Let me describe to you what’s happening, part of the reason that Green Bay is doing a better job than some other parts of the country. There are places where doctors typically work together as teams. And they start off asking themselves, “How can we provide the best possible care for this patient?” And because they’re coordinating, they don’t order a bunch of duplicative tests. And the primary care physician who initially sees the patient is in contact with all the specialists so that in one meeting they can consult with each other and make a series of decisions. And then they don’t over-prescribe, and they make decisions about how quickly you can get somebody out of a hospital, because oftentimes being in a hospital actually increases the incidence of infection, for example. So there’s a whole series of decisions that can be made that improve quality, increase coordination, but actually lower costs.
Now, the problem is more and more what our health care system is doing is it’s incentivizing each doctor individually to say, “How many tests can I perform? Because the more tests I perform, the more I get paid.” And it may not even be a conscious decision on the part of the doctor; it’s just that the medical system starts getting in bad habits. And it’s driven from a business mentality instead of a mentality of, how do we make patients better? (Applause.)
And so what you’ve got is a situation where, for example, the Mayo Clinic in Rochester, Minnesota, is famous for some of the best quality and some of the lowest cost. People are healthier coming out of there, they do great. And then you’ve got places — there’s a town in McAllen, Texas, where costs are actually a third higher than they are at Mayo, but the outcomes are worse.
So the key for us is to figure out, how do we take all the good ideas in the Mayo Clinic and spread them all across the country so that that becomes the dominant culture for providing health care? That’s going to take some time. It involves changing how we reimburse doctors. It involves doctors forming teams and working in a more cooperative way. And that’s kind of a slow, laborious process.
So here’s the bottom line: If we pass health care reform this year, my expectation would be that immediately, families are going to see some relief on some issues, but we will not have the whole system perfectly set up probably until, say, four or five years from now. And I think that’s a realistic time frame.
But if we wait — if we said, well, you know, since we’re not going to get it right, right away, let’s put this off until two or four or five years from now — it’s never going to happen. That’s what’s been going on for the last 50 years now — people have said, we can’t do it right now. And as a consequence, it never gets done. Now is the time to do it, all right? (Applause.)