How health reform can be aborted

Cost-effective, high-quality health care is Donald Berwick's life mission. Health reform can still be killed, before it's born, by stopping him from doing the job we need him to do.
Written by Dana Blankenhorn, Inactive

The headline is deliberately provocative. But this is a point you need to understand.

No law can be better than the people enforcing it. A great law to fight crime is worthless if Barney Fife is sheriff.

This is especially true when a law is new. Your first enforcer creates the regulations, and sets the tone for all that follows. The SEC gained trust during the Depression because Joseph P. Kennedy, a former speculator, was running it. The FBI would not have grown without J. Edgar Hoover.

The passage of health reform makes the next head of the Centers for Medicare and Medicaid a key appointment. Government is already the biggest buyer of health care products and services. The policies set by our next CMS director will determine whether money can be saved, how much, and at what human cost.

No one in the world is better for that job than Dr. Donald Berwick. Cost-effective, high-quality health care is his life's mission. His 100,000 Lives campaign, conducted on a shoestring budget, cut the risks of hospitalization and saved lives at no cost to you.

The President was fortunate to convince Dr. Berwick of the urgent need to come to Washington and become the first post-reform director of CMS.

Unfortunately that seems to scare some people who, in their zeal to see health reform fail, want to torpedo his nomination. They are claiming that he supports rationing, that he's a fan of Britain's National Health Service and will thus bring "socialized medicine" to the United States.

They need to have a great big cup of STFU. Rationing already exists in this country. If you can't pay you don't play. The question is how we say no, on what basis we say you can't pull from the common pool. Private health insurers will go broke without that power, without a rational basis for that power, and basic care will become unaffordable for nearly everyone.

Some Republicans have second thoughts about this. This is not about Dr. Berwick's qualifications, about his integrity, about his skills, or even about what regulations CMS should put in place to enforce the law.

It's about attacking health reform itself, about re-litigating the issue.

We need more than Democrats coming to Dr. Berwick's defense. We need the industry to step in, not just the hospital industry but the health insurance industry, because nearly every strategy insurers want to put in place to control costs is based on work Dr. Berwick has already done.

Senator Pat Roberts calls Dr. Berwick "the wrong man, wrong time, wrong job." Utter nonsense.

If you don't like Dr. Berwick for CMS, Senator, tell us who you do like. Let's compare, apples to apples. Who's your Dr. Fife? Want to bring Michael Brown out of retirement? Maybe the old gang from the Minerals Management Service?

Seriously. The worst thing that can happen to the United States of America right now is for Dr. Donald Berwick to decide this job, and this process, isn't worthy of the aggravation and withdraw. He is the right man, at the right time, in the right job, and those who dare dispute that deserve nothing but contempt, because they know this.

If enough of the industry lets Congress know this, health reform will get a fair test. It can still be killed, right now, even before it's born, by stopping Donald Berwick from doing the job we need him to do.

Thus the headline.

This post was originally published on Smartplanet.com

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