Donald Berwick Quotes
Competition makes things come out right. Well, what does that mean in health care? More hospitals so they compete with each other. More doctors compete with each other. More pharmaceutical companies. We set up war. Wait a minute, let's talk about the patient. The patient doesn't need a war.
Berwick, Donald M. Interview. Escape Fire: The Fight to Rescue American Healthcare. Directed by Matthew Heineman and Susan Froemke, APLITE Film, 2012.
In some areas, the United States has the best performance in the entire world—length of survival rates for breast cancer and some other diseases for example. However, on basic medical services, like infant mortality, we have a poorer record than all the other industrialized countries. Cuba and Costa Rica are better than us in this area and their citizens actually have a longer life expectancy than Americans. Emmanuel makes the argument that the cost differential between US health care and other—even better systems—is so great that we can easily save money and reform our system without rationing medical care or wait in lines for surgery. However, to do so, there must be huge reforms and few in the system want to risk changing anything. It is hard for most Americans to face the fact that other countries offer obvious medical superiority in many areas. For example, in France, if you call their emergency telephone number for a medical emergency a doctor answers the phone, not an operator with only modest medical knowledge. When a French ambulance is dispatched, it does not have emergency medical technicians only, but there is a doctor and a nurse in the ambulance. And the ambulance itself is equipped to do emergency surgery of other critical treatment if time is critical.
Actually politicans, civil servants, and private sector individuals who have been working with heath care all knew how complicated health care was. But Trump, who had no experience with health care and its cost and funding structure, when he was a candiate had advisors who were ideologues and had little experience themselves. So Trump campaaigned explaining how simple it was to repeal Obama Care, and replace it with legislation that would cut the insurance premiums, increase the quality of medical care and cover more people while giving consumers protections like no caps and refusals for previous conditions. When he got into office, he discovered that all his campaign ideas would indeed accomplish the objectives that he claimed but it would also mess up other parts of the health system. Nothing could be done in isolation, So he did not repeal Obama Care and made this statement to explain wht he had discovered since assuming office.
Donald M. Berwick is a former Administrator of the Centers for Medicare and Medicaid Services (CMS). Prior to his work in the administration, he was President and Chief Executive Officer of the Institute for Healthcare Improvement a not-for-profit organization.
