The eminent appointment of Donald Berwick, MD, as head of CMS (Centers for Medicare & Medicaid Services) may seem like a step in the right direction. After all, Dr. Berwick is well known for championing improvements to health care. “At least he’s a doctor,” some might say. But is appointing a doctor really giving physicians a place at the table? Dr. Berwick is also politically capable. Few could argue the reasons for putting him on the list of candidates. But is that reason enough to make the appointment? Is appointing an MD really a place at the table, or is that allowing a doctor to work as a server for the dinner guests?
It stands to reason that Washington is going to appoint someone who is politically astute. It also stands to reason that President Obama would appoint someone capable of delivering fiery rhetoric. In 2004, he unequivocally stated “I’m losing my patience. Not with the people in healthcare, but the system itself. Healthcare professionals are doing so many things so well; they’re putting actual transformation within reach. Now we need to grab it. The clock is a tyrant, and if you spend too much time ‘getting ready,’ you’re going to lose.” In another campaign, he noted “… the attention of the strategic leaders in healthcare has not been focused on the improvement of care. The strategic objectives have focused on more traditional goals such as growth, marketing and capital development. We need leaders to create a new future, not defend the status quo.” In a keynote speech last year, Dr. Berwick was bold enough to state that anyone who claims the U.S. healthcare system is the best in the world is not looking at the facts. Dr. Berwick is clearly a man of passion, unafraid to challenge the system. Sounds like the perfect man to repair a broken system, doesn’t it? Unfortunately, the White House has not asked us that question.
