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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