The White House has announced that President Obama will bypass the nomination process of the United States Senate in order to make a recess appointment of Dr. Donald Berwick to be the head of the Centers for Medicare & Medicaid Services (CMS). This is due to the fact that the White House has been unable to even get a hearing scheduled by the Senate, much less go through the process.
I believe that this nomination is of great importance, and it signals that the administration is serious about moving forward on creative and needed health care reform. Dr. Berwick has been universally praised by a wide spectrum of health care leaders as the best man for this job. President Obama has chosen a strong advocate for a patient-centered health-care system to be in charge of much of health-care reform. This is a very good thing!
There are three aspects of health-care reform that must be considered simultaneously if we are to achieve real reform - cost, access and quality. Cost and access have both proven to be politically polarized topics. Quality, however, should be what unites us all, and that is the experience that Dr. Berwick brings to the table. Dr. Berwick has done more than anyone champion quality and his organization, the Institute for Healthcare Improvement (IHI), is famous among physicians for catalyzing health-care providers around how to improve their care and decrease error. This should not be an ideological issue. Unfortunately, the radical right has already pounced on this announcement, and referred to Berwick as a "radical". This is a tragedy. If Dr. Berwick is a radical, it is because he favors that health care reform must revolve around thechoices, preferences and desires of patients, and not insurance companies. That truly would be a radical change from what we have today. He elevates the needs of patients above insurance companies, government or medical providers.
It has been my privilege to work with Dr. Berwick right here in Bellingham and Whatcom County. The Pursuing Perfection project began in 2001, when Family Care Network and St. Joseph Hospital worked with other community partners to reorganize their work around the patients that we serve. We were one of13 locations in the US and Europe to focus on fundamental improvement in patient care throughout the health care system, and Dr. Berwick traveled to meet with us as a part of the involvement of IHI. He is the real deal.
If a man like Dr. Don Berwick cannot find a smooth confirmation because of political polarization, then no leaders can. That means that the best people will continue to ignore the call of public service, since an unimpeachable record of achievement will be less important than political ideology. What a shame. No, what a tragedy.