Saturday, September 5, 2015

Who is Donald Berwick and why is he so controversial?

The appointment of pediatrician and patient safety expert Dr. Donald Berwick to head the Centers for Medicare & Medicaid Services has sparked considerable controversy. The public storm revolves around Berwick’s statements praising the English health care system and musings about the role of rationing in controlling costs. Berwick’s opponents claim he wants to promote an English-style system in the U.S.

Who is Donald Berwick and why is he so controversial?

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By guest blogger Robert Field:

The appointment of pediatrician and patient safety expert Dr. Donald Berwick to head the Centers for Medicare & Medicaid Services has sparked considerable controversy. The public storm revolves around Berwick’s statements praising the English health care system and musings about the role of rationing in controlling costs. Berwick’s opponents claim he wants to promote an English-style system in the U.S.

Last Month, President Obama appointed him to the post overseeing the Medicare and Medicaid agency during a Congressional recess to bypass Senate confirmation hearings, further angering Berwick opponents.

So, who is Don Berwick, and what is his actual record?

He is, in fact, one of the most respected and honored members of the American medical profession. Prior to his appointment, Berwick worked for 25 years in improving health care quality and is widely regarded as America’s leading expert in the field.

A pediatrician by training, he spent much of the 1980s overseeing quality for one of the largest insurance plans in Massachusetts. In 1987 he directed a national demonstration project on health care improvement, which led him to found the nonprofit Institute for Healthcare Improvement in 1989 (www.ihi.org). That organization is a leader in national safety initiatives that has consulted with thousands of the nation’s hospitals on making medical care safer. Hospitals estimate that IHI’s work has saved over a hundred thousand lives to date. If you have been a hospital patient during the past several years, there’s a decent chance that this work has helped you avoid injury or even saved your life.

In fact, those controversial statements – if you actually read them – are quite similar to pronouncements by Mark McClellan, George W. Bush’s head of CMS. And Berwick’s appointment to the post is supported by most of America’s medical establishment, including the American Medical Association, the American Hospital association, and 90 other group representing physicians, insurers, consumers and business. (See Medscape Today, www.medscape.com/viewarticle/724448.) Even former senior Republican health officials have endorsed him.

Given Berwick’s record, I find it surprising that the administration sought to avoid confirmation hearings. They would provide a perfect opportunity to show how close many of its health care policies are to the mainstream of American medicine.

From my perspective, putting someone in charge of Medicare and Medicaid who has saved countless lives and revolutionized the quality of American health care makes a lot of sense.

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About this blog

Check Up is a blog for savvy health consumers, covering the latest developments, discoveries, and debates from the Philadelphia area and beyond.

Portions of this blog may also be found in the Inquirer's Sunday Health Section.

Robert I. Field, Ph.D., J.D., M.P.H. Professor, School of Law & Drexel School of Public Health
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