MICHELE NORRIS, host:
From NPR News, this is ALL THINGS CONSIDERED. I'm Michele Norris.
Today, President Obama signed into law the second and last piece of the health care overhaul. It's been called the fix-it bill. It will help seniors on Medicare and delay the so-called Cadillac tax on high-cost insurance plans. So now comes an even bigger task turning what's on paper into reality. Much of that responsibility will fall to the person who runs the Medicare and Medicaid programs. It's a position so politically sensitive, it's been without a permanent head since 2006.
NPR's Julie Rovner brings us this profile of the doctor President Obama has selected for that job.
JULIE ROVNER: Tom Scully is not the nominee, but he knows how hard it is to run the Centers for Medicare and Medicaid Services. He did it for three years under President George W. Bush. He says it's one of the least known and most powerful jobs in the entire federal government.
Mr. TOM SCULLY (Centers for Medicare and Medicaid Services): You get into every little nook and cranny of every part of the health care field because generally you're paying a lot of their bills. And on any particular day, if half the Congress isn't mad at you, that's a big shock.
ROVNER: So at first glance, the person President Obama has chosen, Donald Berwick, seems an unlikely candidate. He's a mild-mannered pediatrician and Harvard Medical School professor. But Dartmouth health policy researcher Elliot Fisher, who's worked with Berwick for years, says he's the perfect choice to implement some of the most sweeping changes to the nation's health care system in generations.
Dr. ELLIOT FISHER (Researcher, Dartmouth Health Policy): Don Berwick is a visionary leader who not only understands health care, but also understands and has shown that he can help physicians, nurses and hospital leaders work together to improve the care that patients receive.
ROVNER: For nearly two decades now, Berwick has run something called the institute for health care improvement. It's a think tank dedicated to making health care safer, better for patients and less expensive. The 63-year-old Berwick has been recognized for his efforts with the purpose prize, awarded to those who make civic contributions in a second career.
He's also been named an honorary knight commander of the British empire by Queen Elizabeth for his health care work on the other side of the pond. Now, says Fisher, in his new role, Berwick will have a chance to take the work he's done so far to a whole new level.
Dr. FISHER: He has devoted more energy than anybody else in health care to thinking about what it takes to actually improve the care that patients receive. And he now has the tools in this health care reform package to enable him to work with everybody to help improve care while slowing the growth of health care spending.
ROVNER: David Howes has seen the impact of Berwick's work firsthand. He heads Martin's Point Health Care in Portland, Maine. It's a health plan and group of doctors that joined one of the Institute for Health Care Improvements programs a couple of years ago. Since then, he says, the difference has been dramatic. Instead of waiting a month or more to be seen by some doctors, he says, most patients can be seen in a day or two.
Dr. DAVID HOWES (President and CEO, Martin's Point Health Care): We carefully now measure and manage our care of diabetic patients. There are seven things that diabetic patients need to have followed and managed carefully.
ROVNER: And those changes have paid off. There's better care and a better looking bottom line.
Dr. HOWES: We are way below in terms of the cost of care, the inflation rates of the organizations around us. And that, of course, is a source of real pleasure and pride for our clinicians in our organization.
ROVNER: Howes says he happened to share a plane ride with Berwick last week and they both talked about how much they missed treating patients on a regular basis.
Dr. HOWES: That's really who Don is, you know, at his heart he's a physician who really cares about and loves the care of patients, who wants it to be better and wants it to be more humane.
ROVNER: Before he can accomplish that for the rest of the country, though, Berwick will have to get the Senate to confirm him.
Julie Rovner, NPR News, Washington.
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