Pres Obama has nominated Dr. Donald Berwick, of Harvard Med, to be the administrator of the Centers for Medicare and Medicaid.
I quote Dr. Berwick;
“The decision is not whether or not we will ration, the decision is whether we will ration with our eyes open.”
http://www.humanevents.com/article.php?id=37186&keywords=rationing+czar
Buckle your seat belts here comes Obamacare.
“You could have protected the wealthy and the well,” he said, "instead of recognizing that sick people tend to be poorer and that poor people tend to be sicker, and that any health care funding plan that is just must redistribute wealth."
I agree with the good doctor and support redistibution of wealth. However, I feel that said redistribution should be achieved by different means: EARN IT, YOU LAZY A-HOLES!!! Get a second job, stop spending all your $$$ on smokes, beer, pork rines and drugs. Poorer people tend to be sicker because they choose to ruin their fat asses.
Prior to Obama being elected, I never realized that half the people in this country are total liberal idiots!
a) this is old news
b) Berwicks career has been dedicated to improving quality - period. He’s led the “saving 100k lives” campaign and has probably done more to further the quality agenda in healthcare than ANY one else in the US over the past 20 years bar no one. The fact that there is any focus at all on quality in the US is by and large down to him and his organisation IHI.
c) rationing already happens - you seem to delude yourself that if its “private” the money is endless and there’s no rationing but if its “public” rationing suddenly comes out of nowhere. Rationing happens, costs are spiralling out of control, healthcare is fragmented, poor quality and something needs to change and organisations (providers and insurers) have by and large not stepped up to the plate.
B) So the consumers of healthcare have nothing to do with focusing on quality?
C) Yes, rationing occurs. I ration, you ration, we all ration. I just don’t want Dr. Berwick rationing for me.
…But that isn’t happening. In fact the American Hospital Association (AHA) gave Berwick a flat-out endorsement in a May 20 letter addressed to Senators Max Baucus, chairman of the Senate Finance Committee, and Tom Harkin, chair of the Health, Education, Labor and Pensions Committee:
“His work at the Institute for Healthcare Improvement (IHI) has engaged hospitals, doctors, nurses and other health care providers in the continuous quest to provide better, safer care.” wrote AHA President and CEO Rich Umbdenstock. “This includes dramatic advances in quality improvement, patient safety and end-of-life care through IHI’s collaborative, breakthrough series and other activities,” he added, referring to IHI’s success in success in cutting hospital infection rates and implementing better asthma care and coronary surgery improvements with little additional costs.
“Dr. Berwick is a trusted and respected voice among hospitals, as well as within the larger health care community,” Umbdenstock concluded. “His knowledge of our health care delivery system, its strengths and weaknesses make him uniquely suited to implement provisions in the recently enacted health care reform law.”
I’ve been reading up on Dr. Donald Berwick for time and I think he’s an excellent choice:
here’s an article from Newsweek for example
http://www.newsweek.com/blogs/the-human-condition/2010/03/29/five-things-you-should-know-about-donald-berwick-the-new-medicare-medicaid-chief.html
or this blog:
http://www.thehealthcareblog.com/the_health_care_blog/2010/03/who-is-don-berwick-and-what-will-he-mean-for-reform-.html
my point being that sometimes one has to read from multiple sources, not just from ones slanted to tell you what you want to hear.
uniquely suited to implement provisions in the recently enacted health care reform law.”
And that includes taking my money and giving it to somebody else, of whom I disapprove.
Of course, you’ll justify this also.
"… him uniquely suited to implement provisions in the recently enacted health care reform law.”
THAT is the problem. I’m certain that he is dedicated to improving health care for all. My concerns arise when the discussion turns to how we get there. I agree that we are already paying for health care for the “poor”, but the approach that ObamaCare takes has been tried before and has failed. It is simply the wrong vehicle/path. There are more intelligent approaches to providing quality health care for all but our politicians will never enact them.
explain to me what exactly the consumers have done, or how their behaviour has improved the quality of care provided given that:
standard risk adjusted mortality rates are not published
infection control rates are not published
compliance with hand washing are not published and so on and so forth
those are just a handful or examples but there are dozens of empirical measures about quality that are not made public
how do you, as a consumer, make an informed decision about how to see and why…
I wont justify anything, its just interesting that not one lobbying group in the two months since his nomination has objected yet I’d expect nothing less from you than an objection, it appears that even those with conservative stances and skin in the game find little to object to, you, of course, being the exception.
