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Mayo Clinic, one of the country's top hospitals, is in the midst of controversy after its CEO said that the elite medical facility would prioritize the care of patients with private health insurance over those with Medicare and Medicaid.
The prioritization by the Rochester, MN-headquartered medical practice was recently revealed by the Minneapolis Star Tribune. And it has quickly drawn out some sharp critics—as well as sympathizers.
In a statement to the Minnesota Post Bulletin, Dr. Gerard Anderson, the director of the Johns Hopkins Center for Hospital Finance and Management, compared the prioritization to policies seen in developing countries. "This is what happens in many low-income countries. The health system is organized to give the most affluent preference in receiving health care," he wrote.
Likewise, Minnesota Department of Human Services Commissioner Emily Piper, expressed surprise and concern by the statements of Mayo's CEO, Dr. John Noseworthy. "Fundamentally, it's our expectation at DHS that Mayo Clinic will serve our enrollees in public programs on an equal standing with any other Minnesotan that walks in their door," she said. "We have a lot of questions for Mayo Clinic about how and if and through what process this directive from Dr. Noseworthy is being implemented across their health system."
Specifically, Noseworthy said in a video to Mayo employees late last year:
We're asking... if the patient has commercial insurance, or they're Medicaid or Medicare patients and they're equal, that we prioritize the commercial insured patients enough so... we can be financially strong at the end of the year.
In statements, Mayo has confirmed Noseworthy's prioritization and added that about 50 percent of its patients are beneficiaries of government programs. "Balancing payer mix is complex and isn't unique to Mayo Clinic. It affects much of the industry, but it's often not talked about. That's why we feel it is important to talk transparently about these complex issues with our staff."
Source: Ars Technica
(Score: 5, Interesting) by jmorris on Tuesday March 21 2017, @05:35PM (7 children)
Medicare reimbursement pays a fraction of what private insured patients does and Medicaid pays a fraction of what Medicare does. People who work for a living like getting paid, people who run up half a million in debt getting through the most elite medical schools to get to work at a high prestige place like the Mayo Clinic really want to get paid. They will do a percentage of charity work here in the U.S. exactly like many doctors do charity work overseas, but it can't be the majority of their work.
It is about time we face some brutal math facts. Medical science is inventing all sorts of wonderful procedures and drugs that have helped extended our average lifetime and is inventing ever more, but they tend to be expensive and growing more so, especially at the most elite places like Mayo. It is simply impossible to expect everyone, especially charity cases, to receive equal care to someone with unlimited resources to pay for their care. Their ability to pay for new and exotic treatments do drive the cost down though and they eventually become commonplace and cheap, we see this in the tech world daily. This means charity cases should not expect others to pay for new and exotic treatements and even normal insured people should expect limits as well.
Yes math is real, yes we live in a world of limited resources. Grow the hell up buttercup, you aren't special, you aren't irreplaceable and demanding your neighbors spend themselves into poverty to buy you another year or two is dumb. Everybody dies in the end, most simply aren't worth a million plus in medical care trying to push the exit date back a bit, and these days it is all too common to run up that kind of bill, usually in the last couple of years.
Personally, if I were rewriting the rules in this rip and replace of 0care I'd put anyone with a preexisting condition (i.e. those who couldn't or wouldn't buy insurance before they got sick) into government subsidized high risk pools along with the indigent where they got good but not great care. Access to doctors and common procedures but for example most branded drugs would simply be forbidden, generics only. Yes that means you wait ten years for a new drug to go generic, oh the horrors of getting care a decade out of date. But knowing this would be the fate of those who weren't insured would be a big motivator to get covered. It isn't politically viable to leave the sick untreated so formalize it and design it such that it provides the required market incentives.
(Score: 3, Insightful) by VLM on Tuesday March 21 2017, @05:56PM
This means charity cases should not expect others to pay for new and exotic treatements and even normal insured people should expect limits as well.
Something to consider is that sounds not so nice out of context but my observation of dying elderly relatives is that the only thing less fun than paying for someones $1M of care in their last six months is being the recipient of $1M of care in their last six months and almost universally they all had their fill of doctors toward the end and just wanted to go home or hospice and die in peace. Enough pills and injections and therapies that don't work and ...
