Consider This

. . .it's about time

Pres. Obama's controversial decision to use an interim appointment to name the accomplished pediatrician and healthcare reformer Donald Berwick to head the Centers for Medicare and Medicaid Services (CMS) is welcome news.

It's about time.

This appointment is more than the rush to fill an important office with an $800 million budget overseeing Medicare and Medicaid, and influencing the health of the entire nation.

Berwick's professional mission has been to reform, eliminate waste, humanize a system that should put patients and their families at the center of need. And this threatens the status quo. So does the track record of Donald Berwick who will lead this effort.

Opposition
Obstreperous Republicans protesting Berwick's appointments are invoking some of the myths used in the initial debates over health reform: death squads, rationing, socialized medicine. They were false then; they are false now.

According to The Hill, Lamar Alexander, point person for the Republican party on this, said the appointment showed Obama and Democrats "thumbing their noses at the American people, jamming through a controversial nominee to oversee Medicare cuts in the new healthcare law."

Sen. Charles Grassley's (R-IA) response that the Obama administration of using an interim appointment to "take advantage" of the American people seems disingenuous. "The American people have a right to know about Berwick's background," Grassley wrote. He wants to know Berwick's "thoughts on rationing and government-run health care, and any potential conflicts of interest."

Where has he been? Berwick's qualifications have been an open book since rumor of nomination began to circulate in the spring.

Are you, have you ever. . .
Disparaging someone like Berwick because of favorable remarks Britain's National Health Service would meet standards set by the late Sen. Joe McCarthy: "Have you ever used, or have you ever said nice things about Britain's National Health Service?"

What Berwick's critics ignore (or perhaps don't care to know) are facts of the sort found in the recent study of The Commonwealth Fund. It says, "the U.S. health care system ranks last or next-to-last on five dimensions of a high performance health system: quality, access, efficiency, equity, and healthy lives."

Critics also ignore his own words pointing to waste, delay, premature death excessive expense and the "zoo of payment streams" oppressing ordinary citizens. He wants to d change (not eliminate) how we already ration, to harness resources and save money along with lives. And that gives more time to us all.

This nomination drew support from 130 professional associations, and from former directors in Republican administrations. The organization he founded Institute for Health Improvement (IHI), attracts praise and respect because they not only talk about change, they have actually produced it to vastly improve the way hospitals function to teaching physicians how to work with chronic health problems in their local, community offices. It's nice to have someone influencing policy who has been a bedside pediatrician, treating children, suffering with them and their parents over loss. Few people have had more transparent careers, or leaders willing to reflect upon their mistakes and successes to assess what they can do for others.

While the tactics used to appoint Berwick have been under fire, it's naive to assume he would have gotten a fair hearing, or even one at all. Republicans had already geared up to protest, had already sent a letter to the White House denouncing the choice, and would have done all in their power to undermine the health reform that was passed last year, that the nation says it needs. With this, and other appointments made by Pres. Obama, we have the chance to do the right thing for health reform.

I say, it's about time we have leaders like Berwick in Washington.

Update
Since the announcement of Berwick's appointment, additional stories have appeared, including David Axelrod comments on Fox News (July 10) , discussed in the Wall Street Journal.

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