(Donald Berwick) Health Official Takes Parting Shot at ‘Waste’

[alp227]

Source: NYT

The official in charge of Medicare and Medicaid for the last 17 months says that 20 percent to 30 percent of health spending is “waste” that yields no benefit to patients, and that some of the needless spending is a result of onerous, archaic regulations enforced by his agency.

The official, Dr. Donald M. Berwick, listed five reasons for what he described as the “extremely high level of waste.” They are overtreatment of patients, the failure to coordinate care, the administrative complexity of the health care system, burdensome rules and fraud.

“Much is done that does not help patients at all,” Dr. Berwick said, “and many physicians know it.”

In an interview on Thursday, his last day on the job, Dr. Berwick reflected on his successes, failures and frustrations in trying to engineer a rapid transformation of the health care system while beating back criticism from Republicans in Congress.

Read more: http://www.nytimes.com/2011/12/04/health/policy/parting-shot-at-waste-by-key-obama-health-official.html

[limpyhobbler]

1. Don't be surprised if his next job is working for the Health Insurance Industry or the AMA, n/t

That sounds like an Insurance Industry lobbyist:
Our biggest problem is "overtreatment of patients".

Or the AMA:
Our problem is "burdensome rules". We should be able to do whatever we want, without having to answer to anyone. Just pay us. We're Doctors, we'll tell you where it hurts.

[jtuck004]

2. “My point,” he said, “is that someone, like your health insurance company,...

...is going to limit what you can get. That’s the way it’s set up. The government, unlike many private health insurance plans, is working in the daylight. That’s a strength.”


Exactly.

[SoapBox]

3. So I call to get my Mom (90) a flue shot (stop me if you have heard this one before!)

First, she's on an Advantage plan.

...call to make an appointment to get her the flu shot (about 6 weeks ago). The Primary office says that I need a reason to bring her in...Ok, the flu shot. Not a reason...is this a follow up to a previous issue or is she sick? Uh...she can't be sick to get a flue shot! Can we just walk in for a flu shot? No...you need a reason to come in! Uhhh...flu shot. Sorry...you will need a reason to make an appointment.

SO, I call her Medical Group...they have their own Urgent care...no appointment needed...we walk in and are done in 10 minutes. And, no charge to us.

What the HELL is with the Primary? I just felt like they were going to bill Medicare some big amount for an office visit AND for the flu shot.

Scam?????

[McCamy Taylor]

8. Medicare Advantage is capitated, I believe. They get paid whether your mom comes in or not.

So, they do not want to see her.

[russspeakeasy]

4. Medicare needs to hire someone they can trust

like the great governor of Florida, Rick Scott.

[tcaudilllg]

5. Will be remembered as the worst Democratic overseer of medicare... ever.

[bertman]

7. Please explain the reason for your comment, tacaudllg. I found his remarks

to be refreshingly candid and useful to anyone who feels that government has some very excellent provisions for healthcare--to wit his comment about health insurance companies limiting coverage, and operating in the open--and some very negative aspects such as the near-infantile turf protecting that goes on among government agencies and that is much to the detriment of the citizens.

Is there something about his record that we should know about? The article was only about his comments upon leaving.

Thanks.

[underpants]

6. and with all that waste overhead is still only 3% - private plans range from 13-30%

Waster is relevant

[McCamy Taylor]

9. Some surgical specialists make a lot of money doing procedures on the elderly.

Some of these surgeries---like hip replacements for people bedridden with Alzheimers---do the patient little good. The AMA is biased towards surgical specialties, so they try to keep surgery fees under Medicare high and primary care preventive medicine fees low. That way there is little incentive for a primary care doctor to keep the elderly health but a whole lot of incentive for surgeons to do procedures.

Medicare needs to become universal cradle to grave insurance with more emphasis on disease prevention. But the subspecialists and the hospitals they keep afloat would not like that.