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New Medicare chief speaks out on health care

By Ricardo Alonso-Zaldivar
Tuesday, September 14, 2010; A2

The nation's health-care system cannot be transformed by rationing medical care, President Obama's new Medicare chief said Monday in his first major speech.

Donald Berwick's appointment this summer without Senate confirmation was contentious because some Republicans accused him of being willing to deny care to save on costs. Since then, the administration has kept Berwick out of the spotlight, turning the otherwise well-known medical innovation expert into something of a mystery man in Washington.

Berwick broke his silence Monday, telling an audience of health insurance industry representatives that pushing back against unsustainable costs cannot and should not involve "withholding from us, or our neighbors, any care that helps" or "harming a hair on any patient's head."

He also said he does not think federal bureaucrats have all the answers when it comes to remaking the system. "A massive top-down national project is not the way to do this," he told a conference held by America's Health Insurance Plans, the industry lobbying group.

Berwick, 64, who was a pediatrician and Harvard professor, has long advocated "patient-centered care," or the coordination of services to provide better quality and avoid duplication and waste.

Republicans have seized on previous comments he has made, such as this one from an interview last year: "The decision is not whether or not we will ration care - the decision is whether we will ration with our eyes open. And right now, we are doing it blindly." They say that raises questions about what Berwick really thinks of rationing.

His supporters counter that rationing already takes place, through actions of insurance companies, and that all he wants is to bring the medical decision-making process into the open.

Berwick told the insurers that he has three objectives: better care for individuals; better care for groups of people, such as diabetics or the poor; and reducing per-capita costs by eliminating waste and duplication.

He left without taking questions from reporters.

- Associated Press

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