Summary: Donald Berwick, a visionary leader in the pursuit of quality medical care, said at a forum that our health system’s focus on profits is damaging, wrong, and demoralizing. It blocks improvements in quality. He said, “I remain an advocate of a globally budgeted, single-payer system.”
IHI Forum: Berwick Says ‘One of the Problems in Healthcare Is Greed’, Healthleaders, December 9, 2022, by Christopher Cheney
The focus on profits in U.S. healthcare is “damaging,” Institute for Healthcare Improvement President Emeritus and Senior Fellow Donald Berwick, MD, said during this week’s IHI Forum in Orlando, Florida.
Berwick is one of the country’s leading authorities on healthcare quality and improvement. The co-founder of IHI served as administrator of the Centers for Medicare & Medicaid Services during the Obama administration.
In a meeting with journalists during the IHI Forum, Berwick criticized the financial model of U.S. healthcare. “One of the problems in healthcare is greed. We must address the degree to which the pursuit of profit and the acquisition of money and high valuations and investor-oriented business models has taken over healthcare. It is damaging. It is wrong.”
Individual patients are being harmed, Berwick said. “At the individual level, this is leading to higher and higher out-of-pocket costs, more and more insurance benefit structures where people have to pay more, and disadvantages to people with lower incomes.”
The emphasis on profits limits the ability of healthcare organizations to improve quality, he said. “This is affecting the context in which quality plays out. Our work on improvement depends on a basic foundational structure that can invest in improvement.
The distortion in behaviors and the demoralization that results from profit-driven excess is hurting our ability to improve.”
Other countries have established a better business model for healthcare, Berwick said. “I work in many systems around the world, which include single-payer systems in which there is a much stronger sense of collective duty. In many countries, the ministry of health feels responsible for making sure that resources are allocated in a way that will help the population. There is no minister of health in the United States. There is nobody thinking about whether the healthcare system is making sense for people. I remain an advocate of a globally budgeted, single-payer system.”
Comment:
By Don McCanne, M.D.
Which is better for our health? Greed-driven healthcare? Or single payer? The answer is obvious, as Donald Berwick explains.
Which do we have? Why? Well let’s change that, for our health! Now!
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