The principal reason the Cleveland Clinic (and the Mayo Clinic, which Obama has also praised) is able to deliver high-quality care more cheaply than other similarly prestigious hospitals is that its doctors are not independent contractors who get paid for performing individual procedures. As the clinic explained in a press release about the visit, "Cleveland Clinic's physicians are paid a salary only. There are no bonuses or other financial incentives for the number [of] procedures performed or the number of patients seen. Every physician has a one-year contract and renewal is based upon the results of an annual performance review." Obama didn't mention this in his official remarks either before or after the visit. Partly that was to avoid alienating the American Medical Association, which has endorsed the House version of health care reform. Mainly, though, it was because health care reform would do almost nothing to dismantle fee-for-service medicine.
link: Why Obama's trip to the Cleveland Clinic is misleading. - By Timothy Noah - Slate Magazine
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