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A leading health care provider praised by President Obama has stopped accepting elderly and disabled patients with government health insurance, saying the government isn’t giving it enough money to cover the cost of providing care to them.

Mayo Clinic officials told Bloomberg News it lost $840 million treating Medicare patients in 2008 and beginning Jan. 1 Medicare patients must pay an annual fee and hefty per-visit charges in order to get treatment at Mayo Clinic’s Arrowhead Family Medicine practice in Glendale.

This may give some easy ammunition to critics of the health care reform bill, which also calls for $500 billion in cuts to Medicare, as Mr. Obama has listed the Mayo clinic as an example of where lawmakers could get ideas about how to lower the costs of health care.

In a June 2 letter to Democratic Sens. Edward M. Kennedy of Massachusetts and Max Baucus of Montana, who were key negotiators in the drafting of health care legislation, Mr. Obama applauded the Mayo Clinic and the Cleveland Clinic. At that time, Mr. Obama was pushing an August deadline for passing health care reform and asking Congress to find ways to cut health care costs.

“I want to stress that reform cannot mean focusing on expanded coverage alone,” Mr. Obama wrote. “Indeed, without a serious, sustained effort to reduce the growth rate of health care costs, affordable health care coverage will remain out of reach. So we must attack the root causes of the inflation in health care. That means promoting the best practices, not simply the most expensive. We should ask why places like the Mayo Clinic in Minnesota, the Cleveland Clinic in Ohio, and other institutions can offer the highest quality care at costs well below the national norm. We need to learn from their successes and replicate those best practices across our country.”

Three months later, the Mayo Clinic announced it would no longer accept Medicare patients at one of its Arizona branches as a part of a two-year pilot program aimed at increasing efficiency.

The Mayo Clinic sent a letter in October to the 3,000-plus Arrowhead Medicare patients informing them they could continue to get care at the facility, but would need to pay a $250 yearly administrative fee, as well as office visit fees, which could range between $175 and $400 per visit.

Terror versus crime

Differences over whether to treat the Christmas Day “panty bomber” as a terrorist or a criminal continues to roil, becoming the latest iteration of the ongoing debate between Republicans and Democrats over whether to let civilian authorities or the military handle threats to the nation’s security.

President Obama’s preference, as shown by his advocacy for transferring Guantanamo Bay detainees to U.S. soil to be tried in federal court rather than by military tribunals, has been for the criminal justice system. The Obama administration has called Umar Farouk Abdulmutallab’s failed plan to blow up a flight on Dec. 25 “an attempted act of terrorism” but decided to let the Department of Justice handle the case.

John Brennan, deputy national security adviser for counterterrorism and homeland security, said on “Fox News Sunday” that the bombing suspect would not be treated as an enemy combatant because “he was arrested on U.S. soil.”

“The president has that responsibility, and the Department of Justice makes these determinations about what’s the best tool to use,” he added. “And in this instance, we felt as though it was the best way to address Mr. Abdulmutallab’s case.”

Sen. Jim DeMint, South Carolina Republican, says this was a mistake.

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