Feds To Insurers: Watch Your Backs! No Wait, Work With Us!

Partner content from Kaiser Health News

We're not sure if the good-cop-bad-cop routine works on billion-dollar corporations, but Obama's top health officials are giving it a try.

Dr. Donald Berwick, CMS chief.

Dr. Donald Berwick, head of Medicare and Medicaid, asked insurers for their help in making overhaul work. Courtesy of Donald Berwick hide caption

itoggle caption Courtesy of Donald Berwick

Dr. Donald Berwick, Obama's Medicare director offered an olive branch to health insurers today, asking for their help to make health overhaul a success and to achieve what he said were "shared goals": Cheaper, better health care.

However, the first installment came Thursday when Health and Human Services Secretary Kathleen Sebelius roughed up the same insurers for spreading what she called misinformation about overhaul's costs.

Some commentators dubbed it a thuggish political hit, and a move right out of a Sopranos script. She was, at least, direct.

Berwick was in a bit of a jam. To do his job, he needs a hand from private insurers. Millions of Medicare get their coverage through insurance intermediaries. "The glue that will allow us to work together," he said, "will be shared goals."

Those include, he said, better prevention, more reliable and safer care, and of course, lower costs. He delivered the invitation at a conference in Washington hosted by America's Health Insurance Plans, an industry group.

In contrast to his boss, Sebelius, Berwick's address was more professorial than political. He quoted Einstein's axiom that insanity is doing the same thing and expecting different results, cited Russell Ackoff, a late theorist of "purposeful systems," and, pointed insurers to his own scholarly work for guidance.

Insurers — not to mention, other folks in health care — need to change the way they do business, he argued. But, unlike Sebelius, his core message was, "We can help."

A spokesperson for the Center for Medicare and Medicaid Services said a transcript of Berwick's remarks was not "yet" public. We'll update this post if we get a copy. It was a rare public appearance for the top Medicare official in the wake of his controversial July recess appointment.

Berwick wasn't all softy, though. While he abstained from Sebelius' tough talk, he did caution that CMS is prepared to "play tough when we have to." He added, "authenticity matters" for insurers that might want to take him up on his offer to collaborate. He's not interested in working with folks who play nice in order to "maintain the status quo."

Even though it came on the heels of Sebelius' harsh letter, Berwick's pleas were pretty well received. His comments earned a full 11 seconds of applause — seated — and an industry spokesman, while allowing that Berwick may be in an awkward position, said he liked what he heard.

Top insurance industry lobbyist Karen Ignagni called it a "What-can-you-do-for-your-country speech" in remarks right afterward.

Update: Read the full text of Berwick's remarks here.

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