Wednesday, March 31, 2010

Berwick for CMS: the good… and bad news

berwick_4_.JPG(photo from The Boston Globe)

It seems like a no brainer.  Health care quality and safety guru, accomplished crusader on behalf of cutting costs without reducing (or actually while increasing) quality of care, noted author (if you’re in this business, Crossing The Quality Chasm is required reading) and balanced (i.e., non-partisan) Donald Berwick is the President’s likely candidate for head of the Centers for Medicare and Medicaid Services (CMS).  Given all that, who could oppose his candidacy?  And why?

First, though, the administrator of CMS oversees a nearly $800 billion budget and would sit squarely in the center of the health reform implementation.  If fact, much of the ultimate responsibility for realizing the goals of the new law would fall on his shoulders.  To gain an appreciation for all that Dr. Berwick brings to this task, see his bio page at the Harvard School of Public Health (where he serves on the faculty) here.

Why might his nomination be opposed?  A few reasons:

  • Republicans, bent on defeating/repealing/delaying the implementation of the law, could use an opposition strategy simply as a road block approach.
  • Republicans, bent on turning the tide in the upcoming elections, might relish the opportunity to highlight Dr. Berwick’s views, which they may characterize as particularly “liberal” – see below.
  • Dr. Berwick has often cited the fact that medical supply drives demand, increasing costs without improving outcomes.  Some corners of the industry won’t enjoy having this perspective at the helm of the primary governmental health policy and payment organization. 

I don’t know Dr. Berwick but I’ve followed his accomplishments and contributions for a long, long time.  And when I heard about the possibility that he could be the next chief at CMS, I thought “yes, of course.” 

But not everyone thought that.

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