Mayo’s support of co-ops is misguided at best. Current research demonstrates that they not only will be unable to compete with huge private for-profit plans but would add another layer of bureaucracy to the massive number of health insurance companies- 3178 at last count. And co-ops, like the public option, will not save money.

Harvard physician David Himmelstein has written that a single-payer extension of Medicare For All will SAVE at least $400 billion each year if politicians could bite the bullet and remove insurance companies from the system. This huge savings could pay for an expanded Medicare program that should be able to reimburse, clinics, hospitals, and primary care physicians at a much higher level. Keep in mind that it was the Bush Administration and his supporters in Congress that systematically reduced reimbursements in an effort to cripple Medicare.

Why try to institute another public plan when we already have one in place? A universal plan has four major benefits in addition to the obvious economic benefit:
1. Medicaid would become part of Medicare, thus providing states with immediate relief,
2. getting rid of the accounting nightmare at every clinic, hospital, and physician’s office,
3. there would be a greater emphasis on preventive medicine, and
4. families would no longer face bankruptcy
because of high medical bills.

Lynn Howard Ehrle, Senior Biomedical Policy Analyst, Organic Consumers Association
ehrlebird@organicconsumers.org

It would be ever so much more elegant, efficient, and cost efficient if the Mayo suggestion of an independent body were expanded to include developing a set of health services everyone is entitled to receive, set and audit adherance to professional standards of care, and negotiate annual health care budgets with Congress and the administration. That way health services could be delivered free from interference, yet accountable.

Jim Waun

1. Find a way to establish large and small group practices patterned after centers such as Mayo Clinic and Cleveland Clinic. The integrated group practice concept established by Drs. Will and Charles Mayo works because:
a. It promotes collaboration within and across specialties;
b. It promotes communication and collegiality among health professionals at all levels,
c. It reduces cost by establishing fair salaries and by eliminating, or at least discouraging, duplication of equipment and services.

2. Put more emphasis on healthy lifestyles and health maintenance, beginning at the medical/nursing school levels. Historically, the focus has been on fixing health problems after they occur. Put more emphasis on prevention. “Mayo Clinic Health Letter” was established in 1983 to prevent problems by promoting good health practices as well as physician/patient communication. Books and our web site followed. As a nation, we need to promote availability of reliable, easy-to-understand, comprehensive health information. We also need to eliminate use of tobacco products and address other factors known to contribute to poor health, such as school nutrition programs that promote obesity.

3. Eliminate defensive medicine. Mayo Clinic is self insured. Physicians and surgeons can make decisions in the best interest of our patients in part because they understand our Legal Department will support them in the event of a trivial lawsuit.

4. Require health insurance. You cannot drive a vehicle of any kind on our nation’s highways without insurance. Health care should not be readily available to all at taxpayer expense. Regulate the health insurance industry to ensure fair and affordable costs. As citizens of this nation, we need to thoughtfully evaluate our financial decision making to see if the choices we make are part of the problem. Are two cars, a boat, widescreen TVs and a lake home really necessities? How much should we be investing in entertainment and personal comfort as opposed to health care.

Other measures no doubt will be required, and some of the attributes of a center such as Mayo are not easily duplicated. For example, a major factor in Mayo’s success (perhaps THE major factor) is our large non-physician support staff. These folks, for the most part, were born and raised in small towns surrounding Rochester. They bring to Mayo their work ethic and strong moral values. You can’t put a numerical value on this factor.

David E. Swanson
July 27

A single law hammered out in a few weeks won’t begin dealing with the issues of high costs, poor service, errors and mistakes, inefficiency, and disappointing outcomes plaguing health care. Those complex issues call for an elegant solution that lies beyond Congress’ grasp.

What Congress can do is establish a nonpartisan, blue-ribbon commission, like the 9/11 commission, to develop a new and uniquely American health-care system.

A uniquely American health care system would provide everyone with necessary health services that are neither run by the government nor subject to interference from the legislative and executive branches. Individuals would have their choice of doctors, and services would be provided by free enterprise health care providers organizing themselves to compete on the basis of patient satisfaction and superior outcomes, and profiting from innovation and efficiency.

The commission’s goal would be to develop a nonpolitical, independent regulatory agency staffed by health care professionals, like the Fed, to manage health services.

The commission would need to address several thorny issues currently confounding health care. Private health insurances have intolerable conflicts of interests. Their role must be reconfigured, perhaps as fiscal intermediaries managing payments for services and auditing for access, outcomes, patient satisfaction, and fraud and abuse.

A second confounding issue is paying for health services. Employees’ health care is not a legitimate cost of doing business. Any scheme mandating that employers provide insurance, or that individuals purchase their own health insurance, would simply add yet another layer of bureaucracy to our already smothering nightmare.

There are strong conservative, moral, pragmatic and prudential arguments for having the government pay for all necessary health services. A new source of revenue must be found. A national tax on consumption could be a fair, simple solution.

And the commission would also need to develop a plan for transitioning into a new health care system.

If Congress passes piecemeal legislation this year, without initiating a process leading to systematic health care transformation, we’ll eventually merely end up with a differently dysfunctional, high cost patchwork system of health care.

Jim Waun
June 2009

While the Mayo Clinic may have come to some solid conclusions about what their members and colleagues want in health care reform, what was so refreshing to me is that they were not pushing any agenda down people’s throats and were very committed to listening to what the attendees have to say.

I think we are seeing a sea change in the health care reform debate that is different from the debate I have followed over the past 30 years. New visions and new voices are emerging, which for the first time is reaching out to the public.

The public is the only group that has been consistently been left out of refrom since the get go–since the first report on health care reform: The Committee on the Cost of Medical Care in 1932.

Consistent themes have continued over time. The challenge is–we have left the health care system to the industry stakeholders, when it is you and I, the American public who are the only voters who can give politicians their jobs. That’s why we need to find common ground and build consensus together, so we can have reform vs. more endless debate.

Congratulations and thanks to the Mayo Clinic for being a fresh voice in a public reform debate.

Kathleen O’Connor
Founder and CEO
CodeBlueNow!