Dr. Donald M. Berwick, head of Medicare and Medicaid until last Thursday, stated that up to 30% of spending on health is wasted with absolutely no benefit to beneficiaries (patients). He added that his agency’s cumbersome and archaic regulations are partly to blame. He claims too many resources and too much time is dedicated to things that do not help patients one bit; something doctors are fully aware of too. In an interview last Thursday, Dr. Berwick said: “Much is done that does not help patients at all,

and many physicians know it.” During the interview, Berwick talked about the previous 17 months, while he was at the helm as Administrator of the Centers for Medicare and Medicaid Services, his failures, successes and frustrations, and dealing with criticisms from Republican lawmakers. Berwick’s appointment, which was to expire at the end of 2011, was done in a way that drew criticisms from both sides of the House. President Barack Obama nominated him in April 2010, then there was an investigation regarding his qualifications, subsequently a temporary recess appointment was given to bypass Congress. In Thursday’s interview, Berwick said: “I did not even know if I was fit for it. I came with an agenda. I wanted to try to change the agency to be a force for improvement, covering one out of three Americans.”

Government is much more complex than he had realized Berwick went on to explain that the new health legislation is a “..complex and complicated” one. It is a law that takes time to explain properly. “To understand it takes an investment that I’m not sure the man or woman in the street wants to make or ought to make.” He admitted that government is much more complex than he had realized. Berwick had been President of the Institute for Healthcare Improvement, an organization that trains health professionals; a much faster-moving environment compared to public office. Being a federal official would sometimes infuriate him, because of the much slower pace. Even so, because of the new law’s ultimate destination, it should be supported, Berwick stressed. He gave the manned moon missions as an example – people did not fully understand the intricacies of rocket science, but supported the ultimate aim of the mission. Dr. Berwick said: “We are a nation headed for justice, for fairness and justice in access to care. We are a nation headed for much more healing and much safer care. There is a moon shot here. But somehow we have not put together that story in a way that’s compelling.” If up to 30% of Medicare and Medicaid’s spending is being needlessly squandered, reigning in that waste could save between $150 billion and $250 billion annually. Dr. Berwick said: “I wish they (government) could go faster. I don’t think you want government to be impulsive. You want it to be regulated, with just a tad of conservatism.” Berwick listed five reasons for the enormous waste in health spending: Patients are overtreated

There is not enough coordination of care

US health care is burdened with an excessively complex administrative system

The enormous burden of rules

Fraud

Donald M. Berwick (born 1946)

Dr. Donald M. Berwick, Administrator of the Centers for Medicare and Medicaid Services, July 7, 2010 – December 2, 2011 Dr. Berwick was nominated to be Administrator of the Centers for Medicare and Medicaid on April 19th, 2010. Some newspapers at the time commented that he might be able to reduce health care costs. He was criticized by Republicans regarding some comments he had made about health care, saying it involves a redistribution of wealth, rationing care with “our eyes open”. In the United Kingdom there is universal healthcare, everyone is covered, and healthcare spending represents less than 7% of the country’s GDP. The USA, on the other hand, spends over 17% of GDP on healthcare and has over 50 million people with no coverage at all, and tens of millions more with inadequate coverage. Berwick advocated adopting some of the NHS (National Health Service) approaches of the UK and its NICE (National Institute for Health and Clinical Excellence). NICE decides which therapies and drugs are covered by the NHS. Conservatives dubbed him “Obama’s rationing man.” They said NICE decides what treatments people can and cannot have in the UK. This is untrue – NICE decides which treatments and therapies people will get free (if NICE does not approve it, private health care can still offer it, if it is approved by another national regulatory agency, the MHRA, the UK equivalent of the FDA).