I wish we could all be “so Mayo”

by the Night Writer

Tuesday I spent a chunk of the day down in Rochester at the Mayo Clinic (actually, St. Mary’s Hospital, part of the Mayo complex) while my father’s brother was undergoing an aortic-valve replacement, the same operation my father had in 2005.

It was my first visit to the Mayo campus and the time spent waiting with my aunt and cousins for word on the results of the operation allowed me to ruminate on being in one of the foremost medical centers in the world, the current debate on healthcare “reform” and, of course, on family ties.

One, I’ve never been in a hospital as pleasant as Mayo-St. Mary’s, at least in the parts where I went. The halls were quiet, the waiting room was comfortable, we even had free wi-fi … and nowhere did I encounter that institutional, disinfectant smell that had been such a part of my life a couple of years ago. Even parking was easy; I pulled into an underground lot in front of the hospital, took the elevator to the lobby and a second elevator to the fifth floor and walked to the family waiting room as easily as going to my office. Actually, it was even easier because I didn’t have to go through two security doors, nor did I dodge gurneys and masked orderlies in the halls, or have to work my way around the vortex of a nurses station as I commonly did when my father had his valve replacement or later when he was fighting lymphoma. He had had great care from one of the top guys in the business with his heart surgery at Barnes Hospital in St. Louis, but we were never entirely confident that he was getting the best or most appropriate treatment with his cancer, first at the regional hospital and later in St. Louis. Now, however, I was at the Mayo and my uncle was getting first class care in a setting where we were being treated as customers, almost as if my uncle was someone rich and important like the sheiks that fly into Rochester and the Mayo for their care.

My uncle is important to us, but maybe not so much to the rest of the world, however. He’s a retired rural mail carrier and, hence, a retired federal employee so he has great insurance that apparently covers him traveling 550 miles to get his surgery at the Mayo. Even though he’s well into his 70s and had triple-bypass surgery several years ago after a heart-attack, he didn’t have to go in front of a review board to determine if his quality of life was justified.

To tell you the truth, I have strong but mixed emotions about the healthcare debate that is raging in the U.S. right now (as regular readers already know). I believe very strongly that our current system desperately needs reform, but I believe even more strongly that the plans that are being proposed – in one form of single-payer, nationalized health insurance or another – is the exact opposite way that we should be going. I feel that the chances are good that this will be turned away (this time, anyway) but I’m discouraged that the result will be status quo, which is still unacceptable, and that there will be no stomach left for the good fight to bring about real, market-based reform. Neither the current system or “Obamacare” would affect my uncle: his union and federal coverage would likely still be affect under “Obamacare”, just as it is now. Whether I and other non-federal, non-union folks should be so fortunate is another matter that’s part of the debate.

As I sat with this part of my extended family there was talk of the “Stewart Curse”: my grandfather had died after a series of heart attacks, my father’s oldest brother had died of a heart attack, both of his other brothers had had heart attacks, and there were now two valve replacements in the family history. In addition, my younger brother will need a similar operation, likely in the next two years, and one of my cousins has already had two stents put in. I’m not too concerned for myself, as the risk factors aren’t present in me: my blood pressure is low, my “bad” cholesterol is very low and my “good” cholesterol is, well, “good” and we know my valves are in fine shape, thanks to a little scare a few years back that turned out to be nothing (except a confirmation of market principles). I do have a bit of stress in my life, but I also have resources for dealing with this.

It should be noted that the Mayo is doing very well under the present system, but it is a credible (if so far largely ignored by the administration) voice for reforming this system. In fact, they have long-since used their experience to make a series of proposals on how to go about doing this, including bringing the market incentives back into the insurance equation — not as a way to increase profits, but to improve healthy outcomes. Right now the only way a health plan or a hospital can improve its bottom line is to “save” money by denying care; a nationalized program would further degrade the system into a lowest-common-denominator approach that rations care. In a fair system, such as the Mayo advocates, where insurers and providers compete for the public’s dollars and confidence (the real “public option” in my opinion) there are rewards for innovation, successful outcomes and a culture of excellence. I hope we all live to see it.

(P.S. My uncle came through his surgery in fine fashion, complete with a new aortic valve that is an advanced hybrid that wasn’t available just four years ago when my father had his surgery. Let’s hear it for progress and innovation — and great skill!)

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