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Berwick: Out of Step on Health Care? Or at the Cutting Edge?

By John Reichard, CQ HealthBeat Editor

June 30, 2010 -- Republicans have been making the case that the Obama administration is out of step with the American people on health care—not just in pursuing enactment of the health care law earlier this year, but more recently in nominating Harvard quality improvement expert Donald M. Berwick to run Medicare and Medicaid. But the administration may be making progress in countering the GOP's assertions.

In the case of Berwick, Republicans link him to rationing and promise a vigorous fight over his confirmation. Senate Finance Committee Chairman Max Baucus is treating the charges carefully; he strongly backs Berwick, but is wary of giving Republicans a platform for their arguments and is in no hurry to schedule a confirmation hearing.

The delay might suggest trouble for Berwick. On the other hand, it has created an opportunity for a wide swath of the health care community to speak up on his behalf. Many provider groups already have defended him. And now about 90 groups—including major consumer organizations, health plans with strong reputations for well organized care, and business groups known for innovation in promoting quality and efficiency of care—have sent a letter to Baucus, D-Mont., endorsing Berwick.

Some, such as the AFL-CIO and Families USA are natural allies of the administration, but others do not fall into that category. They include Wal-Mart Stores Inc. and employer coalitions such as the Business Health Care Action Group in Minnesota and the Pacific Business Group on Health in California. Still other groups represent patients that might be particularly vulnerable in a system of rationing, such as the Alzheimer's Association and the American Association of People with Disabilities.

Berwick is "one of the nation's leading authorities on health care quality and improvement," the letter says. "He has dedicated his professional career to closing what the Institute of Medicine has called the 'quality chasm;' that is, the enormous gap between the health care we have and the health care we should have."

The letter notes the Berwick-led "100,000 Lives Campaign" to reduce deaths in the hospital from medical mistakes and his "Protecting 5 Million Lives" campaign to reduce harm from surgical complications, MRSA infections and other factors.

"Unfortunately, some of Dr. Berwick's speeches and writings have been quoted in ways that misrepresent his beliefs," the letter adds, by suggesting he backs rationing and a government takeover of health care decisions. But Berwick's "commitment to patient care is about putting control of health care decisions in the hands of informed patients and their families," the letter says. "The time for distractions and misleading rhetoric has passed. We urge you to confirm Dr. Berwick," it concludes.

Health plans include the Alliance of Community Health Plans, Fallon Community Health Plan, Group Health Cooperative of Puget Sound, and Kaiser. Signatures from the consumer advocacy side include Consumers Union, the Medicare Rights Center, and the National Health Law Program.

The administration also got a piece of good news Wednesday in the form of a new poll by the Kaiser Family Foundation that said favorable views of the health care overhaul law increased seven percentage points over the past month to 48 percent.

The poll showed strong support for such elements of the overhaul as creating health insurance exchanges, giving tax credits to small business to buy coverage, and even giving subsidies to individuals to buy coverage.

On the other hand, the results mean that not even half of the public regards the law favorably. And one element of the law, and perhaps its most important provision —the mandate that individuals buy coverage —remains highly unpopular. The mandate is viewed favorably by only 34 percent of Americans, the poll found.

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