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Don Berwick on Health Care

 

 


ObamaCare is massive step forward, but we need single-payer

While Hillary Clinton doesn't want a "contentious debate" on ObamaCare, the debate among the left doesn't have to be so contentious, says Dr. Donald Berwick in an interview with Truthout. There is room to appreciate what the law can do, he argues, while also understanding its limits.

"I feel the ACA is a massive step forward--a tremendous achievement. But we are still left with a system that fails to solve many problems," said Berwick. "Even with the law, we still have a complex system that is highly expensive to maintain and somewhat captive to the status quo. It lacks teeth to push back on costs."

The ACA's limitations compelled him to run for governor of Massachusetts in 2014 on a campaign fueled by his staunch advocacy of single-payer health care. "On his first day as governor of Massachusetts, Berwick promises to set up a commission tasked with finding a way to bring single payer to the Bay State," reported Talking Points Memo, describing him as "ObamaCare's Founding CEO."

Source: Truthout "News Analysis" by Michael Corcoran , Jun 9, 2016

Institute for Healthcare Improvement: focus on quality

Q: You started the Institute for Healthcare Improvement. Tell me about that.

A: I was recruited to the first HMO at Harvard Community Health Plan to run their quality systems and quality of care. We had an unlimited budget to measure anything we wanted that related to care. So we were watching patient satisfaction and infant mortality, and I kept noticing that everything stayed the same. We were okay, but there wasn't improvement.

[I looked at] how other industries deal with improvement; we studied modern approaches to improvement. We began some experiments and then started a national demonstration project in the late 1980s, with 21 hospitals using these then-new quality-improvement techniques from outside healthcare. And it worked. It was unbelievable. It was so exciting. They were addressing problems that had been chronic for decades with just a little bit of help from people who understood quality. We brought in experts from other industries; a lot of them made breakthroughs.

Source: Medscape interview on 2014 Massachusetts governor's race , Feb 18, 2014

Triple Aim strategy: improve experience, health, and cost

As part of his proposal to improve medical care in Massachusetts, Berwick previously said he would implement the Triple Aim strategy, focusing on improving the experience of care, improving the health of the population and reducing per capita costs of health care.

Berwick said on his first day in office, he would put together a task force of health care stakeholders to review the state's 2011 cost containment law to identify places it could be improved upon.

Berwick doubled-down on his flirtation with the idea of a single-payer system in Massachusetts, saying the time has come to see if it could result in a better, less expensive health care experience. "It is time to explore seriously the possibility of a single payer system in Massachusetts. The complexity of our health care payment system adds costs, uncertainties, and hassles for everyone--patients, families, doctors, & employers," Berwick said. "I will work with the Legislature to assemble a multi-stakeholder Single Payer Advisory Panel."

Source: Springfield Republican on 2014 Massachusetts Governor race , Jan 23, 2014

Explore single payer system in Massachusetts

Berwick said, "It is time to explore seriously the possibility of a single payer system in Massachusetts. I will work with the Legislature to assemble a multi-stakeholder Single Payer Advisory Panel to investigate and report back within one year on whether and how Massachusetts should consider a single payer option."

Democrats initially pushed for a single payer system in the national Affordable Care Act but the language never made it into the final bill that passed in 2010. Supporters of a single payer system argue that it would simplify the billing process and reduce overall costs, in part, due to increased preventative care. Opponents, however, argue government is not efficient enough to be in charge of such an undertaking, and with public officials at the helm of the health care system, the quality of care and the overall health care system would diminish.

In 2010, communities across the commonwealth approved a non-binding ballot question endorsing a single payer system.

Source: Springfield Republican on 2014 Massachusetts Governor race , Jan 23, 2014

2011: #4 on list of most influential health care leaders

Don Berwick has dedicated his life to creating stronger communities and saving lives. Now he's running for Governor to make Massachusetts a beacon for the rest of the nation.

Don followed in his father's footsteps and became a pediatrician, when he learned that caring for Massachusetts' children also meant improving the hospitals, health systems, and communities that families depend on. In 1991, he helped found the non-profit Institute for Healthcare Improvement, where for 20 years he led scores of projects and massive campaigns--credited with saving hundreds of thousands of lives. Don has been named to the list of most influential health care leaders in the country every year for more than a decade. In 2011, he ranked #4 on the list--just after President Obama.

In 2010, the President asked Don to go to Washington to lead the Medicare and Medicaid programs.

Source: 2014 Gubernatorial campaign website, BerwickForGovernor.com , Jan 15, 2014

2010: Ran Medicare/Medicaid agencies, with budget of $800B

In 2010, the President asked Don to go to Washington to lead the Medicare and Medicaid programs. Don took charge of an agency with a budget over $800 billion--larger than the Pentagon's--and led a staff of more than 5,500 people. At one of the most critical times in our nation's history, Don implemented many of the most important provisions of the Affordable Care Act.

The toxic politics of Washington cut short Don's time there. Right-wing pundits attacked his commitment to equity and care for all. Glenn Beck labeled him the "second most dangerous man in America." Senate Republicans vowed to filibuster his confirmation. In the face of the same Republicans who blocked Elizabeth Warren's confirmation to head the Consumer Financial Protection Bureau, Don was forced to step aside after only 17 months leading Medicaid and Medicare.

