Logo for the Cleveland Clinic
Logo for the Cleveland Clinic - 
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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.