Boston’s Berwick to run Medicare

AP is reporting that Obama will nominate Massachusetts pediatrician Donald Berwick — head of the  Institute for Healthcare Improvement Cambridge–to oversee Medicare and Medicaid.

The timing of the nomination is important because Berwick, if confirmed by the Senate, would take over an agency that has not had a permanent chief executive since Mark McClellan stepped down in the fall of 2006.

The Centers for Medicare and Medicaid Services runs the government health care programs for seniors and the poor, providing benefits to an estimated 100 million people — about 1 in 3 Americans.

Here’s a Q&A from Kaiser Health News.

Q: With health overhaul legislation moving forward, how are you feeling about major changes coming to our health system?

A: It’s a pretty exciting time. It’s time to commit to justice and that means universal coverage. We have got to go there. It’s embarrassing that we have not gone there. So that is job No. 1. But to do that simply by funding existing systems is a formula for a spiral we can’t endure. We have to restructure care and the system.

Can we do that from Capitol Hill and the White House? No. We can encourage it, we can support it, we can set some goals out at a price we can afford. But eventually this is going to devolve back to communities…only they can execute the changes and care structures that we really need. It could be an exciting time as we watch the mobilization of change at the level which change has to happen.

  Here’s a 2004 profile of Berwick from the Globe:

At this point, mild-mannered, soft-spoken, self-effacing 57-year-old Don Berwick can best be described as a revolutionary. A lot of people say the current health care system is broken, but by that they mean the manner of financing it. Berwick gets irritated when health care leaders complain about a lack of resources. There’s too much money in the system already, he says. His critique takes aim at the medical profession’s exalted view of itself. He’s convinced that the fundamentals of the current system — the same fundamentals Boston used to build its reputation as the world’s medical leader — are so screwed up that it is no longer possible for the medical profession to provide reliable, high-quality care, no matter how many innovations its renowned doctors roll out, no matter how many awards they rack up. “They want to cure cancer,” Berwick says. “Well, how about curing health care?”

His conclusion: To save the health care system, it first needs to be blown up.

 This from IHI:

We aim to improve the lives of patients, the health of communities, and the joy of the health care workforce by focusing on an ambitious set of goals adapted from the Institute of Medicine’s six improvement aims for the health care system: Safety, Effectiveness, Patient-Centeredness, Timeliness, Efficiency, and Equity. We call this the “No Needless List”:

 No needless deaths
 No needless pain or suffering
 No helplessness in those served or serving
 No unwanted waiting
 No waste
 No one left outIHI works with health professionals throughout the world to accelerate the measurable and continual progress of health care systems toward these bold objectives, leading to breakthrough improvements that are truly meaningful in the lives of patients.