The U.S. health care system got more well-deserved criticism last week from an official who, unfortunately, will not be around to follow through on some of the reforms he instituted as head of the Centers for Medicare and Medicaid Services, or CMS.
Dr. Donald Berwick says as much as 30 percent of the $2 trillion-plus spent on health care in the United States each year is wasted. The causes: overregulation, overtreatment, overcomplexity, undercommunication and fraud.
Not that inefficiency in health care delivery is news. The U.S. spends twice as much per patient as any other country, with little to show for it. By some measures of medical outcomes, we are a Third World country.
Berwick was very familiar with the deficiencies before arriving in Washington, D.C. He had headed the Institute for Healthcare Improvement and, among other tasks, he had been commissioned to help improve Britain’s National Health Service, for which he had perhaps too many kind words.
Because Republicans were fixing to bat those comments back at him during confirmation hearings, President Barack Obama gave Berwick the CMS job during a congressional recess. That appointment was due to expire at the end of December, so Berwick resigned.
Democrats, it should be noted, refused to confirm President George W. Bush’s CMS appointees from 2006 to 2009.
Berwick was respected, if not appreciated, by conservatives as well as liberals. New GOP presidential front-runner Newt Gingrich in 2000 praised Berwick’s efforts to improve health care efficiency, but last year condemned Berwick’s favorable opinion of the British national health care model.
That’s just Newt being Newt.
Berwick will get over CMS. He heads back to private-sector posts that reportedly paid him more than $900,000 before he packed for the D.C. job. But the agency, with a $960 billion budget that exceeds the Pentagon’s, loses an able administrator who during a short tenure launched programs that targeted two major sources of America’s health-system ills.
One, Partnership for Patients, is an attempt to reduce illnesses and complications incurred in hospitals. The second, Million Hearts, will work toward a reduction in the incidence of heart attack and stroke by upgrading the quality of and access to care, increasing public awareness of the causes, and recommending remedial lifestyle changes.
CMS has also made headway against fraud: $4 billion was recovered for the Medicare Trust Fund last year.
Those efforts, as Berwick knows, beg the fundamental question: How will the U.S. bring health care expenses down to a sustainable level?
Too bad he was not given the time, by Congress or an overcautious president, to work toward solving some of the problems he identified.
Berwick says the nation rations health care already, but badly. It’s a fact few in Washington want to acknowledge. The messenger is gone, but the message remains.