Opposition to Berwick is no great surprise

In GOP targets nominee to run health agency, the Boston Globe details plans by Republicans to oppose Dr. Don Berwick’s nomination to run the Centers for Medicare and Medicaid Services (CMS).

Berwick, a pediatrician and president of the Institute for Healthcare Improvement, a not-for-profit organization in Cambridge, is widely respected by many veteran policy officials across the political spectrum, who say he has a firm understanding of how to overhaul parts of the healthcare system that lead to excessive costs, waste, and poor health outcomes.

But GOP lawmakers are becoming increasingly vocal in their attacks on Berwick, citing his support of controlling costs and his statements praising aspects of the United Kingdom’s national health system. They contend his positions show that he would seek to transform US health care into a tightly controlled system, reducing patient choices and delaying treatments.

It’s not surprising to see opposition to Berwick. The same thing would happen to any Obama CMS nominee as Republicans try to find a way to whip up fear and anxiety about health care reform. But the Republicans are in a funny spot on health care spending. Somehow new government spending programs (like the recent health reform law) are bad. But once programs are in place for a while (like Medicare) –more spending is good.

Scare tactics about delaying treatment and reducing choice by rationing do not necessarily hold water either. Somehow it’s accepted that socialized systems have waiting lists and delays while access is easy in the US system, at least for those with health insurance. Yet socialized systems often have accountability for waiting times — such as these detailed UK waiting time stats– whereas in the US it’s hard to even get systematic information.

When waiting times are studied we don’t always look so great. Anecdotal experiences bear that out. Recently a close relative told me about a referral she was given for her son to a pediatric orthopedist in Boston. She has first-rate commercial health insurance and an excellent primary care pediatrician. Yet the first appointment she was offered was three months in the future.

Berwick is a strong choice to lead CMS and I hope he is confirmed.

May 13, 2010

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