At the end of my day, I am frightened for the health of my family.
Take that so-called commandment of building local health care instead of a national one is a good one; too bad something driven from the top-down of the federal government will be *anything* but than the former.
I don't expect you to understand the intricacies of my families medical issues; but if you did you would perhaps narrow-mindedness of his thinking .
So let me ask you a few questions: if the majority in Senate votes with the President, why didn't he bring the nomination to the floor?
If the fear was because of the minority party blocking the vote, can you name any members who pledged to do so?
If this wasn't a sleight-of-hand to avoid the voters from finding out the true nature of Dr. Berwick's position, why wasn't the debate taken to the representatives in Congress?
Who wants to spend half what they do now, on something really important, and get just as much of it as before?
I know I do. The only arguments against such a thing would be ideology or the self-interest of those selling the product.
The product in this case is health. Not health care, health. And it’s the difference between these terms that is the real ideological divide of our time.
The current Administration has launched a war, through the new health care law, to get our costs into line with those of our competitors without reducing our nation’s health.
Dr. Donald Berwick (above) is the President’s general in that war. As head of the Centers for Medicare and Medicaid (CMS), he now controls 4% of our Gross Domestic Product, more than the Department of Defense. He is the David Petraeus of health.
In the end this was the fight conservatives wanted to have, that Berwick’s recess appointment evaded. Once the war is declared, does the President put the commander into the field, or do his opponents?
What Dr. Berwick, a pediatrician by training, has fought for his entire career is patient-centered health. (Sort of like Petraeus has focused on counter-insurgency)
As Berwick said in a now-notorious speech celebrating the 60th birthday of Britain’s National Health Service (NHS):
It means that we who offer health care stop acting like hosts to patients and families, and start acting like guests in their lives.
Berwick’s critics have focused on the fact of that speech, and its praise for the NHS. They have ignored the 10 major criticisms he offered, of which this is the central one.
Berwick believes your bank balance should not define your health. A bureaucrat should not define it. Even your doctor should not define it. You should.
This is controversial. Health insurers don’t like it. Doctors’ associations don’t like it. I don’t think the NHS liked it. It’s certain conservatives don’t like it.
But I like it, and at the end of the day I suspect you like it too.
Here is what Dr. Berwick really said in that NHS speech:
- Put the patient at the center of everything you do.
- Stop restructuring. Change what happens, not who reports to whom.
- Build integrated, local health care systems, not a giant national one.
- Invest in primary care.
- Don’t place all your faith in the market.
- Avoid supply-driven care like the plague.
- Develop a single, integrated approach to measuring health and care.
- Heal the divide among doctors, management, and those who pay for care.
- Train for the future, not the past. Focus on safety, teamwork, and patient-centeredness.
- Aim for health, not health care. Focus on preventing sickness, not just curing it.
These are the 10 health commandments Berwick will now try to impose on Medicare and Medicaid, where the largest portion of our national health budget is spent. That is now his battlefield.
Argue against his strategy if you want, but don’t just build ideological straw men you can knock down. That’s not helpful.
