The recess appointment of Dr Donald Berwick as head of CMS has incited a furor among politicians outraged at what they claim are his advocacy for rationing and fondness for Britain’s National Health Service.
To support their claims, these politicians are using Berwick’s own words, in a way eerily reminiscent of the recent Shirley Sherrod debacle.
It started with Glenn Beck, master of the one-word quote, and then slipped over into more mainstream politicians.
What’s really troubling about all this, in addition to the blatant political motivation, is Berwick is pretty closely aligned with core conservative values.
Don Berwick is now, and has always been, a patient-centric, consumer-oriented ‘radical’ who’s concept for the ideal system is one that is almost entirely patient-focused. Here’s Berwick’s ideal health plan from a piece by Ezra Klein:
“(1) Hospitals would have no restrictions on visiting — no restrictions of place or time or person, except restrictions chosen by and under the control of each individual patient.
(2) Patients would determine what food they eat and what clothes they wear in hospitals (to the extent that health status allows).
(3) Patients and family members would participate in rounds.
(4) Patients and families would participate in the design of health care processes and services.
(5) Medical records would belong to patients. Clinicians, rather than patients, would need to have permission to gain access to them.
(6) Shared decision-making technologies would be used universally.
(7) Operating room schedules would conform to ideal queuing theory designs aimed at minimizing waiting time, rather than to the convenience of clinicians.
(8) Patients physically capable of self-care would, in all situations, have the option to do it.
“I suggest that we should without equivocation make patient-centeredness a primary quality dimension all its own, even when it does not contribute to the technical safety and effectiveness of care,” he says.”
Pretty radical, indeed – returning power to the patient, from the practitioner.
If Berwick’s opponents just took a minute to read what the guy really stands for, they’d discover he’s pretty much aligned with many ‘conservative’ principles – self responsibility, ownership, consumer-centered policies and practices.
Unfortunately, they just don’t care about who Berwick really is – they’ve decided he’s the stick they’re going to use to beat this Administration, regardless of whether he’s good, bad, or indifferent.
As Maggie Mahar noted in HealthBeat, “Thomas Scully, who led the CMS under President George W. Bush [said of Berwick] : “He’s universally regarded and a thoughtful guy who is not partisan. I think it’s more about … the health care bill. You could nominate Gandhi to be head of CMS and that would be controversial right now.”
Here’s hoping the recent Shirley Sherrod disaster has stiffened the backbone of the Administration and caused the wingnut media to think a little more deeply before throwing bombs.
And yes, I believe in the Easter Bunny too.
Jul
27
I agree that the Republicans are on a witch hunt…..Berwick will do well if they ‘just let him do his job’. It really getting old the negativity coming out of the US Senate and Congress. it is time to move on.
Joe,
Except for PAYMENT. He doesn’t believe the Patient should be “empowered” with the responsibility for payment. That’s the killer. It’s all on everyone else’s dime.
Honestly, without advocating for personal responsibility, I could care less what else he stands for. To me, that’s an immediate and total disqualifier.
Concentrating other peoples’ money in the hands of a few breeds fraud, waste and abuse. It’s a law as fundamental as that of gravity. In anticipation your retort, allow me to state that yes, today with the current health care system we concentrate money in the hands of a few, but we have an ability to affect change in today’s system easier than we will with installed career bureaucrats “tomorrow.” Although that smacks of the “Oh yea, well you smell too!” school of logic.
Your employer have a crap health plan? Lobby to have it changed with your employer, go work somewhere else, opt out and buy your own, get a second job with better benefits, etc. Try to oust or change bureaucrats thinking!? Fat chance.
Thanks!
TTUEagle
Allen – on what do you base that assertion re Berwick’s stance on reimbursement?
Also, your statement re ‘installed bureaucrats’ is puzzling; are you referring to the bureaucrats at insurance companies, or regulators, or another group?
Why will the system in 2014 make it more difficult to ‘affect change’? If anything, it will be MUCH easier to compare plans, costs, and networks thru the exchanges. That’s why insurers don’t like them and don’t want to be in them.
Paduda
“Why will the system in 2014 make it more difficult to ‘affect change’? If anything, it will be MUCH easier to compare plans, costs, and networks thru the exchanges. That’s why insurers don’t like them and don’t want to be in them.”
Medicare Supp plans are easy to compare and has no change. Its a perfect example of what the exchanges in 2014 will be. Government set plans with no ability to change at all. Getting a choice of white or wheat bread in the government bread line isn’t the choice we are looking for.
Starting 2014 the government will tell you what you can buy, what you will pay, and dictate every other meaningful decision to do. The label on the policy is meaningless
Joe:
I base my belief on Berwick’s stance on payment for medical services on his admitted adoration of the UK’s NHS and his stated belief that it’s society’s obligation to provide healthcare for its citizens. His words to the NHS: “… You could have protected the wealthy and the well, instead of recognizing that sick people tend to be poorer and that poor people tend to be sicker, and that any health care funding plan that is just, equitable, civilized, and humane must – must – redistribute wealth from the richer among us to the poorer and less fortunate. … Britain, you chose well. … Is the NHS perfect? Far from it, far from it.” Repulsive. What moral right does anyone else have to the fruit of my labor? I know it can be made legal at the whim of the legeslator, but where’s the moral, unchanging foundation?
By “installed career bureaucrats,” I meant those in the Federal Government. Again, I freely admit that we have “installed career bureaucrats” in the healthcare companies today. At least they’re spread out amongst more than one, when (if) this all switches to the Federal government, it will be a monopoly.
When you say easier, what do you mean? We have many HR personnel on staff that evaluate health plan offerings. I’ve never heard anyone say it was too difficult. If someone finds it too difficult to read or understand, complain or perhaps they should pick up a book once in a while and get past the 9th grade reading level most Americans have.
When are people going to start advovcating self-reliance and personal responsibility again!? Things that this nation was built on and what made us different. I look around and all I see (on both sides) are people looking for ways to capture voting blocks by locking them in on economic issues, whether it be for new entitlement programs to hook the electorate or tax breaks for corporations that donate big bucks at election time. Enough already! Notwithstanding citizens who cannot, we need to stand up and support ourselves, teach those who have forgotten how and leave those who refuse behind.
Thanks!
TTUEagle
Allen –
You can’t make that logical leap. Berwick’s statement about the NHS says NOTHING about his views on member contributions, copays, or reimbursement.
His statement may repulse you but your interpretation isn’t fair or reasonable.
Nate – employer and individual plans after 2014 have much more flexibility than MedSup plans do – provider networks, medical management, additional benefits, etc are all flexible, and we’re already starting to see some initial attempts at innovation in the form of smaller networks with higher penalties for OON care.
Perhaps I have more faith in the ability of the industry to adapt. I also have faith in the motives of the vast majority of the people working on implementation of reform. Unfortunately, there’s so much misinformation out there about reform that people are scared of things that aren’t factual or accurate – death panels, for example.
Paduda
Nate – employer and individual plans after 2014 have much more flexibility than MedSup plans do – provider networks, medical management, additional benefits, etc are all flexible, and we’re already starting to see some initial attempts at innovation in the form of smaller networks with higher penalties for OON care.
Perhaps I have more faith in the ability of the industry to adapt. I also have faith in the motives of the vast majority of the people working on implementation of reform. Unfortunately, there’s so much misinformation out there about reform that people are scared of things that aren’t factual or accurate – death panels, for example.
Paduda