In a July 21 article, The Washington Times reported that the Mayo Clinic is “joining the growing chorus of critics the Obama administration is trying to fend off as the debate intensifies from Capitol Hill to Main Street” and that “White House aides did not have a response to the criticism from the Mayo Clinic, which Republicans exploited.” The article later stated: “Sen. John McCain, Arizona Republican, used his Twitter feed to spread the Mayo Clinic statement, adding: 'They are right.' ” A Fox Nation headline also falsely claimed, “Mayo Clinic Rebukes Obama's Rationing,” and linked to a NewsBusters post, as well as the Times article. In fact, in the statement to which the Times and NewsBusters referred, the Mayo Clinic did not criticize Obama's health care proposal. Rather, it criticized the House bill for “fail[ing] to use a fundamental lever -- a change in Medicare payment policy -- to help drive necessary improvements in American health care,” and the Obama administration has itself proposed reforms to Medicare payment policy.

In a June 2 letter to Sens. Edward M. Kennedy (D-MA) and Max Baucus (D-MT), President Obama listed several proposals to reform Medicare, including “reducing overpayments to Medicare Advantage private insurers; strengthening Medicare and Medicaid payment accuracy by cutting waste, fraud and abuse; improving care for Medicare patients after hospitalizations; and encouraging physicians to form 'accountable care organizations' to improve the quality of care for Medicare patients.” Obama also proposed “giving special consideration” to the Medicare Payment Advisory Commission to “identify and achieve additional savings.” Obama said the commission “could be a valuable tool to help achieve health care reform in a fiscally responsible way.”

Subsequently, White House budget director Peter Orszag stated in a July 17 statement that “one of the most potent reforms is a change in the process of health care policymaking: empowering an independent, non-partisan body of doctors and other health experts to make recommendation about Medicare payment rates and other reforms.” And in a July 17 letter to House Speaker Nancy Pelosi (D-CA), Orszag proposed creating a nonpartisan Independent Medicare Advisory Council (IMAC), which would “have the authority to make recommendations to the President on annual Medicare payment rates as well as other reforms.”

Indeed, in a July 21 entry on its Health Policy blog -- posted after the Times published its article -- the Mayo Clinic wrote, “We applaud the direction” of the Obama administration's IMAC proposal, adding, “This, and other, bold concepts have the potential to 'bend the cost curve' in U.S. health spending without compromising health.”

In contrast with the Times article, Time magazine national political correspondent Karen Tumulty wrote in an update to a July 20 post on Time's Swampland blog: “So how is this criticism being received by the Obama White House? It is not being disputed there, in part because this argument is pretty much the same one that OMB Director Peter Orszag is making about the House bill.”

The Mayo Clinic's July 16 statement, as posted on its Health Policy blog:

Although there are some positive provisions in the current House Tri-Committee bill -- including insurance for all and payment reform demonstration projects -- the proposed legislation misses the opportunity to help create higher-quality, more affordable health care for patients. In fact, it will do the opposite.

In general, the proposals under discussion are not patient focused or results oriented. Lawmakers have failed to use a fundamental lever -- a change in Medicare payment policy -- to help drive necessary improvements in American health care. Unless legislators create payment systems that pay for good patient results at reasonable costs, the promise of transformation in American health care will wither. The real losers will be the citizens of the United States.

From Obama's June 2 letter to Kennedy and Baucus:

Health care reform must not add to our deficits over the next 10 years -- it must be at least deficit neutral and put America on a path to reducing its deficit over time. To fulfill this promise, I have set aside $635 billion in a health reserve fund as a down payment on reform. This reserve fund includes a number of proposals to cut spending by $309 billion over 10 years --reducing overpayments to Medicare Advantage private insurers; strengthening Medicare and Medicaid payment accuracy by cutting waste, fraud and abuse; improving care for Medicare patients after hospitalizations; and encouraging physicians to form “accountable care organizations” to improve the quality of care for Medicare patients. The reserve fund also includes a proposal to limit the tax rate at which high-income taxpayers can take itemized deductions to 28 percent, which, together with other steps to close loopholes, would raise $326 billion over 10 years.

I am committed to working with the Congress to fully offset the cost of health care reform by reducing Medicare and Medicaid spending by another $200 to $300 billion over the next 10 years, and by enacting appropriate proposals to generate additional revenues. These savings will come not only by adopting new technologies and addressing the vastly different costs of care, but from going after the key drivers of skyrocketing health care costs, including unmanaged chronic diseases, duplicated tests, and unnecessary hospital readmissions.

To identify and achieve additional savings, I am also open to your ideas about giving special consideration to the recommendations of the Medicare Payment Advisory Commission (MedPAC), a commission created by a Republican Congress. Under this approach, MedPAC's recommendations on cost reductions would be adopted unless opposed by a joint resolution of the Congress. This is similar to a process that has been used effectively by a commission charged with closing military bases, and could be a valuable tool to help achieve health care reform in a fiscally responsible way.

