Tag Archives: Mayo Clinic

Overhauling Health Insurance from the Bottom Up

Over the weekend, following a town-hall meeting in Grand Junction, Colorado, President Obama broadened his rhetoric on health care reform, saying that a government insurance policy was not the only option available to lawmakers.  However, a New York Times article reports:

Speaker Nancy Pelosi said Monday that House Democrats, rather than backing down, strongly supported giving people the choice of a new government health insurance plan. “A public option is the best option to lower costs, improve the quality of health care, ensure choice and expand coverage,” said Ms. Pelosi, Democrat of California.

Grand Junction was selected as a location for one of the President’s town-hall meetings because it was recently profiled in a New Yorker article as an example of a region that successfully manages health costs. The presidential interest in Grand Junction’s system, however, seems strange, because the area’s cost-saving practices have not come about by the sort of top-down overhaul that his administration is promoting for the country. Rather, area doctors developed a grassroots solution:

Years ago the doctors agreed among themselves to a system that paid them a similar fee whether they saw Medicare, Medicaid, or private-insurance patients, so that there would be little incentive to cherry-pick patients. They also agreed, at the behest of the main health plan in town, an H.M.O., to meet regularly on small peer-review committees to go over their patient charts together. They focussed on rooting out problems like poor prevention practices, unnecessary back operations, and unusual hospital-complication rates. Problems went down. Quality went up. Then, in 2004, the doctors’ group and the local H.M.O. jointly created a regional information network—a community-wide electronic-record system that shared office notes, test results, and hospital data for patients across the area. Again, problems went down. Quality went up. And costs ended up lower than just about anywhere else in the United States.

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