Wednesday, July 28, 2010

Disgraceful Republican Attacks on Don Berwick

The Republican attack machine is at it again. Here's what they're saying about Don Berwick, President Obama's inspired choice to lead Medicare and Medicaid:
Utah Senator Orin Hatch: "Dr. Berwick has a great reputation as a pediatrician, but he's made some of the most outlandish statements I've heard in years."

Wyoming Senator John Barrasso, who is an orthopedic surgeon: "health care rationing czar."

Texas Representative John Carter: "Dr. Berwick is a proponent of the British health care system and believes in rationing your health care and redistributing wealth."
I assume that as with the preposterous "death panel" demagoguery, these intelligent men know better. Unfortunately, the Republican campaign of disinformation is likely to be effective.

Anyone with even a modicum of understanding of health care knows that the U.S. rations by income and access to insurance. Those with a bit more knowledge understand that rationing is an ethical requirement, not a moral abomination, if we're ever going to slow the cancerous growth of health care costs.

Berwick's consistent message is that by steady concentration on quality we will improve health and save money at the same time. And, if it is still necessary to contain costs, which it will be, we should ration in a thoughtful manner, concentrating on high cost/low yield areas, rather than on the purely economic grounds we apply at present.

Claiming that rationing (a) does not happen now and (b) is part of a Democratic plot is (c) in line with the Republican claim that reducing taxes on the wealthy will help to lower the deficit. But telling lies in a tone of certainty, and repeating the lies often enough, has proved, alas, to be a effective partisan tactic.

Attacking Berwick for his recognition of the admirable accomplishments of the National Health Service plays well with American exceptionalism and jingoism. But encouraging the body politic to believe that we have nothing to learn from others is like parents telling children they already know enough so why bother with reading or arithmetic.

Health care ethics requires open mindedness and thoughtful deliberation. The Republican tactics are like shouting "fire" in a theater. Insofar as their campaign of fear and disinformation is listened to it will block meaningful health reform and quality improvement.

I hope the administration can orchestrate bold public statements by all of the hospitals and clinics Berwick and his Institute for Healthcare Improvement have helped. The public trusts doctors and nurses more than politicians. The stories these organizations can tell would show the Republican attacks to be disgracefully ill-informed, disgracefully partisan, or both.


Bill Baar said...

Jim Sabin said...

Hi Bill

I went to your blog. Of course you're right that Don has not managed an entity of the scope of CMS. Few people have. His role will be to identify major areas for potential innovation and improvement. This is something he's been doing for at least 30 years. I had the privilige of working with him in the 1980s when I was a medical director at the Harvard Community Health Plan HMO. Don didn't just have great ideas - he gave excellent practical guidance about implementing them. We're lucky to have him at CMS. I'd encourage you to talk with health organizations that have worked with him - you might find your mind changing!



Bill Baar said...

I have...oh I have.

Anonymous said...

The theater's already on fire. The GOP is telling people that the firemen are there to shoot us.

Jim Sabin said...

Dear Anonymous -

I'm sorry for the delay in responding to your comment - I was on vacation at a ranch in Wyoming when it arrived, and I've been slow getting back into the saddle at home.

It's very disheartening that a political party that stands to make major gains in November is behaving exactly as you describe.