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Is Cleveland Clinic a model for success?
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TEXT OF STORY
Kai Ryssdal: Let me take you back to the beginning of the president's press conference last night.
PRESIDENT OBAMA: Before I take your questions I want to talk a bit about the progress we are making on health-insurance reform and how it fits into our broader economic strategy
Did you catch that? It's not health-care reform anymore. It's health-insurance reform. Health care we all like, health insurance, it's easier not to love.
The president's trip to Cleveland today wasn't so much about health insurance, though, as it was health payment. He, and others, point to the Cleveland Clinic as a model for how to get quality care at lower cost.
Marketplace's Tamara Keith has more on how the Cleveland model might translate elsewhere.
TAMARA KEITH: When it comes to health care more isn't necessarily better. But more is exactly what a lot of patients get. More tests, more drugs, more visits with specialists. That's one of the reasons we spend more on health care than any other country, but we don't get better results.
Many say the Cleveland Clinic proves it doesn't have to be that way.
DAVID GOODMAN: We can do it because we know that there are places where it's been done.
Dr. David Goodman studies health-care costs and outcomes at Dartmouth. At the Cleveland Clinic doctors are paid a salary. He says their income isn't tied to how many procedures and tests they order, so they do fewer.
GOODMAN: If many of these high-cost hospitals started practicing like the Cleveland clinic today, next year they would look like Chrysler. They would be bankrupt.
Goodman says that's because Medicare and insurance companies pay doctors and hospitals on a fee-for-service basis.
But that's not the only significant difference. University of Maryland Doctor John Kastor says a big part of the Clinic's success is its culture. Doctors collaborate, specialists work as a team, unlike most hospitals where physicians operate individually.
JOHN KASTOR: Transplanting this organization to community hospitals would be very, very difficult and even to academic medical centers. It's tough.
And putting all this into legislation. That could be even tougher.
In Washington, I'm Tamara Keith for Marketplace.
It really is painful to hear again and again - from Obama, Congresspersons - nearly everyone tells half truths, or even quarter truths. The health care system is very complex, and very personal; few people who study it and know it well will offer 'good' or simple solutions. If someone says 'just do this' -- you need to ask about all the other downsides of that option -- there are bad consequences to every option, including doing nothing.
The providers (such as myself, a speech pathologist) that sign up with the hmo/ppo plans get $70 or less per visit as a 1099 and need to take all the taxes and expenses out before calling it a salary. The middle man, aka insur co, takes a huge cut from the Medicare reimbursement and I'm supposed to see myself as blessed. I used to get $140 as a 1099.
I am completely offended by Pres. Obama's recent public speechs about Health care reform. He recanted health care to offer BEST medical care for all Americans. If best medical care can be offered to all Americans at a great saving tO tax payers, the Presidents and Congress should drop their 'EXECUTIVE' health insurance and become participants of their newly elected Health Care Policy. Maybe they will put more thoughts into something they will be actively involved.
I was very disappointed in this report, which seemed negative and one-sided. I found the comment that if the hospitals in general ran like the Cleveland Clinic they would look like Chrysler unbelievable - no explanation of why it system works for the Cleveland Clinic and other medical centers. I understand that it would mean significant change, but we have the expectation that other segments of our society will adjust when the economics require it, why not health care? Why are we expected to accept that we have to may more and get lower quality (poorer outcomes) than other industrialized countries? I think you really missed the mark with this story - it sounded like a commercial for the status quo.
