We're Rationing People, Not Healthcare

America-hating repugs can force the departure of one of President Obama's recess appointees, but they can't erase what he accomplished.

Steve Benen:

It wasn’t long before Berwick, an internationally-renowned expert in improving quality care and lowering health care costs, starting making a real difference, eliminating waste from the system and saving American taxpayers a lot of money. Just as importantly, Berwick began to establish an administration “triple aim” blueprint: “improving patient experience, improving population health and reducing costs.”

Kate Pickert had a good piece on Berwick’s CMS work earlier in the year:

[I]f he holds on until the end of [2011], Berwick will have been at the helm of the Centers for Medicare & Medicaid Services (CMS) for 17 months. This is a substantial period of time and long enough to have set a tone at CMS and to have recruited key second and third-tier administrators to work on important pieces of the Affordable Care Act. Berwick has already jump-started the Center for Medicare and Medicaid Innovation, the best hope health reformers have for finding smart ways to cut health care spending. Under Berwick’s tenure, the federal regulation of private insurance was also brought under the CMS mantle, a power consolidation that could have long-range implications.

And that’s the silver lining here. Republicans crushed Berwick’s chances without a credible reason, and it limited his CMS tenure to a year and a half. But these were a very productive 17 months, during which Berwick did some incredibly important and worthwhile work.

He should have been confirmed and encouraged to serve indefinitely, but if 17 months of Berwick is the best we can do due to Republican recklessness, it’s much better than nothing.

Wonder what repugs are denying the nation in Berwick? Watch this, from Crooks and Liars:

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Please watch this wonderful interview with Dr. Donald Berwick, who should have been the director of the Center for Medicare and Medicaid Services if it weren't for the Republican idealogues in Congress. Not only does he clearly articulate what the Affordable Care Act does for everyone, he also discusses the ridiculous attacks on him by Republicans who are simply doing everything they can to weaken the impact of the Affordable Care Act. Dr. Berwick was appointed by recess appointment and Republicans refuse to even have a hearing toward Congressional approval, so he was forced to step down from the position.

One of the more notable moments is when Chris Hayes quotes Newt Gingrich on Berwick. Here's what Newt said about him, via ThinkProgress:

Don Berwick at the Institute for Healthcare Improvement has worked for years to spread the word that the same systematic approach to quality control that has worked so well in manufacturing could create a dramatically safer, less expensive and more effective system of health and health care.— Newt Gingrich, August 2000.

By the way, that quote was part of an article Newt wrote while he was a senior fellow at the American Enterprise Institute, before it was the fashion to bash people trying to do something good for this country.

There's a great deal of substance in this interview about what the Affordable Care Act does, and what it says about us as a country. But his most effective and succinct argument is the very last line at the end of the interview where they are discussing the false argument about how health care will be rationed (as if it isn't right now). He says, "Right now, we ration people, not care."

On its face, that's a pretty radical statement, but he's exactly right. By limiting access to health care to those who can pay for it or who are healthy, the system rations care to an entire segment of this population. Berwick contends that the Affordable Care Act opens that universe to everyone and establishes the right to health care, which is something liberals have aspired to for over one hundred years.

Other high points in the interview: About halfway in, Dr. Berwick discusses his own frustration with insurers denying necessary care to patients arbitrarily and in the dark, and contends that the Affordable Care Act will shine a bright light on how care is delivered and how decisions concerning patient care are made. He also defends his time consulting for the United Kingdom's NHS as bringing our ideas to their system, which did have problems.

This is a wonderful interview. Please watch it and share it with as many as you can.