I mean $1M of medical treatment sounds like a nice way to go out if its six months of endless sponge baths by a smoking hot 10/10 nurse. But the reality is that last $1M is usually not that much fun.
It brings up weird market ideas. Imagine terminal diagnosis comes with an offer like "Sign this medical release that basically says 'nothing but bottomless bottle of free painkillers' and instead of spending $1M on aggressive intervention and you're gonna die anyway, we hand you a check for $100K and tickets to Amsterdam while you can still enjoy it. Or you can transfer $2 of refused medical care into $1 of life insurance for your family."
There is an interesting capitalist type of problem were decades ago some cancers meant "you gon die" for sure, but spending an infinite amount of money for decades results in "you almost certainly not gonna die as long as you come in early enough" like skin and breast cancer. Eventually they'll figure out how to fix that outpatient maybe with an OTC pill. But how to figure out which diseases are eventually curable vs not, thats the mystery.
(Score: 3, Informative) by DeathMonkey on Tuesday March 21 2017, @05:58PM (4 children)
It is about time we face some brutal math facts. Medical science is inventing all sorts of wonderful procedures and drugs that have helped extended our average lifetime
The brutal fact is that US life expectancy is actually slipping. Life Expectancy In U.S. Drops For First Time In Decades, Report Finds [npr.org]
(Score: 1, Flamebait) by Anonymous Coward on Tuesday March 21 2017, @06:05PM (3 children)
Note that the drag downwards in life expectancy is due to poor people dying early.
Rich people are doing better than ever.
Policies like Mayo's are part of that problem.
(Score: 0) by Anonymous Coward on Tuesday March 21 2017, @06:16PM (2 children)
Flamebait?
Looks like once again some snowflake can't deal with the fact that reality has a well-known liberal bias.
the richest 1 percent of men lives 14.6 years longer on average than the poorest 1 percent of men, while among women in those wealth percentiles, the difference is 10.1 years on average.
This eye-opening gap is also growing rapidly: Over roughly the last 15 years, life expectancy increased by 2.34 years for men and 2.91 years for women who are among the top 5 percent of income earners in America, but by just 0.32 and 0.04 years for men and women in the bottom 5 percent of the income tables.
https://news.mit.edu/2016/study-rich-poor-huge-mortality-gap-us-0411 [mit.edu]
(Score: 0) by Anonymous Coward on Tuesday March 21 2017, @08:40PM (1 child)
Conservative retards are retarded. They can blame some brainwashing, but once they are past their early 20's they have only themselves to blame. I'm so mad about some of the shit I'm reading I have to say "FUCK YOU CONSERVATIVE PIECES OF SHIT! LEARN TO READ OR MAYBE GET A BRAIN IMPLANT THAT CAN LOGIC FOR YOU!!!"
(Score: 4, Insightful) by Azuma Hazuki on Tuesday March 21 2017, @10:48PM
Don't bother. Since Reagan if not before, "Conservative" has been shorthand for "selfish sociopath" and everyone knows is. Their problem isn't usually lack of intelligence, it's lack of common humanity.
I am "that girl" your mother warned you about...
(Score: 3, Interesting) by sjames on Tuesday March 21 2017, @06:38PM
Another reality, health care costs 4 times as much in the U.S. as in the U.K. Fix that and a hell of a lot of problems will just go away.
Forget the insurance scam and the up and coming replacement insurance scam and follow the money if we want to solve the problem.
Also ban evergreening and paying companies to NOT produce a generic. EVERYONE should probably start with a generic and only switch to the new shiny if the problem isn't adequately addressed. Ban the FDA from pretending that the pill with a B stamped into it is any different than the same pill with an A stamped into it. We already know B is safe and effective because A is and it contains the same stuff. Also ban the FDA from handing out exclusivity on generics when companies do an adequate job licking their boots.
Actually teach the art of clinical diagnosis. A good clinician can diagnose the patient without a battery of overpriced tests. And yes, the tests are over-priced. Most of them consist of diluting the sample (anyone who took chemistry in high school can manage that) dipping a $0.10 test strip into it, and then reading off the color chart. Most even have a machine that takes care of all of that including a coloremeter (much like the paint matching thing at the hardware store).
The reason Medicare pays less is that they know what the actual costs and profits are for the various tests and procedures. They demand val;ue for the dollar because they can. Everyone else is left flapping in the breeze.