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Gubernatorial Candidate Berwick On Health Care, Taxes And His Experience In D.C.

BOSTON — Getting into the race very early is exactly the formula that a once unknown Deval Patrick used to win the 2006 gubernatorial race. With Patrick leaving office in 2014, the first of the candidates to replace him are beginning to step forward. Among them is pediatrician Donald Berwick, who officially announced his candidacy Monday.

The former head of the U.S. Centers for Medicare and Medicaid Services joined WBUR’s Morning Edition to discuss his plans for the upcoming election.

Bob Oakes: You are one of the nation’s top experts on health care quality and cost. As those issues come to fore nationally, why leave that work to try and become governor?

Dr. Donald Berwick at WBUR in January (Jesse Costa/WBUR)

Dr. Donald Berwick at WBUR in January (Jesse Costa/WBUR)

Donald Berwick: I want to continue that work as governor. Massachusetts is being looked to by everyone around the country for success in its own health care reform. It’s very important  to have a governor who knows how to get us to health care reform in the state. We haven’t completed the job yet.

But my interests are much broader than that. My career has been devoted to improvement, improvement of large systems of all types and I’m really interested in communities that thrive, not just health care.

Let’s talk about health care though for just a few minutes. What would you do if elected governor next fall to help control the rising cost of health care in Massachusetts?

I’m really proud to be in Massachusetts, it’s the first state in the union that’s made health care a human right. But in order to make that sustainable we’re going to have to reform health care to make it more continuous more responsive to patients, safer. A health care system that’s better will be more affordable and that’s going to involve change. We need hospitals, and health care overall, to really become seamless and coordinate it, those are big changes and as governor I would guide and insist upon those changes throughout the health care system.

So is the state doing enough now in that regard?

We’re en route but there’s a lot more to do. We’re coming from a health care system that’s been addicted to volumes — the more you do the more you make. And that’s not good for patients. Patients need care that’s responsive to them, that keeps them home. We need hospitals that want to be empty, not full, and that’s a big change.

What about the economy? Massachusetts has fared better than most through the recession, but unemployment is still a problem. It currently stands at 6.4 percent. What would you do to help lower that rate?

For that we’re going to need robust communities, communities with infrastructure that works, transportation, education and attention especially to poverty. And to keeping people from falling victim to loss of jobs. I want to work hard at economic development in this state.

On your website you say you want to focus on improving schools, especially the disparities in resources and achievements. What does that mean?

We have good schools in Massachusetts, we’re probably top of the country, but we have a long way to go and there are disparities in schools. You can walk one mile from a school with 90 percent success rate to one with a 30 percent success rate and that’s not acceptable.

One of the most controversial proposals that the legislature and the governor dealt with in this last year was Gov. Patrick’s call for $2 billion in new revenue by closing a bunch of tax loopholes and raising the state’s income tax by 1 full percentage point while cutting the state sales tax. What was your stance on that plan that was designed to raise money for education and transportation?

We need to invest in our future, our transportation system is badly in need of more upkeep and repair thanks to years of neglect. Same goes for education — we need to invest in our children. How we do that is a matter for further analysis but I’m generally in favor of progressive taxation. I think people who make more need to contribute more. I think people who are at the margin need to be less stressed by the tax system.

Does that mean you are in favor of hiking the income tax?

I don’t think the government has a right to the taxpayers’ money. I think it has to earn that. For 30 years I devoted myself effective organizations. I brought that to [Centers for Medicare and Medicaid Services] in Washington when I ran it for President Obama. And that’s what I would do as governor. I think effective government is necessary in order to earn the taxpayers’ support.

You’re well known in your field but perhaps a political unknown here in Massachusetts. What do you think your biggest challenge will be in getting support from voters who may be unfamiliar with you?

I’ve been very excited by going around the state meeting voters. I find enormous resonance between the agenda that I have and want to pursue, a progressive future for Massachusetts, the well being of our children, healthy communities, and I’m just excited about the opportunity to work for the state that’s given me so much and I’d like to give back to it now.

And you’ve never held elected office, what makes you think your background in health care qualifies you to lead the Commonwealth?

I’ve worked with government and policy for 30 years throughout my whole career. In Washington, President Obama asked me to run the largest agency in government — $820 billion with 5,500 employees. I had a marvelous experience. I believe in government, I believe in effective government and I think I’ve got the skills and the tools to make Massachusetts the example that this country needs.

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