Source: 2014 Gubernatorial campaign website, BerwickForGovernor.com , Jan 15, 2014

Other governors on Health Care: Don Berwick on other issues:
MA Gubernatorial:
Bill Weld
Bob Massie
Charlie Baker
Dan Wolf
Deval Patrick
Jay Gonzalez
Karyn Polito
Lawrence Lessig
Martha Coakley
Marty Walsh
Richard Tisei
Steve Grossman
Tom Menino
Warren Tolman
MA Senatorial:
Brian Herr
Bruce Skarin
Ed Markey
Elizabeth Warren
Gabriel Gomez
John Kerry
Martha Coakley
Mo Cowan

Gubernatorial Debates 2017:
NJ: Guadagno(R) vs.Phil Murphy(D, won 2017 primary) vs.Ray Lesniak(D, lost 2017 primary) vs.Mayor Steve Fulop(declined Dem. primary, Sept. 2016) vs.Lesniak(D) vs.Wisniewski(D) vs.Ciattarelli(R) vs.Rullo(R)
VA: Gillespie(R) vs.Perriello(D) vs.Wittman(R) vs.Wagner(R) vs.Northam(D)
Gubernatorial Debates 2018:
AK: Walker(i) vs.(no opponent yet)
AL: Kay Ivey(R) vs.Countryman(D) vs.David Carrington (R) vs.Tommy Battle (R)
AR: Hutchinson(R) vs.(no opponent yet)
AZ: Ducey(R) vs.David Garcia (D)
CA: Newsom(D) vs.Chiang(D) vs.Villaraigosa(D) vs.Delaine Eastin (D) vs.David Hadley (R) vs.John Cox (R) vs.Zoltan Istvan (I)
CO: Ed Perlmutter (D) vs.Johnston(D) vs.Mitchell(R) vs.Cary Kennedy (D) vs.George Brauchler (R) vs.Doug Robinson (R)
CT: Malloy(D) vs.Drew(D) vs.Srinivasan(R) vs.David Walker (R)
FL: Gillum(D) vs.Graham(D) vs.Mike Huckabee (R) vs.Adam Putnam (R)
GA: Kemp(R) vs.Casey Cagle (R) vs.Hunter Hill (R) vs.Stacey Abrams (R)
HI: Ige(D) vs.(no opponent yet)
IA: Kim_Reynolds(R) vs.Leopold(D) vs.Andy McGuire (D) vs.Nate Boulton (D)
ID: Little(R) vs.Fulcher(R)
IL: Rauner(R) vs.Kennedy(D) vs.Pawar(D) vs.Daniel Biss (D) vs.J.B. Pritzker (D)
KS: Brewer(D) vs.Wink Hartman (R)
MA: Baker(R) vs.Gonzalez(D) vs.Setti Warren (D) vs.Bob Massie (R)
MD: Hogan(R) vs.Alec Ross (D) vs.Richard Madaleno (D)
ME: (no candidate yet)
MI: Whitmer(R) vs.El-Sayed(D) vs.Tim Walz (D)
MN: Coleman(D) vs.Murphy(D) vs.Otto(D) vs.Tina Liebling (DFL) vs.Tim Walz (DFL) vs.Matt Dean (R)
NE: Ricketts(R) vs.(no opponent yet)
NH: Sununu(R) vs.Steve Marchand (D, Portsmouth Mayor)
NM: Grisham(D) vs.(no opponent yet)
NV: Jared Fisher (R) vs.(no opponent yet)
NY: Cuomo(R) vs.(no opponent yet)
OH: DeWine(R) vs.Schiavoni(D) vs.Sutton(D) vs.Taylor(R) vs.Jim Renacci (R) vs.Jon Husted (R) vs.Connie Pillich (D)
OK: Gary Richardson (R) vs.Connie Johnson (D)
OR: Brown(D) vs.Scott Inman (D)
PA: Wolf(D) vs.Wagner(R)
RI: Raimondo(D) vs.(no opponent yet)
SC: McMaster(R) vs.McGill(R) vs.Pope(R)
SD: Noem(R) vs.Jackley(R)
TN: Green(R) vs.Dean(D)
TX: Abbott(R) vs.(no opponent yet)
VT: Scott(R) vs.(no opponent yet)
WI: Walker(R) vs.Harlow(D)
WY: (no candidate yet)
Newly-elected governors (first seated in Jan. 2017):
DE-D: Carney
IN-R: Holcomb
MO-R: Greitens
NH-R: Sununu
NC-D: Cooper
ND-R: Burgum
VT-R: Scott
WV-D: Justice

Retiring 2017-18:
AL-R: Robert Bentley(R)
(term-limited 2018)
CA-D: Jerry Brown
(term-limited 2018)
CO-D: John Hickenlooper
(term-limited 2018)
FL-R: Rick Scott
(term-limited 2018)
GA-R: Nathan Deal
(term-limited 2018)
IA-R: Terry Branstad
(appointed ambassador, 2017)
ID-R: Butch Otter
(retiring 2018)
KS-R: Sam Brownback
(term-limited 2018)
ME-R: Paul LePage
(term-limited 2018)
MI-R: Rick Snyder
(term-limited 2018)
MN-D: Mark Dayton
(retiring 2018)
NM-R: Susana Martinez
(term-limited 2018)
OH-R: John Kasich
(term-limited 2018)
OK-R: Mary Fallin
(term-limited 2018)
SC-R: Nikki Haley
(appointed ambassador, 2017)
SD-R: Dennis Daugaard
(term-limited 2018)
TN-R: Bill Haslam
(term-limited 2018)
WY-R: Matt Mead
(term-limited 2018)
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Page last updated: Jul 12, 2017