Maggie Mahar waxes eloquent on the Mayo Clinic, and contrasts their care and outcomes compared to other health systems in the country.

While true that they provide higher quality care at lower costs, this is partly due to scale and the fact that the Mayo monopolizes health care in the Rochester, MN area. It’s a similar situation to Kaiser Permanente in California.

One cannot extrapolate the Mayo system nationwide, as the health system is fragmented by numerous hospital and small physician groups. Uniting them would require a full bore single-payer system paying doctors a strict salary, which is an unlikely possibility in the current political climate.

As an aside, I also wonder about the concept of strictly salarying physicians without any sort of incentives. Do senior, more experienced physicians resent getting paid the same as new graduates? What about doctors who provide the best outcomes being equally rewarded with those who perform the worst?

I’m not privy to the Mayo salary structure, but I can anticipate significant pushback if every doctor was paid the same.