Affordable Care Act/State of the Union

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President Obama’s State of the Union speech is expected to touch on his Affordable Care Act. Mayo Clinic CEO Dr. John Noseworthy will be a guest at the speech. Local Mayo Clinic CEO Dr. Wyatt Decker will appear on Arizona Horizon to talk about Dr. Noseworthy’s impressions of what was discussed by President Obama.

Dr. Wyatt Decker: Ted, you mentioned one thing, it's primarily insurance reform, and focuses on primary care and access. That's been a good step forward. What remains to be seen is what is the impact of the high deductible and high out-of-pocket plans, so that individual from Gilbert, I can't speak to her case individually, but she may have substantial, thousands of dollars out-of-pocket, and that could still be a barrier to getting care, so there is more to this than meets the eye, and it hasn't unfolded yet.

Ted Simons: So as far as the impact on financial security, talk about that, and critics say that it's, it's raising costs out there. Supporters say no, it's not. What's the answer?

Dr. Wyatt Decker: It depends on the lens you look at it through. That's why we hear so many versions of, of the affordable care act, is it good or bad. Over 900 pages of single spaced law, and so, characterize it as all good or all bad, is unrealistic. There are parts of it that are helpful and parts that probably need more debate and refinement. For example, for medical centers, we're anticipating a substantial cut even through those getting insured, so they are getting insured but the reimbursement rates are below cost of providing that care. So, that, of course, presents an ongoing challenge to medical centers. It is estimated the cost of implementing the affordable care act over step years has been as high as $1 trillion. Of that, 80% or up to 800 billion will be absorbed by hospitals and doctors. So, for the medical community, it means we have got to, to deliver great care at an affordable cost. And at the Mayo Clinic and other organizations, we're working hard to bring down the cost of care because that's a critical component.

Ted Simons: If the ACA had not passed, if it were not existence right now, how does that change the formula?

Dr. Wyatt Decker: We have a fragmented health care system in the United States. That needs to be addressed. And so, one of the points that we're making at the Mayo Clinic, and one of our reactions to the speeches, we really only just have begun in our country to address the fragmented health care system of the United States. And we have an integrated system that communications around patients for complex care, not only can deliver care that's affordable but also excellent quality care, so that's what, what our message is. One comment, the Medicare system was unaddressed by the affordable care act, and is a huge portion of Federal spending and our budget. It rewards volume, but not quality. We would like to see the Government address Medicare and start paying for high quality care that lowers health care costs. That's what should be rewarded.

Ted Simons: When the President said it accomplished all the successes as he listed out, while adding years to Medicare's finances, while keeping Medicare premiums flat, is that accurate?

Dr. Wyatt Decker: It's debatable. What many economists have pointed out, that, that the economy has been in a slump since 2008, and that has driven down the utilization of health care services. And has increased the use of high deductible plants. So, many economists think that the major factor in leveling the cost of Medicare is not the affordable care act, but is, actually, a function of the economy. That's important because as the economy fires back up again, we might see Medicare costs climb. The other piece that's critical to consider is that every day in this country we have 10,000 citizens reaching the age of 65, and going on the rosters of med character so we have to address this and find a sustainable, affordable solution to our Medicare population.

Ted Simons: The President said that the law is helping millions while critics say it's helping those millions but it's limiting the personal choice of doctors, limiting personal choice of treatment.

Dr. Wyatt Decker: Yeah.

Ted Simons: And who is right?

Dr. Wyatt Decker: A little bit of everybody, and there is a bit of exaggeration with everybody. So, so, as you are seeing the theme, somewhere in the middle there is probably truth on both sides. So, for example, one of the challenges with the affordable care act is the insurance products out there are often creating what are called narrow networks. That means that I would be told, which doctors I can and can't see, it must be in a narrow network, and if I develop a complex condition, cancer, leukemia, for example, what if I want to a center of excellence, is that in my network? It might not be, so, we are advising at Mayo clinic, citizens to read the fine print carefully of any plan before they purchase it and make sure it includes the health care organizations that you want to be able to get to if you need them.

Ted Simons: A line of reasoning among supporters that say if your plan doesn't qualify, doesn't meet the standards of the affordable care act, your plan stinks. Is that an accurate assessment?

Dr. Wyatt Decker: Well, there are plans that did not qualify that were considered bare bones plants. They also had lower premiums. So, some would say those plans didn't do a good job covering their, their customers, if you will. Others would argue that Americans have been denied a choice to have a bare bones plan that did not cover conditions that they don't need. So, there is debate on that, and again, you can take either side. But, I think that at the end of the day, we would like to see Americans who, who have access to an integrated health care system that's affordable and comprehensive in nature.

Ted Simons: And you mentioned integrated health system a number of times, that's a big deal for what's going on in the valley right now, isn't it?

Dr. Wyatt Decker: That's right. So, here in the valley, we have a lot of great collaborations going on that we think are going to, to help solve some of these health care challenges. And I'll share a couple of them with you. One is, at Mayo clinic we're working closely with ASU and the school of health solutions to, to develop the field of health, sciences, engineering to the point where we can design health care systems that create value, meaning high quality at an affordable cost. Quick example, we have deployed a telestroke network at Mayo Clinic to 0ver 12 hospitals, and in a matter of 90seconds, a rural Kingman Arizona rancher can be talking to a Mayo Clinic stroke expert as well as his doctor and nurse, and that is saving lives.

Ted Simons: All right, very good, doctor, thank you for your impressions on the speech. It's always a bit in the middle, isn't it? A gray area. It's good to have you here and thanks.

Dr. Wyatt Decker: Great to be here, and thank you very much.

Dr. Wyatt Decker:CEO, Mayo Clinic;

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