Former Medicare Chief Donald Berwick Speaks

Dr. Donald Berwick hit the buzzsaw of American politics as short-time chief of Medicare. Now, he’s out, and talking.

Dr. Donald Berwick has spent his life working to make American health care cheaper and better. Then he went to Washington, and ran into the buzz saw of American health care politics.

Barack Obama appointed Berwick chief of all Medicare and Medicare, health care providers for one out of every three Americans. The giant item in the federal budget. But it was a recess appointment. It needed the Senate’s stamp of approval. Senate Republicans would not give it.

Now, after seventeen months, he’s out.

This hour, On Point: Donald Berwick on American health, health care, and buzz saw politics.
-Tom Ashbrook

Dr. Donald Berwick, administrator, until last Thursday, of the Centers for Medicare & Medicaid Services (CMS), which provides healthcare for 100 million Americans. Former President and Chief Executive Officer of the Institute for Healthcare Improvement, a not-for-profit organization focused on healthcare improvement

Despite stepping down as chief of America’s Medicare and Medicaid programs, Dr. Donald Berwick said it is a "thrilling time in health care." And he said now is the time for change:

"On the one hand I do think we can buckle down as a country and get health care to perform the way we all want it to with dignity, reliability and safety," Berwick said. "The problem is that a lot of people don't understand that possibility. They don’t understand that health care can get a lot better."

Berwick says that he was interested in the ways that corporations remain competitive and noted that “constant innovation is the root of making things better and more affordable and that is true of health care."

He explained that his departure from Washington was due to the absence of "authentic dialogue' about what is needed and what is possible. "Everything has been reduced to sound bites and rhetoric," Berwick said. "It was really hard to engage as I would have wanted to engage with some people who have some skepticism about the law about what the possibilities are."

On the question of redistribution of wealth and health care benefits, Berwick explained that “insurance is redistribution.”

“It is simply a fact that illness and poverty go together. Wealth and health are inversely related,” Berwick said. “If we want to become a country in which if you get ill you get care then we saying that those of us who have more because we are healthier are going to help those of us who have less because we are not going to need the help of others. That is really the moral question for the country: do we help each other with our health."

The New York Times "Mr. Obama first nominated Dr. Berwick in April 2010, but he never received a Senate confirmation hearing. More than 40 Senate Republicans urged the White House to withdraw the nomination last spring, and many vowed to block confirmation."

Healthaffairs.org "As he ticked off to his aides the various stakeholder groups he wanted to check with that day, he was startled when one informed him that Libyan dictator Muammar Gaddafi had just been reported killed. He and his press officer safely predicted that this stunning news undoubtedly would trump the ACO announcement."

Washington Post "It’s a rare moment in an increasingly polarized Washington: One of the highest ranking Republicans endorsing the bureaucrat that the Obama administration hopes will oversee implementation of its health care law. But when we spoke this morning, House Majority Leader Eric Cantor was resolute in his support for Marilyn Tavenner, the woman the White House hopes will oversee the Center for Medicare and Medicaid Services."