Dr. Donald Berwick, in his first major speech as administrator of the Centers for Medicare and Medicaid Services, said that he intends to change the U.S. health care system profoundly and do it by aggressively implementing the Affordable Care Act.
The job “I came here to do is helping to change health care in America to realize its full potential,” Dr. Berwick said during the speech to health insurance executives at the America's Health Insurance Plans' 2010 Medicare Conference.
Dr. Berwick asked the executives for their help in taking the Affordable Care Act beyond its current modest beginnings.
“We need your help. Our nation needs your help. You have and will have a profound influence on the direction our country will take in the crucial next few years,” Dr. Berwick said at the conference.
Calling the new act primarily “a question” rather than an answer, Dr. Berwick said it asks, “Will we redesign health care in America?”
In a more sobering note, the CMS chief also said that “those who wish only to preserve the status quo … cannot be effective partners, and we simply do not have time to pretend that they are. We do not have time for games anymore.”
Dr. Berwick, the former president and CEO of the Institute for Healthcare Improvement, said he would guide the CMS by the “triple aim” set of goals he established at IHI: better quality of care for patients through efficiency and “patient centeredness,” better health for populations through illness prevention, and lower costs by cutting waste and medical errors. “I intend to guide CMS toward the Triple Aim as our highest-level goal,” he said.
Dr. Berwick said that too much U.S. health care is now fragmented, and explained in personal terms what he meant.
“Too many of us know what fragmented, disorganized care looks like. You have to tell your name and address and story again and again to everyone you see. No one seems to talk to each other. Your record is forgotten or unavailable. One doctor prescribes a medicine that conflicts with a medicine another doctor prescribed,” he said.
President Obama appointed Dr. Berwick to lead CMS on July 7 during a congressional recess, bypassing what looked to be a lengthy fight in the Senate for the nominee's confirmation. On the day Dr. Berwick spoke at the AHIP conference, however, the president resubmitted his nomination for full appointment – which would require Senate hearings and a vote – for the second time.
In August, Senate Republicans refused to accept the president's first resubmitted nomination, citing the body's brief periods in session.