Cleveland Clinic’s CEO on the Focus of Health Reform


President Obama has rightly and frequently cited the Cleveland Clinic as one of the health providers in this country that provides the kind of high-quality, cost-effective care that should be emulated nationwide.  Given that fact, it makes sense to take note of an interview the Clinic’s CEO, Toby Cosgrove, provided last week to Newsweek Magazine.

As Dr. Cosgrove points out, the debate over health reform during the August congressional recess has focused almost exclusively on the coverage issue.  In fact, there has even been a tactical decision by some policymakers to refer to “health insurance reform” instead of “health reform.”  This, unfortunately, takes attention away from the issues of quality, delivery reform and cost-effectiveness that will have the greatest impact on the future and sustainability of our healthcare system.

Dr. Cosgrove accurately states, “In the beginning, we were talking about access, cost and quality, and now it seems we are just talking about access and cost shifting, because there’s very little in the program that seems to be going to reduce the cost of health care in the United States.

“…if we just add people to the list of insured without addressing quality and cost, we may end up making the problem substantially worse.  And there’s little in the legislation that suggests an intention to attack the two areas that hold the most potential for reducing costs:  the delivery system and the disease burden in the United States.”

In the interview, Dr. Cosgrove also makes some important points about how U.S. hospitals cannot sustain a higher proportion of patients whose care is reimbursed at Medicare/Medicaid rates, a critical factor in the debate over a proposed government-run health plan.  His thoughts are well worth reading.