Health care leaders decry high costs, low quality care

The economic crisis has created a âÄúnear perfectâÄù political storm that makes now the time for health care reform, according to policymakers and health care leaders who spoke Tuesday. About 400 people turned out for a health care reform panel discussion hosted by Democratic Sen. Amy Klobuchar in the Mayo Memorial Auditorium . There, experts weighed in on how to change the health care system to decrease wasteful spending. Neera Tanden , the Obama campaignâÄôs domestic policy director, kicked off a series of speeches by a variety of health care experts, including a former Republican U.S. senator and the chief medical officer of HealthPartners . âÄúItâÄôs a historic time where the challenge is upon us âĦ to seize this opportunity,âÄù she said. Other speakers diagnosed problems with the health care system by focusing on Medicare and the variation in cost and value of its services. Dartmouth College professor Dr. John Wennberg said per patient Medicare spending varies by region from $5,000 to almost $15,000. He said the extra spending hasnâÄôt translated into better health care âÄî in fact, in some cases it means worse outcomes, like the higher mortality rate for the chronically ill in spendthrift regions like Florida. ThatâÄôs partly because more hospital time and procedures also mean more medical errors, he said. Right now the Medicare system rewards regions with poor quality health care, Wennberg said. Unnecessary care is a big problem, health policy analyst Ellen-Marie Whelan said . Americans spend more on health care than they do on housing or food, she said, and âÄúweâÄôre not getting what we pay for.âÄù The rate of preventable deaths in the United States is higher than that of many other countries, she said. High health care costs are being paid for in jobs, too, as businesses struggle to insure their employees. For example, Whelan said, General Motors now spends more on health care than on steel. That makes it hard for American businesses to compete with overseas companies. The current economic situation will only exacerbate the problem, she said. Unemployment is on the rise, and each 1 percent increase translates to an additional 1.1 million without insurance, she said. Despite the gloomy prognostications, Whelan said the economic crisis may be the impetus for change. Part of the solution is adequately informing patients about different treatment options and letting them make the choice, Wennberg said. Too often the physician ends up choosing, and that means patients end up getting surgical procedures they may have avoided if theyâÄôd had the right information. Minnesota Medicare spending is about half that of Florida, and Klobuchar said amid a health care system wrought with waste, a Minnesota institution âÄî the Mayo Clinic âÄî shows high quality health care can be delivered at low cost. The president and CEO of Mayo Clinic, Dr. Denis Cortese , concluded the afternoon. He said the health care system needs to be consciously engineered. Right now, Medicare pays the most money to the providers that do the worst job, he said. âÄúThe sicker a patient is, the more money you get,âÄù he added. Instead, he said, Medicare should pay for outcomes, results and value. ItâÄôs counterproductive to extend Medicare if itâÄôs not changed, he said. Students will âÄòinherit this messâÄô First-year medical students Damon Olson and Cori Russell said they hear about health care reform all the time in their classes. âÄúMedical students are concerned,âÄù Russell said. âÄúItâÄôs something we talk about all day long.âÄù At the end of the day, Klobuchar said itâÄôs clear that âÄúless expensive models can be better.âÄù Contrary to popular opinion, more money doesnâÄôt mean better care. Medicare, she said, is a good place to start because the program has such a large effect on the health care payment system. Though Medicare isnâÄôt likely to show up on studentsâÄô priority lists, Klobuchar said they will have the biggest stake in this health care system. âÄúThey may feel healthy now,âÄù she said, but theyâÄôll have to âÄúinherit this mess,âÄù so they definitely have a stake. Primary care is severely undervalued in our health care system, Klobuchar said.