Buried beneath the headlines about the failures associated with HealthCare.gov’s rollout is an even more inconvenient fact for Obamacare and its advocates: The law, if successful, would have a limited impact in addressing key problems within American health care. Mayo Clinic CEO John Roseworthy addresses this topic during a Fortune magazine interview with Geoff Colvin.

Q: How will the advent of the Affordable Care Act affect Mayo Clinic?

A: In a number of ways. Most particularly, we expect that it will reduce how well we’re reimbursed for the work we do. But the Affordable Care Act, on which we’re all putting so much attention at the moment, is in the context of an anemic recovery in our economy and a marked shift in the demographics of the American people, with the aging population, plus the prevalence of chronic disease, the rising costs of health care, the rising costs of research. All of that contributes to an unsustainable health care system. It’s too costly — we’re spending too much on health care. This is an effort [by elected officials] to try to get their arms around the cost, and we will need to deal with that.

America’s health care spending is still growing faster than GDP. That trend cannot go on forever. What will cause it to stop, since something must?

One approach is to pay less for the unit of work. I’m not sure that’s anywhere near the whole answer. We’re spending too much on health care because it’s fragmented and the quality is so uneven in our country. There are pockets of outstanding health care, and there are other places not at that level. There are highly efficient, high-quality health care groups, and others that are expensive and don’t deliver that quality.

At Mayo Clinic we’re focusing on the fragmented health care part and on delivering higher quality. We believe that if we can get health care to be more integrated and that if we drive quality through the system, it will actually save money and provide what patients need, which is trusted, affordable, safe health care. Mayo’s focused like a laser on those two aspects: integration of care and providing safer, more efficient care.

Mayo consistently achieves better-than-average outcomes at lower-than-average cost. Is what you have just described a part of the secret?

It is part of the secret of how Mayo has been successful. But that piece is missing in the Affordable Care Act. The Affordable Care Act is really insurance reform. It gets people covered with insurance, but nothing in the Affordable Care Act really addresses the varying complexity of illness and certainly not the varying quality of the work that’s done. That’s why we’re working with the Senate and House to reform the SGR [sustainable growth rate — the method used by Medicare to control spending] and put these elements in it. We think it’s the right thing to do, and we think it’ll help the health system move to more team-based care, sharing of information, and trying for better outcomes. [Emphasis added.]