Elizabeth Warren gets a lot of attention, but I think this Obama appointee is just as interesting.
President Barack Obama appointed Dr. Donald Berwick head of the Centers for Medicare and Medicaid Services Wednesday. Berwick, known as a passionate advocate for improving the health care system, was nominated earlier this year but his nomination turned out to be controversial. Some Republicans accuse him of favoring health care rationing — a charge Democrats dismiss as nonsense.
Here is Doctor Berwick, in 2005, on the idea that the way to cut costs on health care is to charge people more out of pocket in the hope that they’ll ration their own care:
The one part of the plan that I am absolutely against at the moment is the shifting of burden to individual patients. I do not believe that making the individual American patient more “cost-sensitive” has any rationale in science, ethics, or evidence. It will fail, and it will fail miserably. It will result in a shifting of care away from the people who need it the most. It is a displacement of responsibility for changing the system. You know, if CalPERS or Xerox or GE can’t change care through using its purchasing power, then I absolutely promise you that Mrs. Jones can’t. The idea that she will now be more sensitive because she pays an extra ten bucks out of pocket is, to me, nearly stupid. So I really disagree with that element of the agenda. Internationally, when one looks at high-performing systems around the world—and ours is nowhere near the highest-performing one—it is almost a routine characteristic of the best systems that they have first-dollar coverage, and there is no attempt to make patients pay more when they’re sick, which is a stupid thing to do.
I don’t know how someone who uses blunt words like “fail” and “stupid” is going to survive in that job, but it’s certainly refreshing.
He might be fun to watch.