By Jeff Hansel, Post-Bulletin, Rochester MN

U.S. Sen. Amy Klobuchar stood before a receptive audience and rattled off the many things that are wrong with the health care system.

"Every year, Congress says a long-term solution is needed," she said. "But that never comes."

State and federal office-holders from Minnesota gathered at Klobuchar's request Monday at the University of Minnesota Rochester. They explored ways to fix Medicare, the government benefit that reimburses health providers for medical care offered to elderly Americans.

"I would say this will be the number one thing on the agenda of the new Congress and the new president," said Klobuchar, DFL-Minnesota.

If Medicare gave the kind of low-cost, high-quality, safe care that Mayo Clinic does in its Rochester practice, the country would save $50 billion every four years, she said. That number would increase to a $100 billion savings if the nation's health care system as a whole modeled itself after Mayo, which considers the best health outcomes for patients as the priority rather than increasing volume to bring in more Medicare money, according to CEO Dr. Denis Cortese,

Yet Mayo gets less Medicare money, for the same service, than health systems in other states. The goal, Klobuchar said, is to gather information now so she can take bipartisan action when there's a new president.

"I think the country understands now is the time to do this," said U.S. Rep. Tim Walz, DFL-Minnesota.

Former Republican U.S. Sen. Dave Durenberger said it's time to stop focusing on pricing and to focus instead on elimination of harmful medical waste.

States that get the lowest payments from Medicare for health care provided to the elderly are also the states that give the safest, highest quality care with the best outcomes, Cortese said.

"If you want better outcomes, better safety, better service, why don't you pay for it?" he asked.

A different approach

Cortese said he proposed that instead of recently reinstating Medicare payment cuts that had been scheduled, Congress should not have offered any more money. Instead, he said, Congress should have cut payments to medical systems with low-quality care and bad safety records.

"What you need to do is just don't cut the good ones. The message that sent would have begun to change the whole country overnight," Cortese said.

But he said Congress is stuck and needs something like a "federal health board" to accomplish health reform. An existing government agency or a new one could be used, he said.

"What Denis has said is very persuasive. Congress would love this. But basically I say to you it's a cop out," Durenberger said.

Instead of turning responsibility over to a new agency, Congress should return to the days of seeking common ground and finding solutions based on consensus, he said.

"We used to do that," he said.

Access restricted

Cortese said Mayo lost $600 million last year in care for Medicare patients that wasn't fully reimbursed. In Arizona, Mayo is no longer taking new Medicare patients and might stop taking new Medicare Advantage patients.

"We'll probably need to do something similar in Florida," he said. Access to health care will only get worse unless Congress acts, he said.

"The time to act is next year when we're going to have a new president," Klobuchar said.