Under the Patient Protection and Affordable Care Act, the CMS administrator does more than make sure Medicare and Medicaid pay claims in a more or less accurately and timely fashion. The office defines the quality of health care for every insurance plan, sets reimbursement rates for physicians in Medicare and Medicaid, and decides what treatments are more "valuable" than others.
Yikes! That's a lot of power! Sort of makes one want to know more about Mr. Berwick, doesn't it? Goldberg has it:
Berwick not only has a role model picked out for a role that sounds a lot like what he would be doing at CMS, he has a soulmate: For the past 15 years he has consulted for -- or, in his words, been "starry-eyed" over -- Britain's National Health Service. In 2008, at a 60th anniversary celebration of the creation NHS, he told a UK crowd, "I am romantic about the NHS; I love it. All I need to do to rediscover the romance is to look at health care in my own country. "
Berwick complained the American health system runs in the "darkness of private enterprise," unlike Britain's "politically accountable system. " The NHS is "universal, accessible, excellent, and free at the point of care -- a health system that is, at its core, like the world we wish we had: generous, hopeful, confident, joyous, and just"; America's health system is "toxic," "fragmented," because of its dependence on consumer choice. He told his UK audience: "I cannot believe that the individual health care consumer can enforce through choice the proper configurations of a system as massive and complex as health care. That is for leaders to do."
Read the whole thing.