Berwick, after the fact
The tragedy of Dr. Don Berwick’s short tenure as head of the Centers for Medicare and Medicaid Services has been well-documented, including right here on this blog. Berwick got in by a controversial recess appointment because President Obama didn’t have the political courage to fight for his nominee and allow Berwick to face the Democratic-controlled Senate. Berwick, of course, quit late last year when it became clear Obama would not renominate Berwick for the job he is uniquely qualified for.
There have been a number of postmortems in the press, where Berwick discussed his experience running CMS, including the challenges of implementing both the HITECH Act and the Patient Protection and Affordable Care Act and his. continuing efforts to improve the quality of care in this country. But I haven’t seen one quite as good as what Dan Rather just produced.
The former CBS News anchor has been toiling in relative obscurity at HDNet, a hard-to-find cable network run by billionaire Mark Cuban. Fortunately, Rather took to the far more popular Huffington Post this week to share his thoughts on a recent interview he conducted with Berwick.
“Dr. Don Berwick, a pediatrician by training, came to Washington with a sterling reputation among people who actually know something about health care. He had helped pioneer the Institute for Healthcare Improvement, which may sound like another pointy-headed D.C. think tank, but really is a Cambridge, Massachusetts-based organization lauded the world over for helping make health care systems better. For example, they have worked with hospitals on common sense techniques to reduce hospital infections. These are serious people who are welcomed in hospitals and clinics across the country and around the world,” Rather wrote on HuffPo.
That’s right, Rather understood Berwick’s background, unlike, say Dr. Scott Barbour of a crackpot group called Docs4PatientCare. “Utilizing quotes from Dr. Berwick, Dr. Barbour exposed that, ‘He is not interested in better health care. He is only concerned about implementing his socialist agenda,’” read a pitch I received from that organization last year.
I’ve been over this before. Berwick has probably done more to improve the quality of care and save lives than anybody else on the planet today. Some of the people who publicly opposed his nomination privately knew this, as Rather’s interview with Berwick demonstrates:
Yes, most of the opposition was an elaborate lie perpetrated for political gain. In today’s Washington, is anybody surprised? The losers once again are the American people and anybody who comes to this country for healthcare.
You’re wrong about Berwick. Docs4PatientCare is being excessively harsh, too, but their point about his support for a socialized healthcare system is correct. Berwick has made some valuable contributions to patient safety, but these have been outweighed by the destruction he has supported of private medicine.
There is a direct correlation between increasing government intervention in medicine and decreasing quality, and that correlation is nearly linear over 30 years, depending on what, exactly, one chooses to measure. Berwick has been one of the spearheads of that government intervention.
Medicare was the step that got the government involved in healthcare, but they could recognize it’s lack of sustainability as early as 10 years after its inception – in the mid ’70s – and their successive failures to deal with the problem, from DRGs and managed care and to RBRVS to HIPAA and HCQIA to the PPACA, have at every step incrementally reduced the capabilities and flexibility of providers, while adding complexity and cost to the so-called “system.”