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Dr. Donald Berwick: The Leader We Need for Health Medicare and Medicaid
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John August, executive director of the Coalition of Kaiser Permanente Unions, which represents 90,000 health care workers, describes why Dr. Donald Berwick is a good choice to head the Centers for Medicare and Medicaid Services.
President Obama appointed Dr. Donald Berwick to head the Centers for Medicare and Medicaid Services (CMS) this week.
The decision was lauded by the New York Times. “Dr. Berwick’s major credential for the job is that he leads the Institute for Healthcare Improvement (IHI), a consulting group that promotes measures to improve the quality and safety of health care while reducing its costs. He has been enormously successful at getting health care professionals and institutions to work together to reform their practices—exactly what the agency needs.” (New York Times editorial, July 8, 2010.)
I would suggest that inherent in Dr. Berwick’s credentials for the job of getting health care professionals and institutions to work together for reform is leadership.
Leadership is what is needed to take on the health care crisis in the nation. So let’s look at the substance and content of Dr. Berwick’s leadership. Let’s do it in the context of some facts:
- If we continue to spend at the current rate, by the year 2040, health care spending will rise to 30 percent of the Gross Domestic Product (GDP) compared with 17 percent today. That’s at least twice what any other nation in the world spends!
- Since 45 percent of health care spending is funded by the government, at the current rate of growth, it will require 70 percent of income taxes to pay for these expenditures by mid-century.
- Today, health care spending takes nearly 25 percent of a family’s income. By 2020, these costs could double at current annual increase in costs.
The Challenges
What do these facts mean?
They mean that after many decades of inaction, the nation has placed its population at great risk. This kind of spending on health care crowds out wage increases, savings, investment and economic growth and the expansion needed to rebuild the nation’s social and manufacturing infrastructure.
They also mean that the health of the population suffers. Although the United States spends more of its resources on health care than any nation in the world, it ranks at the bottom of the industrialized world on health outcomes.
And let’s remember that these worst outcomes in the industrialized world are even worse for our sisters and brothers who are African American, Latino and Native American.
Don Berwick is a pediatrician and a Harvard professor. His manner is mild and kind. He is a great listener. He is the classic “healer.” He also is a powerful voice:
Listen to what Dr. Berwick says: “We must have courage to achieve success.
The courage to aim high.
The courage to search outside.
The courage to compare.
The courage to trust the workforce.
The courage to trust the patients.
The courage to test change and make mid-course correction.
The courage to ask ‘What am I a part of ?’”
For Dr. Berwick and IHI, success is defined as the Triple Aim:
- Improve the health of the population.
- Enhance the patient’s experience of care.
- Reduce or control the per capita cost of care.
The Triple Aim is much like Kaiser Permanente’s Value Compass. We look at the whole, we look at the system. We recognize that quality, service, affordability, making Kaiser Permanente the best place to work and keeping patient needs at the center of all we do are one cohesive aim—a balanced approach that recognizes that all components of the system are at work at all times, and we must recognize the interactions if we really want to achieve success.
Dr. Berwick will now head up CMS, the federal agency that oversees the expenditure of some $850 billion annually, or about 37 percent of all health care spending in the United States. It is his leadership around courage, the Triple Aim, and placing the economics and science of health care reform into a moral duty that will show the nation that success is finally possible.
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The “business partner” AFL-CIO President Trumka ignored the unanimous vote of delegates to the Pittsburgh convention in support of “single-payer” health care. By eliminating the profiteering of insuance companies the “Medicare for All” proposal would could medical costs by at least one-half with further reductions possible by ending the privatization of health care. This is what most advanced countries have done to make health care affordable.
The major aim of Dr. Berwick’s “Reduce or control the per capita cost of care.” means the major rationing of health care for working people. No mention anywhere is there to be any attempt to “reduce or control” the obscene profits of the health care industry. Such a notion is completely alien to Obama, the Democrats or Mr. Trumka.
And the AFL-CIO is going to be donating millions of dollars more to elect more Democrats in the November election? The necessirty to break with the “lesser evil” corporatist Obama and the Democrats is evident to millions of impoverished working people but never to the “leadership” of organized labor.
Where is the “courage” of Mr. Trumka and the “leadership” of organized labor to break with the Democratic Party? Where is the courage to call for the formation of a new political party the works in the economic interest of working people and opposes the corporate profiteering to further loot the people.
For a further understanding of what the appointment Dr. Donald Berwick is going to mean please check out this article below, with links at the bottom of the article for additional information.
Bypassing congressional confirmation process
Obama makes recess appointment of new chief of Medicare and Medicaid
By Kate Randall
14 July 2010
President Obama utilized the Fourth of July congressional recess to appoint Dr. Donald Berwick as the head of the Centers for Medicare and Medicaid Services (MMS), bypassing the Senate confirmation process and provoking sharp criticism from the congressional Republican right and right-wing media outlets.
Nominated in April, Berwick fills a position that has been vacant since 2006. The administration sees his role as key in implementing the cost-cutting features of the health care reform Obama signed into law in March.
As chief of MMS, Berwick will preside over the agency that finances the health care services of 100 million Americans. He will be tasked with implementing some $500 billion in cuts to the Medicare program for the elderly and disabled over a ten-year period. The administration has portrayed Berwick as a champion of “patient-centered care” and an advocate of a “common-sense approach” to health care.
In fact, Berwick is a proponent of the reactionary research and findings of the Dartmouth Atlas of Health Care study, which contends that many of the procedures and treatments provided by US hospitals are unnecessary, and that major cuts to health care services can be carried out without lowering health care standards. (See article link “Obama nominates cost-cutting advocate as Medicare and Medicaid chief”).
http://www.wsws.org/articles/2010/jul2010/berw-j14.shtml
Mr. Berwick is the champion of “health care rationing”. Look at some terms loosely used. The term “500 billion in cuts to the Medicare program”.
This agency will play God and see if your life is worth living. If the government decided that it is not worth keeping you alive, they will refuse to pay for your health care.
The next time a senior needs any kind of health care, and the government comes back and says that your life is not worth living, and it would be a waste of money to take care of you. Then you will know that the government has just issued decisions based on bureacratic arrogance, and has the right to place a value on your life, and apply the butcher’s to you if it is isn’t worth it to keep you alive.
“Cost cutting” – this means throwing the elderly under the bus, and letting them die. Wake up America, this is a didaster.