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Berwick 'slams' critics of reform law

Former CMS chief outlines five principles for change

Topics: Access to Care, Quality, Performance Improvement, Service, Safety, Outcomes, Accountable Care, Market Trends, Strategy, Health Care Reform

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December 09, 2011

Just days after stepping down at CMS, former Administrator Donald Berwick on Wednesday "slammed" congressional Republicans who stood against the federal health reform law and laid out five principles for health care improvement.

During a speech at the annual conference of Institute for Health Improvement (IHI)—which he led for 20 years—Berwick criticized rhetoric surrounding the overhaul, including the concept of so-called "death panels," which he defined as "the claim, nonsense, fabricated out of nothing but fear and lies, that some plot is afoot to, literally, kill patients under the guise of end-of-life care."

Exit interview: Berwick says farewell to CMS

Calling the notion "hogwash," Berwick noted that palliative care "brings comfort, company, and spiritual and emotional support to people with advanced illness and their families" and "has grown at its best into a fine art and a better science." He said, "[W]e can and should offer people the very best of care at all stages of their lives."

Berwick also discussed use of the term "rationing," and said "the true rationers are those who impede improvement, who stand in the way of change, and who thereby force choices that we can avoid through better care."

In reference to Republican deficit-reduction proposals that would make cuts to Medicare and Medicaid, Berwick said, "It boggles my mind that the same people who cry 'foul' about rationing an instant later argue to reduce health care benefits for the needy, to defund crucial programs of care and prevention, and to shift thousands of dollars of annual costs to people—elders, the poor, the disabled—who are least able to bear them."

Berwick's five principles to change health care
According to the Boston Globe, Berwick laid out five principles he thinks should guide health care improvement:

1. Put patients first;
2. Put the poor and disadvantaged first;
3. Start at scale. He said, "there is no more time left timidity. Pilots will not suffice";
4. Return the money—ensure that employers, states, and taxpayers see their health costs fall; and
5. Act locally.

"The [health reform] law is just a framework," Berwick said in an interview after the conference. "Health care in America can't improve, and it can't become sustainable, without a tremendous amount of community involvement (Baker, "Healthwatch," The Hill, 12/8; Dunis, CQ HealthBeat, 12/8 [subscription required]; Galewitz, Kaiser Health News/National Journal, 12/8 [subscription required]; Conaboy, Globe, 12/8; Conaboy, "White Coat Notes," Globe, 12/8).

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