Donald Berwick Nominated CMS Administrator

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By adding nearly 31 million more people to the U.S. health care system, the success of Patient Protection and Affordable Care Act (PPAC) will largely rest on the progress of one major agency in dealing with the new influx of patients who will be using two of the government’s largest run health programs: Medicare and Medicaid. To begin this implementation, the President yesterday appointed Dr. Donald Berwick for Administrator of the Centers for Medicare and Medicaid Services (CMS).

Dr. Berwick graduate summa cum laude from Harvard College, he also holds a Master in Public Policy degree from the John F. Kennedy School of Government, and he received his medical degree from Harvard Medical School, where he graduated cum laude.

He currently serves as President and CEO of the Institute for Healthcare Improvement, which is an independent not-for-profit organization helping to lead the improvement of health care throughout the world.  The Institute was founded in 1991 and is based in Cambridge, Massachusetts. The mission of the organization is “to accelerate improvement by building the will for change, cultivating promising concepts for improving patient care, and helping health care systems put those ideas into action.”

Dr. Berwick is also a Clinical Professor of Pediatrics and Health Care Policy at the Harvard Medical School and Professor of Health Policy and Management at the Harvard School of Public Health. He is also a pediatrician, adjunct staff in the Department of Medicine at Boston’s Children’s Hospital and a consultant in pediatrics at Massachusetts General Hospital. According to the White House’s press release, “Dr. Berwick has dedicated his career to improving outcomes for patients and providing better care at lower cost.”

His past experience also includes serving as the Chair of the National Advisory Council of the Agency for Healthcare Research and Quality, and as an elected member of the Institute of Medicine (IOM). Dr. Berwick served on the IOM’s governing Council from 2002 to 2007. In 1997 and 1998, he was appointed by President Clinton to serve on the Advisory Commission on Consumer Protection and Quality in the Healthcare Industry. The press release also acknowledges numerous awards that Dr. Berwick has been the recipient of.

Organizations that have already announced their support for Dr. Berwick include the American Medical Association (AMA) and the seniors group AARP.

Now that his appointment is official, Dr. Berwick will face a Senate Confirmation hearing, held by the Senate Health, Education, Labor, and Pensions (HELP) Committee, where Senators are still bitterly divided over the health care overhaul, which may make his confirmation difficult.

According to the Boston Globe, “Berwick could face a tough nomination fight because his cost-cutting ideas could be seen as rationing, leading the Senate to revisit discredited claims that the health care law will include "death panels" assigned to deciding who lives and who dies.” Since the announcement, Republican aides have also been “scouring Berwick's writings, looking for controversial rhetoric.”

Similar to Supreme Court nomination hearings—one that is likely to be announced soon as well—Dr. Berwick’s hearing will “provide the Senate with another platform to fight about health care overhaul, an issue Republicans believe will be key to depleting Democratic majorities in Congress in this November's elections.”

It is amazing that CMS which is responsible for the largest and most complex entitlement program in the federal government had not had an administrator for over two years.  Unfortunately for the President nominations even for the most non controversial appointments take up to six months for the Senate to approve.  Nominees are just that nominees and not allowed to work at the agencies they may eventually run until their confirmation.   This leaves CMS at this crucial time implementing healthcare reform without a leader.

Regardless of whatever political stage or conflicts over health care that may develop, America needs someone who will support the mission and collaboration of science, academia, medicine, industry and physicians.

Adding millions of Americans into CMS will necessitate new ways of diagnosing and treating diseases, which will depend on the effectiveness of new research, therapies, and drugs. More patients will also mean the need for more medical devices and diagnostic tools that can help with prevention and early detection of illnesses.

As a result, we will need a leader that supports industry-physician relations to help address these needs because government funding will not be enough.

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