Finally, a real pony for me and my friends. President Obama may have set back bipartisanship by several minutes in using a recess appointment to put in place his choice for Administrator of the Centers for Medicare and Medicaid Services (CMS). The move was announced an hour ago on the White House blog. I'm no expert in this field, but my son-in-law is deeply involved in the health care battles, and he is quite excited. Republicans had promised a huge fight on this appointment so it's great to see Obama just get it done.
In April, President Obama nominated Dr. Donald Berwick to serve as Administrator of the Centers for Medicare and Medicaid Services (CMS). Many Republicans in Congress have made it clear in recent weeks that they were going to stall the nomination as long as they could, solely to score political points.
But with the agency facing new responsibilities to protect seniors’ care under the Affordable Care Act, there’s no time to waste with Washington game-playing. That’s why tomorrow the President will use a recess appointment to put Dr. Berwick at the agency’s helm and provide strong leadership for the Medicare program without delay.
CMS has been without a permanent administrator since 2006, and even many Republicans have called on the Administration to move to quickly to name a permanent head.
There’s no question that Don Berwick is the right choice to be our next CMS administrator: he’s the founder of the Institute for Healthcare Improvement and has spent decades as a practicing physician and a Harvard professor. He’s dedicated his career to finding ways to make our health care system work better for patients and cost less for taxpayers.
Dr. Berwick has the support of hundreds of health care groups and experts, including the AARP, the American Medical Association, and the CMS administrators under the most recent Republican presidents. As Mark McClellan, who served as Administrator under President George W. Bush from 2004-2006, said:
“What happens at CMS in the next few years will determine whether the new legislation actually improves quality and lowers costs. Don [Berwick] has a unique background in both improving care on the ground and thinking about how our nation’s health care policies need to be reformed to help make that happen.”
Organizations with solid reputations as advocates for sensible health care are applauding this move.
"The Obama Administration is making the best and only choice with a recess appointment of Donald Berwick, M.D. to serve as Administrator of the Centers for Medicare and Medicaid Services (CMS). Dr. Berwick is a highly qualified candidate with extraordinary skill, vast experience and deep dedication to improving America's health care system. Yet he has been the victim of ugly and baseless attacks by opponents of health reform who wanted to undermine his nomination.
Just last week, the Campaign for Better Care organized some 90 of the nation's top consumer, purchaser and provider groups to issue a stirring defense of Berwick. Despite that strong, broad-based support, opponents have continued to misrepresent his work and distort his positions.
My son-in-law tells me that he can vouch for at least one of the organizations strongly supporting this move, Community Catalyst, which is run by Robert Restuccia, an old-time union organizer who represents the interests of we the people with integrity.
If you want to get a feel for the solid humanist, patient-centered credentials of Berwick, read this blog he wrote in May 2009. (It is very promising for this progressive that, in googling for this article, I was told to put the word "radical" in google along with other terms.)
I freely admit to extremism in my opinion of what patient-centered care ought to mean. I find the extremism in a specific location: my own heart. I fear to become a patient. Partly, that fear comes from what I know about technical hazards and lack of reliability in care. But errors and unreliability are not the main reasons that I fear that inevitable day on which I will become a patient. For, in fighting them, I am aligned with the good hearts and fine skills of my technical caregivers, and I can use my own wit to stand guard against them.
What chills my bones is indignity. It is the loss of influence on what happens to me. It is the image of myself in a hospital gown, homogenized, anonymous, powerless, no longer myself. It is the sound of a young nurse calling me, "Donald," which is a name I never use—it’s "Don," or, for him or her, "Dr. Berwick." It is the voice of the doctor saying, "We think...," instead of, "I think...," and thereby placing that small verbal wedge between himself as a person and myself as a person. It is the clerk who tells my wife to leave my room, or me to leave hers, without asking if we want to be apart. Last month, a close friend called a clinic for her mammogram report and was told, "You have to come here; we don’t give that information out on the telephone." She said, "It’s OK, you can tell me." They said, "No, we can’t do that." Of course, they "can" do that. They choose not to, and their choice trumps hers: period. That’s what scares me: to be made helpless before my time, to be made ignorant when I want to know, to be made to sit when I wish to stand, to be alone when I need to hold my wife’s hand, to eat what I do not wish to eat, to be named what I do not wish to be named, to be told when I wish to be asked, to be awoken when I wish to sleep.
Call it patient-centeredness, but, I suggest, this is the core: it is that property of care that welcomes me to assert my humanity and my individuality. If we be healers, then I suggest that that is not a route to the point; it is the point.