has to be us.”

The importance to US:

  • Too many citizens without insurance protection
  • Huge opportunities in efficiency and effectiveness
  • The needs of the patient come first

Dr. Cortese says we need a Learning Health Care System, because the diffusion of information is far too slow. Right now the best-performing aspect of health care is in breast cancer, where patients get the state-of-the-art treatment and recommendations about 85 percent of the time. For atrial fibrillation (an abnormal heart rhythm), it’s more like 15-20 percent.

Dr. Cortese says we should focus on:

  1. Value - outcomes, safety and service, divide by cost over time.
  2. Integration and Coordination - lower costs, better outcomes, better quality. Wisconsin ranks highly in coordinated care. People on the East coast haven’t experience the kind of coordination and integration that people in the Midwest take for granted.
  3. Individualized Medicine - tailoring therapies to the individual, based on the genomics revolution
  4. Science of Health Care Delivery - System engineering for health care.

Dr. Cortese calls for payers to “Pay for Value” and reward providers that provide the best value. Medicare is the largest insurance company in the world, and it reward delay in diagnosis, incorrect diagnosis and bad outcomes.

“Pay for Peformance” is not the same as “Pay for Value.” Don’t just reward process steps, but the outcomes for patients. You can read an article about the differences here.

Dr. Cortese also calls for “Insurance for All” and favors something like the Federal Employees Health Benefit Plan model. All people own insurance, and everyone should participate. Employers can still contribute to insurance, with government contributing on a sliding scale for individuals who can’t afford it.

Jeff Korsmo says Mayo’s role is convening the discussion, and keeping patients at the center. He then gave a whirlwind tour of Mayo’s convening and outreach activities, including linking with AARP, SEIU, AMA and many other national organizations. The Health Policy Center Web site has more background.

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La Crosse Leadership Luncheon

April 28, 2008 – 11:16 am

Part of the special contribution of the Mayo Clinic Health Policy Center’s approach to health reform is its insistence on bringing the patient perspective to the discussion. That’s why the Your Voice, New Vision trailer is in La Crosse today, giving patients the opportunity to share their stories and perspectives.

The luncheon program today also is beginning with an interactive “audience response” session, enabling the 160 attendees to go beyond being an audience, and to participate themselves. Each of the 22 tables also has a laptop that can be used to submit questions.

On a scale of 1-10 (with 10 being most optimistic), voters estimated the likelihood of our ability to effectively reform health care on a national level at 3.8, so they were somewhat pessimistic. Still they said it was highly important: 47 percent say there are major problems, with another 16 percent saying the situation is even worse, and 51 percent say we need major reform. Hopefully we will be able to post the results in their entirety soon after the luncheon. Now we’re getting ready to hear from Denis Cortese, M.D., president and CEO of Mayo Clinic.

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Leadership Luncheon on Health Care Reform

April 28, 2008 – 10:54 am

The Mayo Clinic Health Policy Center is taking its show on the road today, with a Leadership Luncheon on Health Care Reform at the Radisson in LaCrosse, Wisc.

The Health Policy Center held its 2008 National Symposium on Health Care Reform in early March, and now the HPC is seeking deeper input into its recommendations by hosting regional meetings.

You can view a webcast of today’s events on the Mayo Clinic Health Policy Center Web site.

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Presidential Panel Podcast

April 15, 2008 – 11:11 am

At the 2008 Mayo Clinic National Symposium on Health Care Reform, a panel of expert guests joined with representatives of the three remaining major-party presidential candidates to discuss how the candidates’ health reform proposals coincide with or differ from the principles developed through the symposia and policy forums convened through the Mayo Clinic Health Policy Center. The panel was moderated by Cokie Roberts and featured Steven Pearlstein from the Washington Post, Karen Davis from the Commonwealth Fund and Elizabeth McGlynn from RAND Health, as well as representatives from the Clinton, McCain and Obama campaigns.

Panel Discussion on Presidential Platforms


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New York Times Editorial: Quality Care at Bargain Prices

April 10, 2008 – 10:35 am

Today’s New York Times has an editorial entitled “Quality Care at Bargain Prices” that focuses on the findings from the most recently updated Dartmouth Atlas of Health Care. The editorial concludes:

Reducing the cost of medical care will require changing longstanding habits — no easy feat. It may not happen until the medical profession reaches consensus on which treatments will truly improve the health of patients and which are superfluous. The Dartmouth researchers estimate that Medicare could save tens of billions of dollars annually — without reducing the quality of care — if all hospitals mirrored the practice patterns of the Mayo Clinic. That is a very good reason to change.

Here is the press release from The Dartmouth Institute announcing its findings. The Times’ editorial lends support to Mayo Clinic leaders’ call for payment reform, what they call “Pay for Value,” that considers both cost and quality in determining how health care services are reimbursed.

Sacrificing quality to meet budget targets isn’t a desirable solution to the problem of rising health care costs. The good news, as the Times and Dartmouth have pointed out, is it isn’t necessary either.

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Star Tribune Interview with Dr. Cortese

April 1, 2008 – 4:14 pm

Denis Cortese, M.D., Mayo Clinic’s president and CEO, was featured in an extended interview last Sunday in the Commentary section of the Minneapolis-St. Paul Star Tribune. Here’s an excerpt:

Q: THE HEALTH-CARE SYSTEM: CRISIS OR NOT?

A: To the extent that people say the system is broken, I would reject that as a too-simple thought. There is no system.

So let’s design one. The fatal problem that all of our people in Washington have — and many people have in the country: They’ve come to believe that the system is “broken.” That’s like saying, ‘I’ve got a broken car.’ And you’re going to go out and you’re going to fix it. And you go in the garage and you find out, ‘Oh, I forgot. I don’t have a car.’ You can’t fix something that doesn’t exist. Nobody ever designed this to be a system. Nobody’s ever sat down to say here’s where we want to be in the future. That’s what we’re trying to do. We’re trying to get across the message that we’ve got things that aren’t working. Yes, we have a catastrophe coming at us. It’s not a crisis yet. But it will be. It’s a crisis because we know it will be when Medicare hits. We’re going to go bankrupt. Medicare is orders of magnitude more of a significant financial problem for this country than Social Security is, and it’s coming in the next four, five years. Big-time, with all the people retiring. Seeing that and looking at it should be actually a releasing truth because we’re gonna have a major crisis, number one, and number two, we don’t have a system. We should say, OK, let’s go design a system. Let’s start from scratch and create one with a patient at the center.

Go here to read the interview in its entirety. And see the Star Tribune’s wrap-up of the 2008 National Symposium on Health Care Reform here.

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