Berwick’s brilliant tenure cut short

Dr. Don Berwick stepped down as head of the Centers for Medicare and Medicaid Services on Friday, much to the chagrin of the health care community and those familiar with the excellence of his work. His departure is our loss, but it’s worth pausing to appreciate the fact that Berwick was able to serve as long as he did.

President Obama nominated the Harvard professor, policy expert, and pediatrician for the CMS position in April 2010, to the outrage of Senate Republicans who quickly vowed to kill the nomination. The president gave Berwick a recess appointment, allowing him to get to work fairly quickly, even knowing the appointment would expire at the end of 2011.

Congress wasn’t pleased with Obama’s move, but it paid dividends. It wasn’t long before Berwick, an internationally-renowned expert in improving quality care and lowering health care costs, starting making a real difference, eliminating waste from the system and saving American taxpayers a lot of money. Just as importantly, Berwick began to establish an administration “triple aim” blueprint: “improving patient experience, improving population health and reducing costs.”

Kate Pickert had a good piece on Berwick’s CMS work earlier in the year:

[I]f he holds on until the end of [2011], Berwick will have been at the helm of the Centers for Medicare & Medicaid Services (CMS) for 17 months. This is a substantial period of time and long enough to have set a tone at CMS and to have recruited key second and third-tier administrators to work on important pieces of the Affordable Care Act. Berwick has already jump-started the Center for Medicare and Medicaid Innovation, the best hope health reformers have for finding smart ways to cut health care spending. Under Berwick’s tenure, the federal regulation of private insurance was also brought under the CMS mantle, a power consolidation that could have long-range implications.

And that’s the silver lining here. Republicans crushed Berwick’s chances without a credible reason, and it limited his CMS tenure to a year and a half. But these were a very productive 17 months, during which Berwick did some incredibly important and worthwhile work.

He should have been confirmed and encouraged to serve indefinitely, but if 17 months of Berwick is the best we can do due to Republican recklessness, it’s much better than nothing.

And if you missed Chris Hayes’ MSNBC interview with Berwick over the weekend, it’s well worth watching.

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