Donald Berwick

The Opening Bid

Earlier this month, Medicare finalized the rules of a new program—mandated by the Affordable Care Act—that will pay hospitals based on the quality, not just the quantity, of care they provide. Centers for Medicare and Medicaid Services (CMS) Administrator Donald Berwick has called the initiative a “historic change” to the current system, which too often incentivizes doctors to provide more care at higher costs—even when that extra care doesn’t translate into better health.

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Elizabeth Warren may be the best choice to head the new Consumer Financial Protection Bureau. Or she may not be. As I wrote previously, I really don't know. But I do have one more thought about what's apparently the main argument against her candidacy: Her relative lack of managerial experience. Warren's critics say that she's never run an organization like the new consumer bureau. She may be brilliant, charismatic, and passionate, but she hasn't demonstrated that she has the chops to lead the agency. All she has done is lead the Congressional Oversight Panel on the financial bailout.

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Last week, President Obama named Donald Berwick as head of the Centers for Medicare and Medicaid Services. He used a recess appointment, which means Berwick won't go through Senate confirmation--or, in this particular case, get so much as a hearing.  I defended the move, basically arguing Democrats needed to exploit procedural rules because Republicans were doing the same to them, especially over appointments. Several of my readers, particularly conservative ones, wrote back to say they disagreed.

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The recess appointment of Donald Berwick to run the Centers for Medicare and Medicaid Services has provoked the expected Republican procedural outrage (see here and here.) Some liberals have been chuckling at this response from Pat Roberts: This recess appointment proves the Obama Administration did not have the support of a majority of Democrats and Republicans in the Senate and sought to evade a hearing. Of course, Republicans have no intention of letting Berwick be confirmed with a mere majority vote.

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The conservative attack on health care reform has always been a highbrow-lowbrow combination. The lowbrow route attacked health care reform as a draconian cut in health care benefits, wantonly slashing costs and denying care to the elderly. The highbrow attack took the opposite line, insisting that health care reform was doing nothing whatsoever to control costs and blaming the Obama administration for its lack of steel.

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Save Donald

This column is a collaboration between KHN and The New Republic. He’s a socialist! He’ll redistribute wealth! He wants to pull the plug on grandma! That’s what Republicans said about President Barack Obama back in 2009, while he was trying to make health care reform bill law. Now they’re saying it about Donald Berwick, the man Obama has appointed to help make health care reform work. Who is Berwick? He’s one of the nation’s well-respected and best-known authorities on our health care system.

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