Mayo reveals Rx for health system

Last spring, Mayo Clinic leaders joined the nation's health care debate, outlining their positions on what was needed to fix the ailing system. They spent nearly a year traversing the country, convening industry officials and academics to refine those positions.

On Tuesday, in a meeting near Washington, D.C., they listed the steps they hope the next president will take to fix the health care system.

Mayo's list touches on issues regularly debated by presidential candidates -- covering the uninsured, for example -- as well as those that are not, such as changing the way care is paid for to reward better-performing doctors and hospitals. The year of refining has reinforced the positions announced last year, but left the core goals unchanged.

The issue of covering the uninsured probably has had the most airing on the presidential campaign trail.

"Insurance for all should be a principle," said Dr. Denis Cortese, Mayo's chief executive, talking to reporters at the end of a two-day conference in Leesburg, Va., that capped the clinic's yearlong effort.

Mayo's position is that everyone should be required to buy private health insurance. Employers could contribute to the cost or, in the case of those who can't afford it, the government would chip in.

Other recommendations include introducing electronic medical records to which different providers could link for better coordination of care.

Now Mayo wants Medicare to change how it pays for care. Providers with better outcomes and lower cost over time -- thanks to fewer complications -- should get more money while those with bad outcomes should get less, Mayo argues. The reasoning is that such a system would raise the overall quality of care and ultimately reduce spending.

It makes sense for Mayo to get in on the national debate, said Dick Pettingill, chief executive of Allina Hospitals and Clinics, the second biggest group in the state after Mayo.

"If you're really going to reform something like Medicare," said Pettingill, "you have to start the debate now."