Tuesday, December 6, 2011

Don Berwick Says Medicare is Wasteful

I was thrilled when Dr. Don Berwick took over as head of the Center for Medicare and Medicaid Services (CMS).  It was a politically charged appointment and the GOP wasn't standing for his type of medicine.  He would have never been confirmed and now he is saying goodbye to Washington.  Dr. Berwick admits Government is more complex than he realized and said "Government decisions result from the interactions of many internal stakeholders-different agencies and parts of government that, in many cases, have their own world views."  Ya think?

He also said the GOP criticism of him and his policies was "purely political, a world of sound bites" and that they "completely distorted his meaning."

Berwick reflected on his 17 months in office and said these are the ways we waste money in healthcare:
1.  Over treatment of patients
2.  Failure to coordinate care
3.  Complex administrative restrictions on the health care system
4.  Burdensome rules; and
5.  Fraud

I would say 9/10 physicians queried would agree 100% with this assessment.  As Berwick says, "Much is done that does not help patients at all, and many physicians know it."  The problem is that patients don't know what is helpful and what is wasteful.  They depend upon our judgment and ethical decision making to know. 

Items 3 and 4 regarding the complexity and burdensome rules placed on caregivers is also true.  The complexity of treating patients is enough without jumping through government and insurance hoops that add no benefit to anyone.  Despite the restrictions, Fraud is rampant and more rules and regulations will not stop it.  Simplify the system and it will be easier to detect fraud.

We truly do need health care reform, not just health insurance reform.  Obama is headed in the right direction by insisting we have 100% coverage for all people...no opt out of the system.  Can we at least agree on that and work together to improve health care for everyone?

Ciao, Dr. Berwick.  Thanks for trying.


Jennifer Selby Long said...


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OldSquid said...

Good article from "Health Affiars" on Dr. Berwick.


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