Berwick “Perfectly Designed” for HHS Secretary Post?

Several well-informed sources independently told me that Institute for Healthcare Improvement founder Dr. Donald Berwick had been chosen by the Obama administration to run the Centers for Medicare & Medicaid Services — a fascinating selection. (This article, though, reminds us of Don’s background in public health and in government commissions that deal with a broad swath of the policy elite.)

But would Berwick continue to agree to serve under an HHS secretary with less prestige, Congressional clout, presidential access and deep understanding of health care than Tom Daschle? I’m presuming here that Berwick already had a personal relationship with Daschle and his senior advisers. Still, Berwick has spoken in recent months of reform from “the inside out,” and there are few “insider” positions with more influence over health care than being in charge of the Medicare program.

Alternatively, does Berwick now become a providentially squeaky clean choice for a boost upstairs to HHS secretary? Or does President Obama understand, more than most, that having inspirational oratorical skills and do-gooder instincts is not the same as possessing the political savvy to run a department with a budget of three-quarters of a trillion dollars? But perhaps I am underestimating Dr. Berwick’s political chops. Not to mention the powerful “return to idealism” message a Berwick choice would provide as a counterpoint to the “limousine liberal” Daschle debacle.

As a tireless crusader for quality improvement, Berwick has repeatedly preached the message “that every system is perfectly designed to achieve exactly the results it achieves.” That means he is perfectly qualified to work for the U.S. Government.

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10 replies »

  1. Well, if he wants to redistribute the wealth around, he can give me half of his money…Also, Obama can give me half of his money too. I LOVE America, you put your hand out and there is always someone willing to give you something for doing nothing…So, you two put your money wher eyour mouth is, or shut the h**l up

  2. Donald Berwick is a most excellent choice. I salute Presdent Obama for considering Dr. Berwick. I could have written “hats off” to the President but I wear a turban! [www.fammed.buffao.edu/safety]
    Donald is an enlightned and motivated individual with all the wisdom, knowledge, skills and abilty required to advance the Nation’s objective to provide value for money in healthcare. The Nation needs leaders with sharp minds, with their hearts in the ‘right palce’. Healthcare must address the three vital dimensions of ALL: body, mind and spirit.
    This internationally respected person is the right one, in my view, for taking on this challenge.

  3. We have been begging the Obama administration & our new head of HHS Secretary Sebelius to invite us to the discussion table to lower health care costs. We are still waiting to be contacted. We know you are busy but come on, what will it take to get someone with real world, everyday experience taking care of thousands of the sickest, oldest, and most costly patients to the table?
    Dr Anderson geriatric specialist is well known for her physician home care program over the past 10 years seeing real patients that reduces costs by 75% and increases quality of care.
    See more at:
    and program video at:
    dr anderson & associates

  4. undoubtedly. Dr. Berwick has done more for health care cost & quality that anyone I can think of. Contrast to the limelight seekers of the past, Berwick would actually be committed to the job and do what is in the best interest of our Nation.

  5. For CMS director, the primary requirement should be getting someone who understands the profound damage caused by Medicare’s administered pricing schemes, and who is dedicated to phasing them out and dumping them on the ash heap of history.

  6. I like Jon Kingsdale (Exec Director of the Massachuesetts Connector) for CMS. He is unbelievably savvy about managing the interests of different players in the industry, and his leadership skills in holding the MA health care reform together have been impressive.
    Don Berwick is one heck of a nice guy and a terrific speaker, but Kingsdale has the low profile and track record we need in an effective CMS administrator.

  7. Berwick is excellent but I believe his expertise is too focused on in-patient Hospitals.
    That is NOT the future of economically sustainable US health care
    Rick Lippin

  8. Dr. Berwick has made valuable contributions to the quality improvement movement, but he is extremely hostile to using financial incentives to improve health care, even if such incentives are used to reward higher quality (I get the impression he has contempt for most health economists). On the other hand, a couple of years ago in a Health Affairs interview he declared that physicians who don’t cooperate with quality improvement efforts should be fired. Losing your job is the same thing as a 100% reduction in income—which sounds to me like a pretty severe financial penalty.

  9. I would be elated if Berwick was appointed HHS secretary. He has inspired change in even the most cynical administrators and he truly understands the challenges facing all facets of health care.
    This is one choice that would actually make me confident that the *right* change would happen.