Mayo Clinic Health Policy Principles

1991 Statement

The Mayo Clinic recognizes that national health policy is an issue of major importance, and that a number of significant proposals have been made to reform the national health care system. While Mayo is not attempting to develop a specific proposal, we believe that certain principles should guide policy makers in developing national health policy.

1. Guaranteed basic level of health insurance coverage - some basic level of health insurance coverage should be available to all, regardless of ability to pay, in order to ensure the societal good.

   The definition of the basic level of coverage should be made at the Federal level, as well as the decision on how to guarantee individual coverage (employers, individuals, government).

2. Individual freedom to purchase additional services - in order to promote freedom of choice, those who wish to purchase additional services should be free to do so, and should be free to purchase services outside of their coverage plan and without regard to plan reimbursement limits.

3. Freedom of choice - the patient should be free to choose his or her own health care providers, or to voluntarily choose an insurance plan that limits provider choice. It is appropriate for insurers to use financial incentives to encourage the use of high-quality, cost-effective providers, as long as patients retain the right to choose other providers if they are willing to personally accept responsibility for additional costs incurred. Consumer choice is necessary to ensure quality care, competition and innovation.

4. Private providers - a system of multiple private providers of care should be maintained in order to guarantee freedom of choice and innovation.

5. Multiple payers - a system of multiple payers should be maintained to ensure patient freedom of choice, competition and innovation.

6. Reimbursement - reimbursement should be adequate to ensure excellence and innovation, but should also provide incentives for efficiency and quality.

7. Patient responsibility - in order to promote a more productive society, the system must encourage patients to take responsibility for their own health, through healthy lifestyles and cooperation in preventing illness and injury. Individuals should also be involved in decisions on their treatment, including decisions on when the use of life-sustaining technology to prolong their own life is desired.

8. Education and research - the system must ensure that adequate and identified funding for education and research is provided. The education system must ensure an adequate supply of medical personnel while maintaining high education standards. Medicine should increase research into the effectiveness of diagnostic and treatment modalities, and disseminate the results of such research to practicing physicians. Education and research are necessary to provide for continuously improving future health care.

9. Cost control - high-quality care must be provided in a cost-efficient manner. A cost control program should include:

   • patient financial responsibility through copayments and deductibles, as a method of controlling utilization and making better choices as to when to use the health care system.
   • limiting the tax-exempt status of health insurance to the basic benefit package as an incentive to include deductibles and coinsurance,
   • research to develop practice guidelines with the goal of eliminating unnecessary services as well as encouraging necessary services,
   • support for the testing of new technologies in order to ensure that they improve outcomes in a cost effective manner,
   • malpractice reforms to reduce defensive medicine and wasted resources,
   • elimination of State health insurance mandates that go beyond the basic level established pursuant to point 1.
   • uniform claim forms for all third-party payers, in order to reduce administrative overhead costs.

10. Quality assurance and ethical standards - patients should receive high-quality care. In order to ensure the integrity of the health care system, physicians and other health care providers should practice in accordance with high quality and ethical standards enforced through a system of responsible peer review.

11. Volunteerism and philanthropy - in order to address unmet health care needs, the system should encourage volunteerism and philanthropy.