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The Case Against (and for) Donald Berwick

Margaret Dick, for HealthLeaders Media, March 16, 2011
Major Players Endorse Berwick

The White House has released a seven-page, single-spaced document that lists more than 200 organizations that support Berwick’s nomination. Here are some of the ones that really matter: AARP, AMA, AHA, AHIP, Medical Group Management Association and the American Public Health Association. When was the last time they all agreed on anything?

Why he should stay: It looks like Berwick can get everyone to the table and that is vitally important as ACA moves to implementation.

Why he should go: No downside here.

Why it may not matter: Berwick can stay right where he is until the end of 2011. By then he will have filled his management positions with people who pretty much think like him. Marilyn Tavenner, who is now second in charge at CMS, would probably become the acting director. Also, the Obama administration has tucked the Office of Consumer Information and Insurance Oversight into a safe place within the mammoth CMS. It is a preemptive move to counter legislative efforts to defund the office, which is charged with developing healthcare reform rules and regs. Steve Larsen, the widely respected and consumer-friendly former Maryland insurance commissioner, heads that office and has already issued a first round of rules.

Why it does matter: His supporters consider Berwick a visionary and an innovator in terms of patient-centered quality healthcare. As the head of CMS he will have the final say over what pilot projects are funded through the new Center for Medicare and Medicaid Innovation. That is important because much of the heavy lifting in terms of policy development will be formed around the successful pilots.

Berwick's chances for confirmation depend more on politics than anything else.

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7 comments on "The Case Against (and for) Donald Berwick"


Obamacare rationing (11/28/2011 at 1:09 PM)
"Berwick's record as a healthcare shepherd is unassailable." Should read: "Berwick's record as a healthcare shepherd fleecing the flock with his ideals about rationing is unassailable."

sheryl.oconnor (3/21/2011 at 5:10 PM)
Don Berwick, MD is who we need at the top of the CMS food chain. If I could vote, he would have mine hands down. He is an innovator who has done so much for quality in healthcare. Not voting him in would be a travesty and I would hope that President Obama would work this across the aisle with the Republicans. We will all lose if Congress doesn't vote Dr. Berwick into this position.

Michael Millenson (3/19/2011 at 11:47 AM)
The statement that 60 votes are needed to confirm is factually incorrect. A majority, 51 votes, is needed. But because the Republicans have threatened a filibuster [INVALID] and filibusters have become so easy, for both parties - 60 votes are needed to stop a filibuster. It's clear the votes are not there to do that, so the nomination is dead on arrival. The reporter and editors should know the rules of Congress. It's pretty easy.