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Excellent healthcare is by definition redistributional?

Posted July 17, 2010

Donald Berwick, MD, pediatrician and professor in the Department of Health Policy and Management at Harvard, has been newly appointed by President Obama as the Administrator of the Centers for Medicare and Medicaid. Dr. Berwick also serves as the President and CEO of the Institute of Healthcare Improvement. Dr. Berwick was appointed using President Obama’s recess appointment powers that bypass the usual Senate confirmation process.

The nature of the appointment process which eliminated debate and fact-finding was unusual enough but Dr. Berwick’s widespread views including “Excellent healthcare is by definitional redistributional” which appears to refer to his unabashed approval of the British National Health Service are garnering no small national debate. Click here to read in further detail. The British National Health Service is based upon rationing and redistributing resources. Prince Charles’s efforts to have CAM therapies including in the National Health Service have been met with mainstream derision and rebuff. Remember that Prince Charles commissioned a former Barclays Bank chief economics advisor with no medical background to produce the famed Smallwood Report that concluded possible “savings of between £500 million and £3.5 billion could be achieved by offering spinal manipulation therapies such as chiropractic as a standard NHS option for back pain. It claims that up to £480 million could be cut from the prescription drugs bill if 10 per cent of GPs were to offer homoeopathy as an alternative to standard drugs, and that £38 million could be saved by switching 10 per cent of depression patients to St John’s wort, an herbal remedy. “Click here to read further. British mainstream medicine continues to deride the report’s conclusion. One wonders if American mainstream medicine would do otherwise.

As an editorial in the Wall Street Journal  entitled “The Berwick Evasion” quotes from Dr. Berwick’s 1996 book entitled “New Rules”, Dr. Berwick and a co-author argued that one of “the primary functions” of health regulation is “to constrain decentralized, individual decision making” and “to weigh public welfare against the choices of private consumers.” Click here to read in further detail. The clear translation of his viewpoint is that the bureaucrats will know best and will decide all. That is of deep concern to those who value healthcare freedom of choice.

While Dr. Berwick’s views and actions as CEO of the Institute of Healthcare Improvement to reduce hospital acquired infections and avoidable medical errors are commendable and exemplary. In many minds, the Bush administration took worthwhile action to insure that Medicare no long pays for avoidable medical errors.  The cost savings and improved quality of care was measurable from this one action.

However, with the current mainstream realization that more medical care isn’t always better, how do we mesh one size fits all government-run and administered healthcare with care that best meets individual needs and avoids more medical care? Click here to read further. An increasing number of consumers have gone outside the conventional system to seek the advice and counsel of alternative/integrative/or functional practitioners. Dr. David Eisenberg’s published 1997 study in the Journal of the American Medical Association noted that Americans made 628 million visits to alternative health-care practitioners, 243 million more than visits to all primary-care physicians. Apparently many Washington bureaucrats still do not ‘get the message’ that Americans distrust government waste and government intrusion into their lives as evidenced by many current political movements and election results.

Americans increasingly vote integrative practitioners and CAM therapies with their pocketbooks to achieve healthcare freedom of choice. It is highly unlikely that American consumers would continue to frequent integrative medicine if it did not produce the desired results. Indeed some surveys have found satisfaction rates of up to 85% with CAM practitioners and therapies. Click here to read further

Could government run and administered achieve the same satisfaction rate? The current waste and fraud within government run healthcare systems makes one wonder about U.S. national healthcare under bureaucrats such as Dr. Donald Berwick.

Deborah Ray, MT (ASCP)