Thursday, July 29, 2010
Welcome, Dr. Donald Berwick. Once you pull the arrows out of your back, you can get down to the important work for which you are supremely qualified: fixing the government health-insurance programs.
President Obama named you head of the Centers for Medicare and Medicaid Services through a recess appointment. That deprived Senate Republicans of another televised round denouncing "socialized medicine" -- though they are
churning out press releases calling
you a "health-care-rationing czar" and advocate of "cookie-cutter medicine."
A pediatrician and expert on medical economics, you are a savior to we who pay the bills through our premiums and taxes. But to the folks milking the system and the politicians they control -- Republicans, but some Democrats, too -- you are a threat.
Nonetheless, the American Medical Association and the American Hospital Association both sing your praises. They also have stakes in this business but understand that you know what you're doing.
You got into trouble by saying that a civilized health care system must treat the poor, and that will require a "redistribution of wealth" from the better- to the lesser-off. That is obvious, if not a politically adroit choice of words. You could have then noted that medical subsidies also go up the income ladder -- such as when dishwashers' taxes support the Medicare benefits of millionaire retirees. In this country, the great majority of the uninsured are working poor. (The very poor have Medicaid.)
Anyhow, you've run programs to reduce medical errors and hospital-acquired infections. That improved care and cut costs at the same time. The former president of Thedacare in Appleton, Wis., credits your "principles of continuous improvement" with helping reduce the cost of inpatient care at his hospital by 25 percent.
When did saving taxpayers money become socialistic? When Republicans decided to define "free-market solutions" as seeing how many tax dollars they can shovel into private coffers.
Exhibit A is their Medicare drug benefit, which was written to enrich pharmaceutical companies and insurers. By forbidding the government to directly negotiate drug prices, Republicans maximized the program's costs. Unlike everyone else in our capitalistic system, taxpayers are apparently not allowed to bargain for a better deal. That would be socialism.
Exhibit B is the Republicans' tireless assaults against the "public option," which was stripped out of the final health care legislation. The public option was to be a government-run health insurance plan that competed with the privately run plans. Its purpose was to stop private insurers from overcharging for their plans -- and sending their inflated bills to the taxpayers.
Speaking of overcharges, socialized medicine and government-run systems, let's look at Exhibit C. Medicare is a government-run system that's far more socialized than anything in the new health care reforms. And it's a major cause of America's growing deficits.
You'd think that the alleged haters of socialism and deficits would at least support ending overpayments
participating in the Medicare Advantage program. But no, the Democrats had to do it alone.
By the way, these bloated charges had driven up the premiums paid by ordinary folks enrolled in traditional Medicare. They tacked an extra $89 to the average couple's 2009 premium, according to the Center on Budget and Policy Priorities.
Dr. Berwick, part of me wishes that your hearing had gone forward. When your critics got to the "wealth distribution" part, you might have asked what in their religion goes against saving the lives of working-class Americans.
Not every manager of medical spending can be trusted to preserve the glories of American health care, but you can. So go forth, Dr. Berwick, and trim a few thousand off our health care bills. We taxpayers won't mind.
COPYRIGHT 2010 THE PROVIDENCE JOURNAL CO.
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Views expressed in this column are those of the author, not those of Rasmussen Reports.
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