Kudos to President Obama for making a “recess appointment” of Don Berwick to run the Centers for Medicare and Medicaid Services (CMS).
Berwick may be the ideal choice for the job. He is the right candidate at exactly the right time. The new health law makes possible broad reforms in the way we deliver health and long-term care. But it by no means guarantees these changes will be implemented. It will take a tough, commited head of CMS to break through the politics, inertia, and special interests to make the possible real.
As head of the private Insitute for Health Care Improvement (IHI), Berwick was a tireless advocate for high quality, cost-effective medical care. Under his leadership, IHI pressed hospitals to improve routine procedures aimed at saving lives. These included tasks such as routine handwashing and monitoring of mediciations as patients transfer from one care setting to another. Easy to support these ideas, but Berwick was convincing hospitals to actually implement them.
Berwick has been an outspoken critic of our fragmented health system for years, pushing instead for more coordinated care. He has argued that as much as half of all health spending is wasted.
At a time when politicians decry the high cost of health care but are afraid to make the decisions to manage these expenses, Berwick will be in a position to do something about them. As the biggest payers of health care, Medicaid and, especially, Medicare will be well-positioned to drive needed reforms.
Despite his credentials, and even though CMS has been without a permanent head for four years, Berwick’s nomination was being blocked by Senate Republicans. In an effort to turn his choice into yet another partisan battle over health reform, they blasted Berwick as “Dr. Death” who would end care for elderly patients.
To listen to the GOP, Berwick would implement the fantastical death panels that health reform critics invented last summer. Their claim is absurd and irresponsible, to say nothing of offensive.
Berwick will shake things up. He will surely struggle to manage the massive CMS bureaucracy where Medicare and Medicaid officials rarely even talk to one another. And his recess apointment will last only until the end of 2011. But if anyone can begin the process of making today’s medicine more cost-effective while improving patient care, it is Berwick.