Health Leader Berwick, Now A Candidate, Seeks 'Compassionate Government'

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

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,
“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.

This article was originally published on August 29, 2014.

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Martha Bebinger Reporter
Martha Bebinger covers health care and other general assignments for WBUR.



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