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Health Leader Berwick, Now A Candidate, Seeks ‘Compassionate Government’

First in a series of profiles of the gubernatorial candidates

“It’s become naïve or unpopular to talk about a compassionate government, but that’s what I want," said Democratic gubernatorial candidate Donald Berwick, seen here at WBUR in January. (Jesse Costa/WBUR)

“It’s become naïve or unpopular to talk about a compassionate government, but that’s what I want,” said Democratic gubernatorial candidate Donald Berwick, seen here at WBUR in January. (Jesse Costa/WBUR)

BOSTON — “Can you hear me on the porch?” asked Donald Berwick as he looked from his audience in the living room of a West Roxbury home to the overflow crowd on a side porch.

“Yes, we hear you fine,” a man called out, “and you’ve got our vote.”

Berwick, 67, chuckled, but he didn’t let up. This was a roomful of potential donors, a roomful of prospective volunteers, a roomful of regular voters, and with just a few weeks before the Sept. 9 gubernatorial primary, Berwick felt the urgency. He knew he needed their support.

The Democrat from Newton launched into his stump speech, highlighting the ways he says he is unique in the 2014 race for governor.

“I’m the only candidate for governor committed to single payer health care, Medicare for all,” Berwick said. “I’m the only candidate opposing casinos and for the casino repeal. My focus on poverty, if you haven’t heard it yet, it is very strong. I think this is a commonwealth that can end hunger. Chronic homelessness — zero.”

Berwick’s positions are built on a foundation of what he calls progressive values: a commitment to social justice, equality and compassion. You’ll hear these words in every Berwick speech. They are rooted, he said, in his childhood.

‘We Need Not Be Embarrassed To Say We Help’

Berwick grew up in rural Moodus, Connecticut, the oldest son of the local doctor and a civic-minded mother.

“It was a very small town, everyone was in it together. You literally knew everybody,” Berwick said in an interview. “So the sense in the town of being connected to each other and responsible for each other was extremely deeply woven into my experience as a kid.”

Berwick left Moodus for Cambridge, Massachusetts, where he attended Harvard University as an undergraduate and then as a medical student. Berwick and his wife Ann, who chairs the state’s Department of Public Utilities, raised four children.

“We’re a very close family,” he said. “We spend as much time together as we possibly can,” much of it outdoors, he added.

Weekends were often spent hiking in New Hampshire and eventually in parks all over the world. Berwick made it a point to travel with each of his children.

He remembers his first time on an airplane, when he looked down at mile after mile of homes, highways and farms, and realized how many people he did not know. But he still felt a small-town connection to all those unseen faces.

It’s a connection that is central to his run for governor.

“It’s become naïve or unpopular to talk about a compassionate government, but that’s what I want,” Berwick said. “We need not be embarrassed to say, you know, we help. That’s what we do, as a nation, as a state, and we use government to do that.”

‘Sir’ Berwick Hits D.C. Backlash

Berwick trained as a pediatrician and took care of children for about 20 years before shifting to the executive side of medicine. In 1991, he founded a nonprofit, the Institute for Healthcare Improvement (IHI), in Cambridge. Now with more than 140 employees, IHI has a presence in every state in the U.S. and more than a dozen countries. Berwick and his organization gained a reputation for tackling complex problems through the 100,000 lives campaign, which documented reductions in medical errors that were killing patients.

He’s widely respected, if not revered, by many health leaders for the results he’s achieved, but also for his leadership style. Former employees say he urges them to take chances and calls failure as an opportunity to learn. He does not want to hear, “that problem’s too big,” or “that can’t be done,” said Joe McCannon, who’s worked with Berwick since 2001.

“Don absolutely will not settle for that,” McCannon added. “He’s just relentless in his optimism and his belief that change is possible. And that’s totally infectious.”

In 2005, Queen Elizabeth II knighted Berwick for his work to improve the United Kingdom’s National Health Service. In 2010, President Obama tapped Berwick to run the agency that oversees Medicare and Medicaid. He was in charge of an $820 billion budget and some key aspects of Obamacare. Berwick’s supporters cheered, but the backlash hit hard and fast.

On his Fox News show in 2010, host Glenn Beck called Berwick “the second most dangerous man in America” because, Beck said: “Not only does he want to blow up the best health care system in the world — not perfect, but the best in the world — his idea of a fix is to make our system just like Great Britain’s health care system.”

