captainsblog | Here's your exclusive Western New York weather forecast: Great! If you're a duck.

Those of you in the southeast who want wet, or in the southwest who want cool? This is where it's been.

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Highlights of the day, other than frizzy hair from the humidity, include getting new replacement parts for WALL-E, and a new aerator for our kitchen sink, at Ed Young's Hardware. Jesus on a pogo stick, we should forget both private insurers and the public option and just put Ed Youngs in charge of health care. It's quick, personal, expert, friendly and amazingly cheap.

Eleanor already wrote about our follies with Wot We Got, which basically amounts to the world's largest Chinese fire drill when it comes to covering three relatively healthy people. Even getting a quick, personal, expert and friendly (but not cheap) CSR on the phone from Blue Cross, who even gave us her full name and direct extension, wasn't enough to actually fix the problem without us starting a circle jerk of checks between them, us and Eleanor's former employer.

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Interesting new form of censorship I ran into today. An old friend of mine on That Other Thing posted a link to an article saying, in essence, that the Mayo Clinic has come out against the currently proposed version of health care reform. That struck me odd, since the Mayo Clinic approach to health care was just cited in an extensive New Yorker piece last month as evidence of an alternative to the profit-driven broken system we now have.

So I posted a link to it. (I tried to post a summary of it as well, but darn there's that 419-character limit again.) Moments later, I got this message:

Hi Ray -- The link you attached to your comment is coming up as a dangerous link on my system, so I took it down. I'm not doing that as a way to silence your view as I like to engage discussion, but even though I'm sure the link was fine, our server didn't like it, and that's a sign that other servers might feel the same way.

I am not for a second suggesting that my friend was the source of the censorship, but I do think something's afoot with an article from the New Yorker- about as staid a periodical as you can find- tripping peoples' malware meters. I wonder if it's a variation on Googlebombing, where users who just don't like something's content report it as a bad website to keep people from reading it. I've run into this locally in the past, with one of the local political sites coming up with a "Get Me Out of Here!" page for my "protection." The only malware in that scenario had to do, I suspect, with the fact that the site was competing with the most notorious and vindictive pay-for-play political website in this entire region (Jenn, and especially her boss, know exactly who I mean).

Anyway, since I can ramble on all I want about it here, this is what I wanted the readers of the Mayo Clinic "press release" to look at. The full piece is here, and the part about Mayo's approach to health care was this:

The core tenet of the Mayo Clinic is “The needs of the patient come first”—not the convenience of the doctors, not their revenues. The doctors and nurses, and even the janitors, sat in meetings almost weekly, working on ideas to make the service and the care better, not to get more money out of patients. I asked Cortese how the Mayo Clinic made this possible.

“It’s not easy,” he said. But decades ago Mayo recognized that the first thing it needed to do was eliminate the financial barriers. It pooled all the money the doctors and the hospital system received and began paying everyone a salary, so that the doctors’ goal in patient care couldn’t be increasing their income. Mayo promoted leaders who focussed first on what was best for patients, and then on how to make this financially possible.

No one there actually intends to do fewer expensive scans and procedures than is done elsewhere in the country. The aim is to raise quality and to help doctors and other staff members work as a team. But, almost by happenstance, the result has been lower costs.

“When doctors put their heads together in a room, when they share expertise, you get more thinking and less testing,” Cortese told me.

Skeptics saw the Mayo model as a local phenomenon that wouldn’t carry beyond the hay fields of northern Minnesota. But in 1986 the Mayo Clinic opened a campus in Florida, one of our most expensive states for health care, and, in 1987, another one in Arizona. It was difficult to recruit staff members who would accept a salary and the Mayo’s collaborative way of practicing. Leaders were working against the dominant medical culture and incentives. The expansion sites took at least a decade to get properly established. But eventually they achieved the same high-quality, low-cost results as Rochester. Indeed, Cortese says that the Florida site has become, in some respects, the most efficient one in the system.

You want to drop the public option and just convert all our hospitals, medical practices and the rest of Big Medical to the Mayo model? Fine with me. But I think we'd still do better just letting Ed Youngs handle it.