Health Care Access is not the same as Coverage: Here’s Mayo’s Economic Reality

I have been going to the Mayo clinic for over 10 years and wanted to bring this personal view of healthcare to people’s attention. Money talks and Medicare no longer will.

Published March 15th, 2017

By John Freivalds

The Mayo Clinic is a mystical concept in many people’s minds.  I used to think that it was a place only Kings and Presidents of countries went for the best medical care.  But when my knees went bad I found out otherwise.  And my situation points out that access to Mayo or other top other clinics, like Cleveland, Mt. Sinai, Johns Hopkins or MD Anderson around the country does not mean than you can get treated there.

 I lived in Dubuque, Iowa for 33 months before moving back to the Twin Cities; Dubuque is a 6 hour drive from Minneapolis and a city of some 60,000 blue collar workers.  In Dubuque the medical selection is not great, as in many smaller cities around the country.  You may have one orthopedic surgeon who operates on shoulders, wrist, knees and ankles -- any part of your body that has bones.  He (or she) accepted Medicare and Medicaid and still does.

Through my late wife Margo, who had many hip surgeries at Mayo, I had an “in” and now have a Mayo Clinic number which is golden -- I guard that as closely as my social security number.  I got an appointment when both my knees were “disasters” in Donald Trump talk, and I got both replaced.  The orthopedist who replaced them was the head of Orthopedics at Mayo who has tons of patents and who the Star Tribune, according to a survey, found out is the best paid physician in the State.  Mayo is a place where they even have orthopedic surgeons whose specialties are as specific as "right knee or left knee."  I had Medicare and excellent supplemental private insurance which covered the cost -- about US $35,000 per knee.  My walkathon knees are a testament to the skill that is found at Mayo.

Due to my late wife’s complex hip issues and a variety of my knee and other problems, I have been to Mayo over 30 times (stay at the Microtel for $49 a night and not the Kahler) and friends often  call me to see if I can get them “in” or speed up the process for them to see a specialist. Mayo has no shortage of patients as they see 150,000 out of town people a year.

Now Mayo will triage those people from Dubuque who don’t have private insurance and first operate on those people who do.  The people in Dubuque without private insurance will then have to find the surgeon who is a jack of all body parts for their orthopedic surgery.

I don’t fault Mayo’s financial triage decision as it has 2,000 top notch doctors and surgeons on the staff, nurses who can make decisions and facilities that can’t be matched, the Gonda building in particular. The waiting areas have individual laptops where you can click on the internet until your name is called.  And they have a business model which allows you to come in for preliminary tests and x-rays at 9:00 AM and have the results on the surgeon's computer screen at noon. You can’t do a blame game on Mayo, it's an economic reality and in our system, “them that has gets” (the best medical care).  When Governor Dayton fainted and needed to have hip surgery where did he go-Mayo.

What is unfair is that without expensive private insurance (with deductibles as high as $10,000 a year) you are denied the best care.

Mayo also serves as the clinic for Saudi Arabian citizens as their government ships them off the Mayo for procedures which can’t be done at home.  Newspapers are available in Arabic in the international center and Rochester is one of the few American cities that welcomes Arabs as they pump up the economy.  You could say that now Mayo is more welcoming to Saudis who pay in cash as opposed to Medicare seniors from Dubuque who overwhelmingly if not ironically voted for Trump.