Beck and many Republicans were particularly concerned about Berwick’s support for “redistributing health care.” Berwick believes if the U.S. succeeds in making health care a legal right, the change will be redistributional, because poor Americans will then have access to something that more prosperous Americans already enjoy.

But opposition to Berwick grew, with 42 Republican senators eventually telling Obama they would not vote to confirm him. Berwick’s recess appointment lasted only 17 months.

“I don’t think Mother Teresa could have been confirmed in that environment,” said Tom Scully, a Republican who ran Medicare and Medicaid under President George W. Bush.

Berwick was held in high regard inside the federal health agency, but became the target of conservatives’ frustration about Obamacare, Scully said.

“He’s kind of an academic,” Scully added. “I don’t think he was particularly astute at the politics, but he was thrown out as the nominee in the most intensely partisan, heated time in health care in the last 50 years.”

Berwick said he’s proud of the drug and prevention benefits for elders that took effect during his tenure and a program to reduce hospital readmissions. Some colleagues thought the experience would sour his interest in politics, but instead it inspired his run for governor.

Taking His Message On The Campaign Trail

Standing in socks, his head covered with a scarf, Berwick addressed about 200 men in turbans and women wearing delicate embroidered head shawls at the New England Sikh Study Circle in Milford. It was his second stop on a Sunday packed with appearances.

“I think Massachusetts can be a beacon … an example of the direction the country ought to go,” said Berwick, drawing a contrast between the blue Bay State and Capitol Hill.

His stump speech was well received there.

“You couldn’t have spoken better to Sikhs than you did if you had been coached,” said study circle member Sarbpreet Singh. “It was wonderful to hear the words social justice, equality — those are absolutely fundamental to the Sikh faith.”

Berwick asked Singh to send him some literature, so that he can learn more about the faith.

At the August Moon Festival in Quincy, the reception was more muted. Berwick weaved through the crowd, as he passed out flyers and pointed to his picture on them.

“I’m Don Berwick, that’s me,” he said repeatedly. “And I’m running for governor in Massachusetts. So please, I’d love your help, thank you very much.”

Berwick received a lot of friendly but blank stares, even when politics and health care overlapped. At a booth run by the Joslin Diabetes Center, Berwick paused to ask three women about their work and the rate of diabetes among Asian-Americans.

The women hadn’t heard of Berwick, but Chihiro Hernandez said, “It’s great to have someone in the race who understands the issues.”

Back in the West Roxbury living room, later that day, some supporters challenged Berwick.

A woman who said she plans to vote for Berwick was worried that she won’t be able to persuade others to do the same. How, she asked, does Berwick plan to pay for all the things he’d just mentioned: prison reform, pre-kindergarten classes across the state and more funding for state colleges and universities?

First, Berwick said, he’d cut money that is being wasted now. For example, he said it costs a lot more to keep drug offenders in prison than it would to fund the services they need to beat the addiction.

Second, Berwick said the state would save billions by moving to single payer health care.

“If I’m successful,” he said, “the insurance companies will come out of the woodwork fighting this, because this threatens the insurance company business.”

“You’d get rid of the insurance companies?” came a woman’s question.

Berwick nodded.

But they’re huge employers, the woman added. What do you do about people who are displaced?

“There’s a transition problem that’s serious, I totally agree with you,” Berwick said. “This has to be a transition plan, not a violent plan. But we’re talking about the biggest job creating strategy we could have in the commonwealth … because of what it does to businesses.”

Berwick pointed to Vermont where a study projects substantial savings as that state moves to single payer health care. As with Medicare, Berwick said people would keep their doctors; the change would be in how physicians are paid.

Getting back to revenue, Berwick said he’d end most tax loopholes. And he’d raise taxes, but only on higher income earners.

“I cannot see burdening, a $30,000 or $40,000 or $50,000 wage earner, who’s having trouble making ends meet for her family, with higher taxes,” Berwick said. “But I certainly can see going to people who are at the higher end of the wealth spectrum, they owe more. And I’m going to have that battle. If I’m governor, we’re going to go for fair taxation.”

As the admittedly select West Roxbury event ended, I couldn’t find anyone who doesn’t support Berwick. But even if he can build on this momentum, he has very little time left.

Berwick does not appear daunted.

“We’ve got the strongest message, we’ve got a very strong field operation,” he said. “We’re in very good shape for this last intense couple of weeks before the election.”

The primary is on Berwick’s 68th birthday. At a time when some people are slowing down, Berwick said he expects another 30 years of vigorous, vital work, which he hopes will include the corner office on Beacon Hill.

