Don Berwick

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Christopher Lydon Is Back On WBUR — And Talking Health Care

Christopher Lydon

Christopher Lydon

Mark your calendar (that is, set a smartphone alarm) to tune your dial (that is, set your tablet to livestream WBUR.org) tonight. It’s old news that the lively intellect of Christopher Lydon is back on WBUR, but the fresh news is that tonight, he’s going to be talking health care, with some lofty interlocutors (uh oh, my anticipation seems to be making me channel his vocabulary…) From Radio Open Source:

We’d love to begin the show with some vox pop, as we call it. Please call 617 353 0692 and leave a short message that we can use at the top of the program. Here’s the question: Speaking as a patient, and think of your own health, how is the modern “miracle” medicine working for you?

Our guests in this conversation (9 p.m. Thursday, January 16th on WBUR, Boston at 90.9 FM) will include Dr. Tom Lee, former CEO of Partner’s Healthcare, professor at Harvard Medical School and author of “Eugene Braunwald and the Rise of Modern Medicine”; Dr. Don Berwick, pediatrician and candidate for governor in Massachusetts; and cardiologist Eugene Braunwald.

The Rise of Modern Medicine: do you think of the miracle tech that has made death by heart attacks a rarity? Or do you think of a money-driven industry that’s made heroes out of hospitals at a huge price to patients and the national economy? Dr. Tom Lee makes it a history lesson that unfolded over the last 50 years in Boston. What happened to health in healthcare?

The conversation has already begun in the comments, including this one:

I’ve been in the healthcare business for 25 years as a sales representative. The buildings keep getting bigger, the administrations more dense, the regulation more arcane…There is so much money thrown at healthcare; how could this NOT happen?

Listeners, would love to hear afterward what you think.

What Makes Berwick Run: Spurned Medicare Chief Seeks To Lead Massachusetts

Dr. Donald Berwick (Jesse Costa/WBUR)

Dr. Donald Berwick (Jesse Costa/WBUR)

Dr. Don Berwick — pediatrician, health care improvement guru, Anglophile, Obamacare booster — has a really, really great bedside manner. He leans in; he listens. He’s deeply thoughtful about seemingly intractable problems (Medicaid expansion, for instance, or the way doctors get paid) without being alarming. In short, he’s the guy you want in the exam room when your kid falls off the jungle gym.

And if you live in Massachusetts, he wants to be your governor.

The last time you probably heard about Berwick, a Democrat, he was being lambasted by certain (Republican) members of the U.S. Senate who vowed to block his confirmation as President Barack Obama’s designated Administrator of the Centers for Medicare and Medicaid Services. Berwick served as the head of CMS for 17 months, and then, with regret but little discernible bitterness, he returned home to Newton, Mass., and decided to run for governor. (Before heading CMS Berwick served as the director of the Institute for Healthcare Improvement, a nonprofit in Cambridge.)

We spoke with Berwick mostly about health care on his way to more far-ranging interview on Radio Boston. In a 30-minute discussion, Berwick talked about the “majestic” Affordable Care Act and compared re-inventing health care to throwing a hat over a very tall wall and climbing over to retrieve it. Here, edited, is some of our (very long) interview:

So, overall, how is your campaign going?

I’m thrilled by how things are going. Of course, people are interested in health care, it’s a very big issue for our country and our state. We have to get this right. I keep saying the truth, which is that the eyes of the country are on Massachusetts. We’re, what, five years ahead of the country in broadening coverage. Health care is a human right in the state now, and you can’t say that in any other state, and that’s what began in 2006. So we’re kind of pioneers for the country. Now, in order to make that possible, we have to reform health care.

Health care has to meet people’s needs better, at lower cost, without harming anyone, but by making health care better, that’s the best way to improve, to contain costs. That’s the journey we’re on, since the cost containment enterprise is now started, and everyone’s watching, everyone’s watching. Continue reading

Essay: Patient’s Death Highlights Medicine’s Promise, Failure

(bogelo/flickr)

By Jonathan Adler, Ph.D.
Guest Contributor

A new class of doctors entered the world this spring: medical school graduates, who will join the legions of caretakers we turn to for insight and comfort and rescue. Among the most elite of this new group of caretakers are those who graduated from Harvard Medical School in May. Their graduation speaker was Dr. Donald Berwick, the former Administrator of the Centers for Medicare and Medicaid Services. His speech, reprinted in a recent issue of the Journal of the American Medical Association, eloquently highlighted both the “glory of biomedical care” and its blind side. Dr. Berwick dedicated his address “To Isaiah,” as he told the story of one of his patients from many years ago whose life and death touched him and stands as a call to action for what the medical profession ought to be about.

Dr. Berwick met Isaiah when he was 15 years old, a rough kid from a rough neighborhood, living with his mother, his brothers, and his mother’s ten foster children in a third-floor walk-up in Roxbury. Isaiah had a bad case of leukemia and a worse case of despair. As Dr. Berwick put it, in the sanctity of his clinic at Children’s Hospital, “the glory of biomedical care came to Isaiah’s service” and over time Isaiah was cured of leukemia. But years later, Isaiah was found convulsing on a street corner, brain dead as the result of uncontrolled diabetes. He never came out of this state and died two years later, at age 39. As Dr. Berwick said, “Isaiah, my patient. Cured of leukemia. Killed by hopelessness.”

Dr. Berwick gleans two lessons from the sad story of Isaiah. First and foremost, doctors must vociferously attend to their patients’ illnesses, no matter who their patients are. And second, that doctors must also seek to cure the injustice that Dr. Berwick believes was the true cause of Isaiah’s death. Continue reading

GOP Pounds Berwick In Hearing On Health Care

It would be no surprise if Don Berwick, at one time an even-tempered Harvard pediatrician, is now questioning his decision to become the administrator of the Centers for Medicare and Medicaid Services in the rough-and-tumble era of national health reform.

Today, according to a report in The Boston Globe, Berwick got “pounded” by House Republicans who finally got their chance to grill him during testimony at a Ways and Means Committee hearing on health care. Here’s an excerpt of the exchange, in which Berwick staunchly defends the new law:

Under pointed questioning, Berwick was unflappable and sounded enthusiastic, even while frustrating Republicans by refusing to offer a “yes” or “no” answer to many questions.

In one exchange, Committee Chairman Dave Camp, a Michigan Republican, pressed Berwick repeatedly on Berwick’s past praise for the British health care system.

“Is the British health care system a good model?” Camp asked.

“The American health care system needs an American solution,” Berwick replied.

Camp persisted, asking: Do you still think a government-run single payer system is the best option?

“I believe the Affordable Care Act is the right solution for America,” said Berwick.

“If I could have a simple yes or no answer?” said Camp.

He didn’t get one.