Patience with Berwick

Do I totally agree with Don Berwick ("Reviving Healthcare," July 2010)? No. Do I totally disagree with Berwick? No. I think we will have to wait to see what actions he is able to take and then monitor the outcomes. He has promoted some good change in healthcare and appears to be able to get some things done.

Some of his comments floating around on the internet bother me, but I was not there to hear the whole presentation. As far as redistribution of wealth, we have that now with people going to the emergency room for care and not paying. Those of us with insurance or who pay taxes foot the bill.

We have a lot of room for improvement when it comes to quality of care. Where we actually stack up is not as critical (unless we’re at either end of the scale) as the fact that we recognize there are problems that need fixing.

I am not in favor of the current healthcare bill passed by Congress. I don’t think it is a reform of healthcare, but rather a reform of who pays when and to whom. Will young, healthy people get insurance? If they can pay a penalty of less than $1,000 a year instead of $4,000 to $6,000 a year in premiums, probably not. With preexisting conditions gone, they will wait until they get sick and then get insurance. When they’re well, they will drop the insurance again, which will put only the sick into the paying pool.

There is too much lacking in the bill when it comes to details of how the steps will be accomplished. Maybe Berwick will include some of his quality-of-care and cost-reduction ideas into those holes. I don’t know how, but we definitely need healthcare reform, and it should have included tort reform to minimize defensive medicine costs.

Mickey Christensen
Baton Rouge, LA

Government issue

I’ve been a fan of Don Berwick and his writings for many years, finding his insights into U.S. healthcare enlightening. But his appointment to head the Centers for Medicare and Medicaid Services seems misguided.

While his desire to transform the U.S. healthcare system with a systems solution would be refreshing, his recent testimony tells me he will use his post as a platform for social change, rather than quality improvement. He talked about redistributing wealth from the rich to the poor and rationing care as the desired outcomes of healthcare reform, along with his love of a single-payer system like the United Kingdom.

I think those of us healthcare professionals who struggle to make the system work despite the best efforts of politicians and insurers are going to be sorely disappointed when we realize Berwick is now one of them.

Larry Smrz

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