Minnesota’s world-famous Mayo Clinic is receiving a considerable amount of flack over statements by its CEO John Noseworthy that the hospital would have to prioritize private insurance patients over those receiving Medicare or Medicaid. This statement was made at the end of last year from a video message Noseworthy had recorded for a staff announcement. It was published this week by the Star Tribune.
“We’re asking ... if the patient has commercial insurance, or they’re Medicaid or Medicare patients and they’re equal, that we prioritize the commercial insured patients enough so ... we can be financially strong at the end of the year to continue to advance, advance our mission,” Noseworthy said in a videotaped speech to staff late last year. The Star Tribune obtained a transcript of the speech, and Mayo has confirmed its authenticity.
Mayo is hardly alone in trying to build its privately insured clientele. Hennepin County Medical Center, for example, is building a new ambulatory center and North Loop clinic in part to attract privately insured patients.
The initial reactions from most people not earning tons of money was less than positive. Minnesota’s Commissioner of Department of Human Services Emily Piper was taken aback.
"Fundamentally, it's our expectation at DHS that Mayo Clinic will serve our enrollees in public programs on an equal standing with any other Minnesotan that walks in their door," she said Wednesday afternoon. "We have a lot of questions for Mayo Clinic about how and if and through what process this directive from Dr. Noseworthy is being implemented across their health system."
Others were less surprised about the statement than they were that someone of Noseworthy’s import would be willing to say it out loud.
“The most interesting thing isn’t that it’s happening, it’s that a high level executive actually said it out loud,” said Mat Keller, who monitors health care policy and hospital finances for the Minnesota Nurses Association.
Noseworthy and others’ arguments are that there has been an increase in the amount of Medicare and Medicaid patients they see and that they need to get more money in order to pay for all of the great things that they do. And the Mayo Clinic seems fearful that they won’t be able to keep the lights on. Here’s an example of why:
Mayo Clinic reported a strong financial position in 2016, with contributions of $466 million to its pension plan for staff and more than $600 million in capital projects.
“The outstanding work of Mayo Clinic employees is the engine that drives our mission to our patients, advances important research and educational initiatives, and positions our institution as a key voice for the future of health care,” says John Noseworthy, M.D., president and CEO, Mayo Clinic. “Our strong financial performance enables Mayo to hire and retain the best talent, and invest in technology, facilities and our staff as we strive to deliver the best outcomes and service to our patients.”
So they made a profit but they need more profit? Gotcha. The work done at facilities like the Mayo Clinic is God’s work and creating a society where that work is prioritized by a financial caste system of private and government insurance sounds like something that only a monster would conceive of. As long as Republicans are steering the ship, this kind of commodification of our public health system will continue to operate like a two-tier caste system.