Policy-ish

Obama To Pick Berwick For Chief Of Medicare

President Obama will nominate health quality guru Dr. Donald Berwick, the head of the Boston-based Institute for Healthcare Improvement, to run Medicare and Medicaid, administration sources confirm.

It's been a long time coming. The powerful agency has been without a permanent administrator since Dr. Mark McClellan left the job in 2006. The new health law adds even more power and a hefty set of responsibilities to the post.

For health care wonks, no administration job is more closely watched than the administrator of the Centers for Medicare and Medicaid Services. The agency is in charge of not only the two largest public health insurance plans, but also the Children's Health Insurance Program, the law that regulates clinical laboratories, and a 1996 law on patient privacy and insurance protection. Altogether, CMS oversees insurance that covers somewhere in the neighborhood of 100 million people.

So what took Obama so long? The delay in naming a CMS leader was pragmatic. Officials figured they couldn't get anyone confirmed by the Senate for the extraordinarily sensitive position until after the conclusion of the health overhaul debate. Even now, any nominee faces an uphill battle, given the bad taste in many GOP mouths following the health fight.

Berwick, a mild-mannered Harvard professor and pediatrician, had been mentioned on and off for the post since before Obama even took office. Berwick kept getting bounced off the list, however, as administration officials looked for someone who had run a large health system. That's experience Berwick, with his academic background, lacked.

Now, however, the new health law's emphasis on changing Medicare to emphasize quality while containing costs made Berwick a more logical choice than ever.

Since 1991, when Berwick founded the Institute for Healthcare Improvement, that's basically been his mission in life, as NPR's Chris Arnold reported back in 2002. He built the organization into a national movement, complete with an annual meeting that draws thousands of health professionals each year and political-style campaigns that have successfully challenged hospitals to change their way of doing things in order to avoid medical errors. Http://www.remakingamericanmedicine.org/lives.html

Last summer, while Congress was debating how to write a bill that might bring down health costs, Berwick was one of four health care "geniuses" who convened a meeting in downtown Washington with doctors and hospitals administrators from around the country who already proved they could slow spending. Interestingly, one of those who put that meeting together with Berwick was the most recent CMS Administrator, Mark McClellan.

For his efforts, Berwick has been awarded the Purpose Prize for people over 60 embarking on second careers, as well as an Honorary Knight Commander of the British Empire by the Queen of England for his work with the British National Health Service.

Berwick's nomination is expected to be announced soon.

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