All you need to know about Dr. Donald Berwick, President Obama's choice to head the Centers for Medicare and Medicaid Services, is summed up in the nominee's own words. At the 60thanniversary celebration of Britain's socialized National Health System, Berwick praised NHS, which he clearly views as superior to America's private medical system: "You could have had the American plan ... Britain, you chose well."
The families of 1,200 patients who died prematurely in recent years while in the care of NHS doctors and nurses might beg to differ.A shocking 2010 report by Queen's Counsel Robert Francis found that NHS patients were left unattended "for unacceptable amounts of time" in urine- and feces-soaked beds. At one NHS hospital, four members of the same family -- including a newborn girl -- died within 18 months of each other because of medical blunders. "There can no longer be any excuse for denying the enormity of what occurred," Francis noted, harshly criticizing "a lack of care and mistreatment which have no place in any civilized and well-run health service."
Yet Berwick has called NHS a "global treasure," saying he is "a romantic about NHS. I love it." It's no coincidence that this centrally planned, government-run health care system appeals to a Harvard-educated pediatrician who views patients not as individuals, but as members of collective "units of concern" defined by age, disease or socioeconomic status. Berwick has criticized the use of new life-saving technologies and wants non-physician "primary care providers" to ration care by controlling access to specialists and diagnostic tests to reduce each "unit's" per-capita costs. He has also characterized aggressive interventions in terminally ill patients as "assaults," not heroic attempts to extend their lives.
This is a radical departure from the focus on individual patients and their private relationship with doctors of their choice that have made American medicine the best in the world. And while Berwick was among the first to introduce industrial-style quality controls in 3,000 American hospitals, which by all accounts has been a huge success in improving patient care, his rigidly ideological view that America's health system should mimic Britain's NHS is inimical to the preservation of individual freedom and high-quality care. His nomination should be decisively rejected by the Senate. Americans live longer, healthier lives than Brits precisely because government bureaucrats have not been in charge of their health care for the past 60 years. If confirmed by the Senate, Berwick will define that quality down to British standards. That would not be choosing well.