Correction: Due to a typo, an earlier version of this story said the CMS budget Berwick oversaw was $820 million. It was $820 billion.

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  • downtown21

    The Obama appointee is trying to position himself as a “political outsider,” which is preposterous.

    Of course, I’ve never understood the fascination voters have with political outsiders, anyway. Governor Patrick created a sweeping transportation reform bill that was badly needed in this state, and made the critical error of presenting it to the voters before looking for support from the legislature…the legislature decided to teach him a lesson and shoved the whole bill right back in his face just to prove that they could. The end result is that our state is still stuck with a crumbling infrastructure and a funding model so flawed that it’s bordering on demented.

    You can have the greatest ideas in the world, if you can’t form alliances and build support to turn your ideas into reality none of it matters. After alienating Beacon Hill by insisting a lifetime of public service is something to be ashamed of, how is Berwick going to get along with anybody there? He won’t, and his administration would be a disaster.

    • FrancisMcManus

      The legislature wasn’t motivated to teach Governor Patrick a lesson, they were afraid to fund it.

      • downtown21

        Ridiculous.

        They shot down his 19 cent gas tax hike and then a few weeks later they raised the sales tax, despite every credible expert telling them that funding transportation with a sales tax is insanity. Coming up with a new revenue source wasn’t the problem. It was all about showing the governor that the real power in Massachusetts lies with the Speaker and if you don’t ask for his support before introducing a bill, HE’S GOING TO DESTROY IT even if he thinks it’s a good bill just to assert his authority.

        Governor Patrick had the right ideas, but he didn’t know how to win support for them and make them into reality. A candidate that’s going out of his way to alienate the very people he’s going to have to work with if he wins is setting himself up for disaster.

        • RatSavage

          Plenty of people know how to make nice with the politicians, but that won’t move the Commonwealth forward.

  • SueD

    Nice profile…our state would be lucky to have Don Berwick as our Governor and I hope that happens! (I believe the CMS budget he oversaw in Washington would have been ~$800 billion, not million.)

    • Martha Bebinger

      Thanks SueD – my oversight – will fix!

      • SueD

        You are most welcome, Martha!

    • WBUR

      Thanks for catching our typo, Sue. We’ve posted a correction.

  • dust truck

    ABC! Anyone but Coakley!

    If it’s Coakley, I’m voting for Baker. (Of course if it’s that tea-nut, then I’m just not voting at all, I can’t vote for hacks.)

    • downtown21

      I’m no fan of Coakley, but I really can’t understand how you could vote for someone who four years ago promised to respond to the recession by making thousands of workers unemployed as his first act as governor. Coakley is awful but she would STILL be the lesser of two evils.

      And let’s not overlook the obvious: someone who isn’t ashamed to still be a Republican after the direction that party has taken since 2006 has very questionable judgment. Y’know I’m not really a Democrat? I only vote Democrat because the GOP gives me no choice!

      • dust truck

        Well that’s true. Now I’m depressed.

        • downtown21

          Don’t be depressed, VOTE GROSSMAN! :)

          • dust truck

            SIR, YESSIR!

          • downtown21

            Berwick is the guy you want Grossman appointing as the head of the task force to come up with recommendations on how to improve access to healthcare in Massachusetts.

  • JohnnyBeagle

    Health Care is 43% of the state budget. In my house, payments to health insurance companies, co-pays, and deductibles are my single largest monthly budget item. None of the other candidates from either party have a plan to deal with this. The other candidates either make a passing remark about “transparency” to fix this or worse, one candidate does not even list Health Care as a key issue on his campaign web site. While the other candidates are content to follow the polls and not upset the status quo of the legislators on Beacon Hill, Don Berwick is an actual leader for the people.

  • downtown21

    Upon reading this a second time, I can’t help noticing how much it reads like a press release from the campaign office.

  • Art_emisia

    Don Berwick has my vote. Note that he is also the only candidate who favors repealing the awful casino law in Massachusetts. I have family living near the casinos in Connecticut. Trust me. They are not good neighbors.

  • Eugenia Marcus

    I’m working very hard to help get Don elected. His contributions to health care are legendary with his Institute for Heathcare Improvement (IHI). It has saved thousands of lives by recommending policies that curb medical errors. He will be a breath of fresh air in the Governor’s office and will save the Commonwealth millions of dollars.

  • Gunnar Jensen

    In this related video we find the liar-in-chief, Obama, lying to the face of the American people: http://youtu.be/DXqKp5B0ZLE?t=1s

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