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DONALD BERWICK Printer Friendly Page

This Will Make You Sicker
By Eileen Toplansky
August 2, 2010

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July 15, 2010

How Donald Berwick Will Run Your Health Care
By Ben Domenech
May 13, 2010


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  • Was appointed by President Bill Clinton to the Advisory Commission on Consumer Protection and Quality in Healthcare
  • Supports a government-run, single-payer health care system
  • Said: "[A]ny health-care funding plan that is just, equitable, civilized, and humane must ... redistribute wealth from the richer among us to the poorer and the less fortunate. Excellent health care is by definition redistributional."

Donald M. Berwick was born in 1946 in New York City, and was raised in the small town of Moodus, Connecticut. After receiving a bachelor's degree from Harvard College in 1968, he went on to earn a master's in public policy from Harvard's Kennedy School of Government and an M.D. from the Harvard Medical School, both in 1972.

Berwick started his medical career as a pediatrician in an HMO known as the Harvard Community Health Plan (HCHP). In 1983, the head of HCHP appointed Berwick as Vice President of Quality-of-Care Measurement, a position that required him to travel around the United States and study quality-control measures in other industries (such as aeronautics and manufacturing), with the aim of applying those same principles in health-care settings.

In 1987, Berwick and a group of associates received a grant to initiate a National Demonstration Project on Quality Improvement in Health Care; through this program, Berwick and his colleagues shared their suggestions with 21 health organizations across the U.S.  In 1989, Berwick left his job with HCHP in order to teach courses on how to improve medical treatment in the United States. Two years later, he used additional grant money to establish a nonprofit organization known as the Institute for Healthcare Improvement (IHI), based in Cambridge, Massachusetts. He remains the President and CEO of that organization to this day.

In 1997, President Bill Clinton appointed Berwick to the Advisory Commission on Consumer Protection and Quality in Healthcare. From 1999 through 2001, Berwick chaired the National Advisory Council at the Department of Health and Human Services' Agency for Healthcare Research and Quality.

Opposed to free-market health-care systems, Berwick favors a single-payer model. He is particularly fond of Great Britain’s government-run National Health Services (NHS) and its National Institute for Health and Clinical Excellence (NICE), a body of bureaucrats who evaluate the relative costs and benefits of various medical therapies in order to determine what procedures the NHS will cover.

In Berwick's calculus, America's health-care system traditionally has been inferior to Britain's because of the free-market elements present in the U.S. system. In 2005 he said, disparagingly, that “up to 98,000 Americans each year die in hospitals, not from the diseases that brought them there but from injuries caused by their medical care.” Berwick contends that the American health-care system would be safer if physicians had fewer opportunities to make decisions regarding the treatment of their patients, and were required instead to follow established, formulaic protocols as spelled out by a bureaucracy modeled on the British NICE. "The more I have studied it, the more I believe that less discretion for doctors would improve patient safety," Berwick said in 2004. "Doctors will hate me for saying that." Added Berwick on another occasion: "Young doctors and nurses should emerge from training understanding the values of standardization and the risks of too great an emphasis on individual autonomy."

In 2008 Berwick co-authored an article for the journal Health Affairs, where he explicitly advocated the rationing of care: "The hallmarks of proper financial management in a system … are government policies, purchasing contracts, or market mechanisms that lead to a cap on total spending, with strictly limited year-on-year growth targets." On another occasion, in a June 2009 interview, Berwick stated: “It’s not a question of whether we will ration care. It is whether we will ration with our eyes open. And right now, we [Americans] are doing it blindly.”

On July 1, 2008, Berwick traveled to Britain to deliver a speech at a 60th anniversary celebration of the NHS. In that address, he depicted the U.S. health-care system as chaotic, likening it to “a zoo” where hundreds of “immoral” health-insurance companies were recklessly running up administrative costs that were “at least three times as much as in England, maybe more.” Berwick told his audience that American insurance companies “have a strong interest in not selling health insurance to people who are likely to need health care”; and that they “try to predict who will need care, and then to find ways to exclude them from coverage through underwriting and selective marketing” -- all in the interest of “increas[ing] their profits.”

Condemning “the darkness of private enterprise” for having made health care “unaffordable as a human right” in the United States, Berwick lauded Britain's NHS for “guaranteeing it as a human right.” He derided people who favored free-market systems as benighted ideologues who had gullibly sworn allegiance to “the invisible hand of the market,” rather than choose what Berwick viewed as the wiser alternative: “using [the] tax base to provide a single route of finance.”

Berwick further impugned the American health-care system for having “protected the wealthy and the well, instead of recognizing that sick people tend to be poorer and that poor people tend to be sicker, and that any health-care funding plan that is just, equitable, civilized, and humane must – must – redistribute wealth from the richer among us to the poorer and the less fortunate.” “Excellent health care,” he emphasized, “is by definition redistributional.” (Click here for a video of Berwick's speech.)

In recent years, Berwick has served as Clinical Professor of Pediatrics and Health Care Policy in the Department of Pediatrics at the Harvard Medical School, and as Professor of Health Policy and Management at the Harvard School of Public Health. He has published more than 130 articles in professional journals on health-care policy and related matters. And he has co-authored several books, including Cholesterol, Children, and Heart Disease: an Analysis of Alternatives (1980); Curing Health Care (1990); and New Rules: Regulation, Markets and the Quality of American Health Care (1996).

Berwick is a key backer of Physicians for Human Rights (PHR), an international organization that has aggressively and dishonestly singled out Israel as a human-rights abuser. In 2000 Berwick began donating thousands of dollars to PHR, which was then focusing most of its investigations on the Jewish state's alleged mistreatment of Palestinians during the newly launched Intifada. Berwick continued to support PHR in 2002, when the group falsely charged that the Israeli Defense Force had massacred hundreds of Palestinians in Jenin. Indeed, Berwick backed PHR even after it had presented an award to Eyad Sarraj, a Gazan activist who endorsed suicide bombings against Israeli civilians. The American Thinker points out further that in 2008-09 PHR accused the Israeli military of deliberately targeting Palestinian medical facilities and wounded civilians during Operation Cast Lead, and that PHR has played "a pivotal role in the campaign to prosecute American officials for alleged acts of torture committed at the Guantanamo Bay prison camp." Through all this, Berwick's support for PHR has remained steadfast.

On July 7, 2010, President Barack Obama appointed Berwick as Administrator of the Centers for Medicare & Medicaid Services (CMS), which oversee those two federal programs. It was a recess appointment, meaning that Berwick did not come under Senate scrutiny prior to securing the position.

To remain in effect, a recess appointment must be approved by the Senate before the end of the next session of Congress, otherwise the position becomes vacant again. Thus Obama nominated Berwick for the CMS post in January 2011. But Berwick was unable to garner enough votes for Senate confirmation, and resigned from CMS the following December.

In June 2013, Berwick announced that he would be running for the governor's seat in Massachusetts.



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