CosgroveÕs organization .. is routinely rated among the best in the nation for a number of its specialties.
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 isnÕt the political will this year to address the larger issues. Given the complexity and contentious nature of the debate, that shouldnÕt be a surprise, but it also shouldnÕt 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 nationÕs gross domestic product — on health care. The Organization of Economic Cooperation and Development, a group of 30 of the worldÕs leading industrialized nations, reports that the United StatesÕ health care spending per capita is $7,290 — more than double the $2,964 average among member nations.
The spending doesnÕt necessarily mean better results. The infant mortality rate in the United States is higher than the organizationÕs 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 SunÕs editorial board, Dr. Delos ÒTobyÓ 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 Òthe easy partÓ 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.
CosgroveÕs 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 $4.8Êbillion 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 patientÕs 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 doctorsÕ 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 40Êpercent 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 shouldnÕt let the chance to make that happen pass.
Copyright 2009 Las Vegas Sun
