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Overhauling health care
Congress should consider the Cleveland Clinic as a shining example of what can be done
Sunday, Sept. 27, 2009 | 2:09 a.m.
Over the summer the health care debate in Congress shifted focus. Improving the quality of care and reducing the costs became secondary issues to providing insurance coverage for more Americans.
That shift reflects the larger reality in Washington — there isn’t the political will this year to address the larger issues. Given the complexity and contentious nature of the debate, that shouldn’t be a surprise, but it also shouldn’t be the end of the efforts to overhaul medical care in America.
The need to address the cost and the quality of health care is obvious. Americans spend more than $2 trillion a year — one-sixth of the nation’s gross domestic product — on health care. The Organization of Economic Cooperation and Development, a group of 30 of the world’s leading industrialized nations, reports that the United States’ health care spending per capita is $7,290 — more than double the $2,964 average among member nations.
The spending doesn’t necessarily mean better results. The infant mortality rate in the United States is higher than the organization’s average, and life expectancy here is below average. The United States also lags in the number of doctors and acute hospital beds per capita.
In a meeting Wednesday with the Las Vegas Sun’s editorial board, Dr. Delos “Toby” Cosgrove, president and CEO of the Cleveland Clinic, said changing the system is necessary, but because of the complexity of the issue, it will take time. He called increasing coverage “the easy part” of the debate.
To improve the quality of health care will take a sea change in the way patients and those in the medical field think. Cosgrove, who has been called on by the White House and Congress to offer advice on health care legislation, understands that. The Cleveland Clinic is run differently than most American hospital systems, and it is incredibly successful.
This year it was held up as a model of efficiency and quality care by President Barack Obama.
Cosgrove’s organization, which runs the Cleveland Clinic Lou Ruvo Center for Brain Health in downtown Las Vegas, is routinely rated among the best in the nation for a number of its specialties.
The 85-year-old clinic has a $4.8 billion budget and 38,000 employees in Ohio, Florida, Nevada, Canada and the United Arab Emirates. It has been known as an innovator for its medical care and business operations.
For example, doctors who handle the same diseases or organs are grouped together. That saves a heart patient from having to trek across the city to see a heart surgeon — the surgeon works with the patient’s cardiologist. That provides a collaborative team approach to care, which benefits the patients.
Unlike most hospitals in the nation, the Cleveland Clinic hires doctors as salaried employees. Typically, doctors are paid based on the things they do — see patients, perform procedures, run tests — but making them employees, Cosgrove said, frees them to practice medicine and work with patients.
Cleveland Clinic doctors are known for the outstanding quality of their work. They regularly publish reports in medical journals and often produce new procedures and devices. For example, Cosgrove, a renowned heart surgeon, holds 30 patents on medical devices.
The clinic also prides itself on its focus on patients, and it measures its success with an immense amount of data. The clinic annually publishes reports on the outcomes of its procedures and treatments, giving patients and medical professionals a clear view of the quality of the work. As well, patients are regularly surveyed and their comments play a role in doctors’ annual evaluations.
Hospital officials have also found ways to streamline services, reducing duplication and costs. Cosgrove said efficiencies in the system have helped the hospital offer a generous payment forgiveness plan and provide $150 million in free care a year.
The clinic also champions preventive measures. Cosgrove notes that 40 percent of the premature deaths in the nation are linked to obesity, inactivity and smoking. The clinic promotes wellness programs and has offered its employees a generous plan, including smoking cessation programs and access to gyms. Cosgrove suggests that Congress offer a tax incentive to businesses that offer similar programs, which is an excellent idea.
Congress, though, may not get that far this year. Given the hysteria fanned by those opposed to any change, Congress has its work cut out for it just to pass the current plans that would expand insurance coverage.
Those plans should only be a first step of the debate. The nation should be set on overhauling the entire system to make it the best in the world. Congress shouldn’t let the chance to make that happen pass.
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The Cleveland Clinic is a private business - not government run
The Cleveland Clinic is run differently than most American hospital systems, and it is incredibly successful.
The Cleveland Clinic is a private business - not government run
The 85-year-old clinic has a $4.8 billion budget and 38,000 employees in Ohio, Florida, Nevada, Canada and the United Arab Emirates. It has been known as an innovator for its medical care and business operations.
The Cleveland Clinic is a private business - not government run
Hospital officials have also found ways to streamline services, reducing duplication and costs.
The Cleveland Clinic is a private business - not government run
Unlike most hospitals in the nation, the Cleveland Clinic hires doctors as salaried employees.
The Cleveland Clinic is a private business - not government run
Good post Future. We will soon benefit here from the Cleveland Clinic. No reason to cram down America's throat a govt dominated health care plan that robs us blind and rations our care, and steals from the elderly. If the Cleveland Clinic accepts Medicaid patients all the better.
And, and, and if you don't want to pay, please stay away...
If you haven't heard yet:
The Cleveland Clinic is a private business - not government run and if you don't want to pay, please stay away...
"The Organization of Economic Cooperation and Development, a group of 30 of the world's leading industrialized nations, reports that the United States' health care spending per capita is $7,290 -- more than double the $2,964 average among member nations."
So what to make of the Sun's editorial board praising a privately operated hospital? If we had a free market for health care, it could easily replicate the Cleveland Clinic model. Why, in this supposedly freedom-loving, capitalist country, do we need government to control our health care? Should we throw away our bedrock philosophy for socialism?
"The spending doesn't necessarily mean better results. The infant mortality rate in the United States is higher than the organization's average, and life expectancy here is below average."
But the editorial quotes the Cleveland Clinic as saying that "40 percent of the premature deaths in the nation are linked to obesity, inactivity and smoking." Not inadequate health care? Either our inferior health care system is to blame for our ranking in the OECD list or it isn't. The Sun editorial board appears to have blown a gaping hole in its own talking-point arguments.
The Clinic is a nonprofit organization, NOT a private business.