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Q&A: Don Berwick Reflects on Healthcare Reform, Part II

Cheryl Clark, for HealthLeaders Media, December 10, 2012

HLM: So how have you been spending your time in the last year?

DB:  For the 30 years prior to CMS, I had been deeply engaged with the improvement movement in the US and abroad, trying to help healthcare get better.

All that got interrupted by my stint in Washington, because there are ethics and procedural guidelines one has to follow, and that disrupted some of those long-standing professional and personal relationships.

So I've been working and visiting with hospitals, healthcare systems and physician groups who are trying to think about the new climate they're in, and how much better care can be with redesign.

And abroad, in Singapore, England and New Zealand, studying what they are doing and learning. Singapore, for example, is very concerned about its aging society, and continuity of care. Their population is growing very fast because they have long lifespans.

And I've been really interested in visits with communities around the U.S. where I see interesting changes starting to take place, where organizations are thinking hard about how to adopt strategies focused on patient centered and community based care.

HLM: What questions should I have asked you that I didn't?

DB: You didn't ask me the optimist or pessimist question. The answer is, I'm an optimist. I like what I'm seeing at the local community level. And the next couple of years, the story of healthcare in America may be told community by community rather than from inside the Washington beltway.


Cheryl Clark is senior quality editor and California correspondent for HealthLeaders Media. She is a member of the Association of Health Care Journalists.
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5 comments on "Q&A: Don Berwick Reflects on Healthcare Reform, Part II"


RK (12/11/2012 at 4:48 PM)
Where can we learn about how the future story of health care is being told? Of strategies referred to in communities in the US, Singapore, and New Zealand that improve community and individual care.

dr. dre (12/10/2012 at 5:51 PM)
Re: "DB: Right. Right now, with $2.7 trillion in play, the status quo is very, very loud, and very well funded, and heavily connected to campaign finances, because lobbyists have earned entry into the politicians' doors. They speak loudly, and they do not always defend the interests of the poor. The importance of making sure that medical treatment actually works, the toxicity of overtreatment, the need for better valuation of clinical practices[INVALID]all of those things don't have the voice that the status quo has. HLM: Which lobbyists are you referring to? DB: Anyone whose job depends on the status quo, and for whom changes are painful. They would rather see things continue or even get more support for what they do." This is a breath-taking assault on free speech. He would deny stakeholders the right to voice their opinions? Assuming he was correctly quoted, this is frightening.

mike stebbins (12/10/2012 at 1:03 PM)
the VA already makes "death panel" like decisions. They decided that since I was 52 year old diabetic they wouldnt fix a serious stenosis at C5-C6 because, "you arent going to live long enough to enjoy the benefits of the procedure" my terminal illness? Well controlled diabetes and otherwise in good health. If the VA can make those kinds of decisions with impunity, what is to stop CMS for doing the same?