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posted by martyb on Tuesday March 21 2017, @04:46PM   Printer-friendly
from the ham-and-mayo-on-wry? dept.

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


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  • (Score: 5, Insightful) by JoeMerchant on Tuesday March 21 2017, @08:16PM (2 children)

    by JoeMerchant (3937) on Tuesday March 21 2017, @08:16PM (#482367)

    The problem with healthcare in the US is precisely that: everyone expects Ferrari healthcare, handmade - lots of expert craftsmanship, expensive components made from exotic materials. Not only does everyone expect this, but the organization providing healthcare refuse to differentiate: Mayo Clinic has one set of doors, and all patients walk through the same ones.

    There is no option for Chevy healthcare, your choices at large company healthcare plans basically boil down to: how much of your deductable do you want to pre-pay in premiums? Not: do you want to pay for all the latest exotic cancer therapies, joint replacements, etc. or do you just want to get basic preventative and emergency health care when you need it?

    The Ferrari healthcare system is terrified that if people had a choice (with proportionate price tags), they'd choose Chevy, and that would de-fund the Ferrari healthcare development system to a point that it collapses. So, we're all left to struggle, attempting to pay for Ferrari healthcare, and being told that if we don't pay for the Ferrari, there's not a viable Chevy option.

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  • (Score: 2) by bradley13 on Wednesday March 22 2017, @07:22AM (1 child)

    by bradley13 (3053) on Wednesday March 22 2017, @07:22AM (#482584) Homepage Journal

    You're right: there needs to be an option for "Chevy" health care. We have a similar situation here in Switzerland: 15 or 20 years ago, the government decided to dictate the minimum coverage that *must* be included in any health care policy. This has since been added to, and added to, and now includes all sorts of stuff including various flavors of "alternative medicine". Funny, the insurance now costs (after inflation) 2-3 times as much as it did before the government got involved. Dear well-meaning politicians: thanks for your help.

    However, alternative medicine aside, there is another problem: Most people would love to save money by having a "Chevy" policy instead of a "Ferrari" policy...right up until they fall ill and only "Ferrari" health care can save them. I remember watching this play out in New Hampshire, about 30 years ago. There was a little girl whose family was on welfare. The state had clear policies of what health care they would pay for, and what they wouldn't. Organ transplants were not on the list, but this little girl needed a liver transplant. While not exactly routine today, 30 years ago that was even crazier. Anyway, the state said (correctly, imho) "nope, not covered". The public outrage was enormous, of course, because little kids are photogenic.

    Anyhow, the point is: If you are going to allow Chevy policies, you've got to also be willing to enforce them. And that, in turn, requires a public that is sufficiently educated to say "you made your bed, you lie in it" - i.e., a public that is willing to see people denied Ferrari health care when they chose to pay only for that Chevy. I don't think that's going to work...

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    • (Score: 2) by JoeMerchant on Wednesday March 22 2017, @01:07PM

      by JoeMerchant (3937) on Wednesday March 22 2017, @01:07PM (#482683)

      As someone else posted, it works in Cuba. In Cuba, you get good Chevy healthcare provided by the state - if you want more, you pay for it out of pocket in Miami.

      I rode a commuter train from Zurich to Schafhausen once upon a time - that train had no problem with "two tier service" - if you wanted a quiet, uncrowded car with big chairs, you could pay for that, or you could ride something like a metro for much less money - makes sense, it costs much more money to provide the big cars.

      Of course, everybody is willing to sacrifice everything in matters of life and death. I think, perhaps, the answer to "two tier" healthcare is that insurance pays for the lower tier, and if you want "supplemental care" you save that money yourself - as you say: make your choices and live with them. The U.S. seems to be trying to train people to this with "high deductible" insurances that include individual savings accounts - but it still falls short, the "high deductible" insurance is still paying for all the Ferrari options up to some crazy high lifetime caps, and that's where the insane costs come in.

      It doesn't help that in the US all the bills are written to ~10x actual prices and "negotiated down" by a multiplier of ~0.08 to ~0.12 depending on your insurance, and thus not all providers take all insurances - and if you are private pay, your "negotiating power" is either x0.9 if you pay or x0.0 if you choose the (all too viable) bankruptcy option instead. So, we're getting a lot of Chevy healthcare with Ferrari price tags on it, and without insurance you are paying for a Ferrari, even though it's the same Chevy that the insured get.

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