These are some of the issues I look forward to discussing with you in greater detail in the weeks and months ahead. But this year, we must do more than discuss. We must act. The American people and America's future demand it.

From Orszag's July 17 statement:

There are a number of steps that can be taken to bend the curve -- health IT, investing in research into what works and what doesn't, and changing incentives so that doctors and hospitals give you better care not just more care. But one of the most potent reforms is a change in the process of health care policymaking: empowering an independent, non-partisan body of doctors and other health experts to make recommendation about Medicare payment rates and other reforms.

Today, the Administration sent a letter to congressional leaders outlining our support for this approach, with a proposal for an Independent Medicare Advisory Commission (as well as Senator Rockefeller's similar proposal to accomplish this through the existing MedPAC) to detail how one might accomplish this goal.

The Independent Medicare Advisory Council (IMAC) would be an independent, non-partisan body of doctors and other health experts, appointed by the President, confirmed by the Senate, and serving for five-year terms. The IMAC would issue recommendations as long as their implementation would not result in any increase in the aggregate level of net expenditures under the Medicare program; and either would improve the quality of medical care received by the program's beneficiaries or improve Medicare's efficiency.

From Orszag's July 17 letter to Pelosi:

We agree that it is critical that health care reform is not only deficit neutral over the next decade, but that it does not add to our deficits thereafter. That is why the President, in his June 3, 2009, letter to Senators Kennedy and Baucus, expressed his openness to ideas about giving special consideration to the recommendations of the Medicare Payment Advisory Commission (MedPAC). One constructive approach to implementing this idea is embodied in legislation introduced by Senator Rockefeller that would make MedPAC an independent Executive Branch agency, empowering it to improve efficiency and performance throughout the Medicare system.

A similar approach to creating a more dynamic and efficient Medicare system is embodied in the attached draft legislation. This draft bill would establish an Independent Medicare Advisory Council (IMAC), which would have the authority to make recommendations to the President on annual Medicare payment rates as well as other reforms. Both the annual payment updates and the broader reforms would be prohibited from increasing the aggregate level of net Medicare expenditures.

This proposed legislation would require the President to approve or disapprove each set of the IMAC's recommendations as a package. If the President accepts the IMAC's recommendations, Congress would then have 30 days to intervene with a joint resolution before the Secretary of Health and Human Services is authorized to implement them. If either the President disapproves the recommendations of the IMAC or Congress passes such a joint resolution, the recommendations would be null and void, and current law would remain in effect. The review process would permit intervention if the IMAC's reforms are not in keeping with the goals of Congress or the President, while retaining autonomy for implementing annual payment updates and other Medicare reforms for the IMAC.

Either the Rockefeller proposal or the attached legislation would represent a critical step forward in creating a health care system that rewards quality, restrains unnecessary costs, and provides better care to more Americans. I respectfully request that you and your Committees consider these proposals as you continue your important work of reforming health care and laying a new foundation for economic growth for our nation.

The Mayo Clinic's July 21 blog post:

Late yesterday, Mayo Clinic became aware of the concept of development of an Independent Medicare Advisory Council. We applaud the direction of this proposal. We view favorably the concept of an independent body that can move Medicare to a “value- based payment” model. An independent Medicare advisory commission focused on defining value, measuring it, and finding ways to pay for value could have significant, positive impact on health care for the long term. While we think the proposal's timeline of 2014 is too long to wait to see value-based reforms, we look forward to working with the administration on refining and strengthening their new proposal. This, and other, bold concepts have the potential to “bend the cost curve” in U.S. health spending without compromising health.

From the July 21 Washington Times article:

A world-renowned clinic that President Obama held up as an example of good medicine said Monday that the American people would be “losers” under the House's health care proposal, joining the growing chorus of critics the Obama administration is trying to fend off as the debate intensifies from Capitol Hill to Main Street.

Minnesota's not-for-profit Mayo Clinic, which Mr. Obama has repeatedly hailed as offering top quality care at affordable costs, blasted the House Democrats' version of the health care plan as lawmakers continue to grapple with several bills from each chamber and multiple committees.

The Mayo Clinic said there are some positive elements of the bill, but overall “the proposed legislation misses the opportunity to help create higher quality, more affordable health care for patients.”

“In fact, it will do the opposite,” clinic officials said, because the proposals aren't [R]patient-focused or results-oriented. “The real losers will be the citizens of the United States.”

[...]

White House aides did not have a response to the criticism from the Mayo Clinic, which Republicans exploited. Sen. John McCain, Arizona Republican, used his Twitter feed to spread the Mayo Clinic statement, adding: “They are right.”

From the Fox Nation: