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Globe Editorial

In Berwick, Obama chooses innovative leader for Medicare

May 17, 2010

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SENATE REPUBLICANS haven’t even waited for the confirmation hearing for President Obama’s candidate to run Medicare and Medicaid — Dr. Donald Berwick, a Harvard pediatrician — to begin using him as a tool to renew the debate over the recent health reform law. It’s within their rights to question the worthiness of Obama’s nominee, but they’re picking the wrong target.

Berwick, who has run the Cambridge-based Institute for Healthcare Improvement for the past 19 years, has been a leader in promoting innovative ways to improve the quality of care, thereby cutting the costs of medicine. He is well-qualified to make the many crucial decisions surrounding Medicare and Medicaid, and could end up being one of the most significant appointees in the administration.

Yet Republicans such as Senate minority leader Mitch McConnell are painting Berwick as a proponent of rationing health care, because the nominee supports, for instance, a payment system that reimburses hospitals based on what it should cost to treat a patient successfully, rather than on the sheer numbers of tests and procedures being run. McConnell takes Berwick especially to task for once praising the British health system, which covers everyone.

Never mind that Berwick has already won endorsements from AARP and the American Medical Association, neither of which advocates rationing. Republicans hope to create the impression that Obama’s efforts to cut health care costs are sending the nation down a slippery slope toward rationing of services.

Berwick’s confirmation hearing, which has not yet been scheduled, will provide him with a forum to remind senators — and the public — about the upside of the recent reform law, including immediate benefits such as including children on their parents’ policies until they are 26 and granting tax credits to help small businesses manage their insurance costs.

Beyond that, Berwick could describe some of the work his institute has done to reduce medication errors and hospital-acquired infections. Other reforms he has championed include such measures as keeping hospitalized patients propped up to prevent pneumonia and extending hospital visiting hours so that friends and family members can help monitor patients’ care. Though basic, such simple reforms can make a big difference in curing patients.

Under the reform law, Washington must find $400 billion in Medicare savings over 10 years. Improved care that stops patients from returning to hospitals with infections or pneumonia is one good way to achieve that goal. Let the health care debate begin — again.

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