both TonyRo76 and LasVegasDave.
Posted on 08/13/2009 12:03:00 AM PDT by Stand Watch Listen
When President Barack Obama visited the Cleveland Clinic, he used it as a platform for his national health reform efforts. The Clinic, the largest regional employer and an international health-care giant, in turn has used the visit as a springboard to lobby for its views.
In a wide-ranging conversation at The Plain Dealer Wednesday, Clinic Chief Executive and President Dr. Delos "Toby" Cosgrove talked about the future of health care. He expressed frustration that policy-makers are now focusing reform efforts on access to insurance, instead of reducing costs and making Americans healthier. He also explained why he called lawmakers in Washington naive.
What follows are edited and condensed excerpts.
What is your biggest concern about health-care reform?
If you wind up bringing 40-some million people under some sort of insurance, regardless of what the insurance is, I think that it's likely that we're going to see a tremendous escalation of costs for the entire country. That is coupled with the fact that we expect health-care costs to go up anyhow across the country because there are more people, more old people and more things we can do for them.
What has been left out of the discussion?
The first is we need to develop a more efficient health-care delivery system by increasing the integration of hospitals and having more collaboration between physicians and hospitals. Physicians are the ones who order the most tests and procedures, and it's difficult to control costs unless you have them be part of the delivering of efficient care.
The second item is the burden of disease in the United States: Smoking, inactivity and obesity. Those three things drive chronic conditions, and chronic conditions account for 75 percent of the cost of health care in the United States.
If we don't keep efficiency and healthy living in mind, the rest of it is just all cost shifting.
You have said recently that you were surprised by how naive lawmakers have been about health-care reform. Can you expand on that?
First of all almost all the legislators in Washington are lawyers, and they started delving deep into health care about January. I've had discussions with a lot of them and I was surprised about the questions they were asking, which seemed sort of basic knowledge.
This is the biggest industry in the United States and this affects 100 percent of the people. To have decisions made on this with just a few months of learning is a little terrifying.
It seems that promoting healthier living wouldn't be controversial. Why isn't that part of any of the reform proposals?
The Cleveland Clinic's Dr. Mike Roizen (the hospital's chief wellness officer) has been pushing hard to get reimbursement for people to be counseled around wellness and that could come up as an amendment. The Clinic has taken a strong public stance against tobacco -- we don't hire smokers -- and we have given our employers membership to Weight Watchers and Curves to help fight obesity. I've also talked with Cleveland Mayor Frank Jackson about banning trans fats at restaurants throughout the city, like Mayor Michael Bloomberg has done in New York.
What do you make of the real public anger about health reform?
Fear of change. I think it's a real concern.
Are you fearful that what ends up on the table does more harm than good?
I don't think I can say that because I don't know what we're dealing with. It changes daily. I'm on the phone for half an hour every day with Washington.
As a regular consumer, when will l actually see change?
I think something will pass this fall. It will then have to go and be interpreted by all the various bodies in Washington. So two years from now, I think you'll start to see health-care reform rolling out. I'll be very surprised if we all don't feel it.
The president has touted your integrated delivery system, which includes employed physicians and an extensive electronic medical record system that allows all the hospitals to share records. How do you see integrated delivery playing out at other hospitals across the United States?
We need to build collaborative organizations. For example, the Cleveland Clinic has 17 family health centers, community hospitals and the main hospital. Not all the facilities do everything. The Clinic recently had one community hospital stop doing heart surgeries and another closed its neonatal unit because the care can be provided at other hospitals within the system.
At the end of the day you have to say what is the best thing for the patient.
The best thing for the patient is getting them someplace where people have practiced it over and over.
“First of all almost all the legislators in Washington are lawyers, and they started delving deep into health care about January. I’ve had discussions with a lot of them and I was surprised about the questions they were asking, which seemed sort of basic knowledge.
This is the biggest industry in the United States and this affects 100 percent of the people. To have decisions made on this with just a few months of learning is a little terrifying.”
How true!!
One question I haven’t heard anyone ask of our esteemed representatives is this. Since hardly any of you has read the bill, who wrote it?
How did this and the other monstrosities (cap and tax, the porkulus, etc) come into existence and how did they do so almost overnight?
I bet the answer is all the democratic pressure groups have been working on their pieces of the sausage waiting for the time when the grinder was controlled by the dems and they could throw all the pieces in. What a revelation it would be to have the answer to this question!
One question I haven’t heard anyone ask of our esteemed representatives is this. Since hardly any of you has read the bill, who wrote it? How did this and the other monstrosities (cap and tax, the porkulus, etc) come into existence and how did they do so almost overnight?
Who wrote it...Congressional staffers, special interests groups, the socialists that desire to turn the nation's safety nets into permanent entitlement hammocks.
IMHO...this Bill was written long ago. Remnants were probably left over from the Hillarycare fiasco. As the Defense Dept has contingency plans...so too the special interest groups have Bills, plans, policies to 'implement' at any given time.
They just need a apathetic/uninformed electorate, a compliant Congress and a 'charismatic leader that can maintain the 'campaign' mode indefinitely.
Democrats!
Honestly, just read HR 3200 - there's plenty to be angry about.
Not if we heartless conservatives, in concert with the majority of Americans, have anything to say about it.
Jeez, Jackson and Bloomberg are both abject morons and trans fat is just the latest fad boogeyman.
There is an increasing irrationality apporaching paranoia about smoking in America. Cosgrove is one of the extreme examples. He’s a huge believer in nanny-state laws.
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