B) So the consumers of healthcare have nothing to do with focusing on quality?
C) Yes, rationing occurs. I ration, you ration, we all ration. I just don’t want Dr. Berwick rationing for me.
I can tell you first hand that at a minimum in Illinois the availability of health care is already being rationed for everyone. The “needs” folks who decide if an area “needs” a new facility from private business is currently pretty much denying everything that is not a sort of community health - state wide. So, I guess the plan is that you can go to any doctor you want as often as you want…but that doctor may not be allowed to have the facilities available for you to get proper diagnostic imaging, ambulatory surgery, on and on and on.
Sure sure, there are other MRI, CT, Nuclear Imaging, and Surg. Centers…but they all have lines at the door (literally and figuratively)
One group I work with wants to simply move Interventional Radiology from one floor to another…the state wants to know why they “need” the system at all as there are five other cameras in the city limits (at other hospitals). So I suppose they just need to tear out their camera and send all of their angiogram/stent patients to their competition across town…
Why do you hate beer and pork rinds?
Well you may be right, but given that people have known about healthcare acquired infections for years / decades but routinely failed to do anything about it (sector wide) until Berwick came along it appears that leaving it to the providers to sort out is not going to happen.
I genuinely could not care less how the care is provided, public or private. The only thing that I’ve stated is that it should be accessible to all but I don’t particularly care how, and what is available should be a minimum acceptable standard (treatment of long term conditions, acute episodes and elective procedures as clinically required) this would not extend to treating varicose veins - you want them sorted pay for them yourselves.
I don’t care how it is funded - through private insurance with a credit against tax, through the tax system. I don’t care if the providers are public, private or charitable.
I do however think that many here will read those single sentences by Berwick and make a judgement and simply not be able to look past it, in spite of the fact that his peers, from both sides of the aisle, in business and healthcare, apparently can.
Unlike probably anyone else in the healthcare game, Berwick has only been driven by the patient experience and quality.
He has probably more experience of healthcare provision globally than anyone working in the sector, he established an organisation to work solely on improving it and he is interested in driving out waste and improving quality. Those are two qualities that I think I’d want as a starter for 10 in someone taking on this role.
Who (including illegals) currently do not have access to health care and what services are they not able to get? Where are they? You think that is the case in the US?
the thread was at berwick, not who has / does not have coverage, the only point I was making was that he is one of the few healthcare professionals that have committed their entire careers to focusing on quality and outcomes and IMO that makes him a good choice…the rest is just noise and has been discussed here ad nauseum
.
“The decision is not whether or not we will ration, the decision is whether we will ration with our eyes open.”
At least this guy has a realistic view of things and isn’t promising everything to everyone. We (USA) have to come to grips with this.
If you want more, pay for it yourself. It’s that simple.
I’ve been reading up on Dr. Donald Berwick for time and I think he’s an excellent choice:
here’s an article from Newsweek for example
http://www.newsweek.com/…-medicaid-chief.html
or this blog:
http://www.thehealthcareblog.com/...ean-for-reform-.html
my point being that sometimes one has to read from multiple sources, not just from ones slanted to tell you what you want to hear.
Thats seals it for me.
You cant remove one from the other. Berwick (Obama) seem to claim that people are dieing in the streets and play the quartet of heart strings on the gullible who somehow buy into the idea that there are people who die in the streets due to their inability to get health care. Sure, there ARE folks who die in the streets of one thing or another - they are not however folks who go to a doctor (ED, Public Health or what not) and are tosssed out due to their inability to pay. Some things have no treatment, or no sensible treatment options for anyone - let alone a non-compliant person who never lived a proper lifestyle to begin with. Then, we get Katie Curic (how ever you spell that bitches name) doing some story on national news on how some evil doctor would not provide (expreimental) treatment on this poor poor person who later died…
I’m curious, if “rationing” is a necessity, does this guy/Obama administration have a plan for increasing the supply of medical care? Such as plans that would increase the amount of doctors, nurses and other healthcare providers and changes to laws and practices that would allow such services to be provided by lower paid professionals (nurse practioners instead of doctors).