MEET DONALD BERWICK – the New Health Care Rationing Czar

The President’s Recess Appointment Prevents The American People From Hearing An Explanation Of His Controversial Views

BERWICK ON HEALTH CARE RATIONING

DONALD BERWICK: “The Decision Is Not Whether Or Not We Will Ration Care—The Decision Is Whether We Will Ration With Our Eyes Open.” (“Rethinking Comparative Effectiveness Research,” An Interview with Dr. Donald Berwick, Biotechnology Healthcare June 2009)

BERWICK ON THE BRITISH NATIONAL HEALTH CARE SYSTEM

DONALD BERWICK: “I Fell In Love With The NHS…To An American Observer, The NHS Is Such A Seductress.” (Donald Berwick, “Celebrating Quality 1998-2008,” speech at London Science Museum, September 30, 2008)

DONALD BERWICK: “I Think The NHS Is One Of The Great Human Health Care Endeavors On Earth. It Can Be An Example For The Whole World, An Example, I Must Say, That The United States Needs Now More Than Most Other Countries Do.” (“Power” by Donald Berwick, speech to 17th annual National Forum on Quality Improvement in Health Care, December 2005)

DONALD BERWICK: “One Of The Reasons I Love The NHS Is Because It Is Political, Because The Political Voice Properly Owned Is The Voice Of The People.” (“A Case of US and Them—The HSJ Interview: Don Berwick” by Paul Dempsey, Health Service Journal April 10, 2003)

BERWICK ON SINGLE-PAYER HEALTH CARE

DONALD BERWICK: “I Admit To My Own Devotion To A Single-Payer Mechanism As The Only Sensible Approach To Health Care Finance I Can Think Of.” (Foreword to Quality in the Veterans Health Administration: Lessons from People Who Changed the System (Jossey-Bass, 1996) by Donald Berwick, p. xi)

BERWICK ON WHISTEBLOWER PHYSICIANS BRINGING ATTENTION TO DENIAL OF CARE

DONALD BERWICK: “Denying Patients A New Treatment: A Doctor Working In An NHS Trust Thinks It Is Wrong That His Patients Will Be Denied A New Treatment For Cancer.  Should He Contact The Local Media?  Should The Trust Punish Him If He Does?  …  The “Cooperation” Principle Suggests That The Doctor Should Cooperate With His Colleagues And Implies That Contacting The Media Would Not Be Helpful.  But The “Openness” Principle Means That The Committee Should Be Open With Patient, Doctors, And The Community On Why It Is Denying Patients A Drug. …  If The Trust Has Lived By The Principles And The Doctor Has Not, Then It Might Be Legitimate To Punish Him.” (“Refining and Implementing the Tavistock Principles for Everybody in Health Care” by Donald Berwick et al., BMJ September 15, 2001, p. 618)

BERWICK ON END OF LIFE CARE

DONALD BERWICK: “Measurement Forces Upon Us Some Uncomfortable Awareness That In Our Multi-Attribute World We Face Choice: An 84-Year-Old Man Lies In Intensive Care On A Respirator, The Victim Of His Fourth Heart Attack.  ‘It Is Time,’ Says The Surgeon, ‘For A Tracheostomy.’  ‘What Are His Chances?’ Asks His Wife.  ‘One In A Hundred,’ The Surgeon Replies.  ‘Please Go Ahead Then,’ She Decides,  ‘He’s All I’ve Got.’ … What Do We Want?  Is It Better Not To Measure, We Are Tempted To Say.” (“E.A. Codman and the Rhetoric of Battle: A Commentary” by Donald Berwick, Milbank Quarterly 1989, p. 264)

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