Where is The Guy from IHI?

Public Policy Contributor Bradley Flansbaum writes…

I admire Don Berwick. His writings are provocative, innovative and ahead of the health policy curve, even if I do not agree with him all the time.

Enthusiastic is an understatement to describe my reaction when Obama nominated him to head CMS. Without reluctance, I assert that not as a partisan, but as a frontline doctor who genuinely cares about our healthcare system.

My bird’s-eye view of what works, and more often than not, what does not in healthcare delivery gives me an appreciation of where he wants the American system to pivot. Many docs would probably agree.

Putting aside the negative press he continues to receive, if you take the time to listen or read his opinions in their entirety, you will quickly realize the man does not resemble his op-ed descriptions. I am sure that one year ago, before the brouhaha erupted when the President nominated him, docs from red and blue states would have exited a Berwick sponsored IHI conference and not given politics, ideology, or practice approach a second thought. I mean it. It is a shame what has happened since.

Anyway, I digress.

Yesterday, this op-ed by Dr. Berwick appeared in the Washington Post. To my knowledge, this was his first foray into the mainstream media, and I was anxious to read his coming out declaration. Midway into the piece however, I needed to read the author’s name again, as I was not sure if the writer was Robert Gibbs or David Axelrod, or Berwick himself.

Has the man lost his voice?

Unfortunately, this was a Whitehouse press release, not the scribing of an innovative clinician and scholar:

“The Medicare Board of Trustees estimated last month that the Affordable Care Act produces savings that extend the life of the Medicare Hospital Insurance Trust Fund for 12 years, to 2029. The actuary of the Centers for Medicare and Medicaid Services (CMS), an independent office, reached the same conclusion. And the Congressional Budget Office has estimated that the law will reduce the federal deficit by more than $100 billion over the next 10 years and more than $1 trillion in the following decade. Those are real savings that help today’s and tomorrow’s Medicare beneficiaries.”

One can be dismissive of my observation given the political climate of late. The last thing Berwick needs is to create ripples with a controversial editorial. I understand. However, if this is a harbinger of the future, and it might be—that is why I am blogging this statement after all—count on watered down, baby step initiatives the next two years to go along with this “safe” communiqué. Honestly, I expected more as a first signal, and Berwick is capable of much better.

If pre-midterm election trends are on target, my suspicion is Berwick will have his hands tied, and a magnifier over his keyboard. CMS will not get the master reboot many folks envisioned with him at the helm.

I truly hope I am wrong.

UPDATE: This story adds some meat to the bone. While there are no major revelations revealed, he is carrying out the law after all, the ACA implementation and its potential repercussions (that under “usual” circumstances would hardly evoke a peep) may create road blocks for his future tenure.

Brad Flansbaum

Bradley Flansbaum, DO, MPH, MHM works for Geisinger Health System in Danville, PA in both the divisions of hospital medicine and population health. He began working as a hospitalist in 1996, at the inception of the hospital medicine movement. He is a founding member of the Society of Hospital Medicine and served as a board member and officer. He speaks nationally in promoting hospital medicine and has presented at many statewide meetings and conferences. He is also actively involved in house staff education.

Currently, he serves on the SHM Public Policy Committee and has an interest in payment policy, healthcare market competition, health disparities, cost-effectiveness analysis, and pain and palliative care. He is SHM’s delegate for the AMA House of Delegates.

Dr. Flansbaum received his undergraduate degree from Union College in Schenectady, NY and attended medical school at the New York College of Osteopathic Medicine. He completed his residency and chief residency in Internal Medicine at Long Island Jewish Medical Center in New York. He received his M.P.H. in Health Policy and Management at Columbia University.

He is a political junky, and loves to cook, stay fit, read non-fiction, listen to many genres of music, and is a resident of Danville, PA.

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