As expected, Don Berwick will step down as head of the Centers for Medicare and Medicaid Services next month according to the Associated Press.
Berwick’s controversial year on the job following a recess appointment achieved little compared to his initial ambitions. The administrator, in a final interview with the Washington Post‘s Sarah Kliff, showed that he had much more in mind:
SK: How well do you think this will work? It requires a pretty big paradigm shift by the health-care system, which right now, like you said, doesn’t focus much on coordination.
DB: I am very optimistic. The more I travel, the more I see growing receptivity to this. People know health care has got to transform into something much more. I think times are really different, not absolutely everywhere, but in professional societies there’s a sense of readiness. I think we might be on the verge of better care. And the financial situation adds a new sense of urgency.
Berwick is headed back to the private, or at least the academic, sector of work thanks to simple math. Facing 42 solid votes against his renomination in the Senate, an oncoming Supreme Court decision, and the pressure of an election year which may well see the president’s signature health care law fall to pieces, it was clear there was little opportunity or political benefit for a nomination fight which would inevitably put rationing back on the front page across the country. Berwick will have to be content to support President Obama’s unpopular law without drawing a taxpayer-funded salary.
Berwick’s tenure was shortened thanks overwhelmingly to an awareness of his past statements. These views were expressed over the course of decades in venue after venue, frequently with video of his controversial remarks which made Berwick’s claims that he did not support rationing fall flat. Once again, Berwick provides us an example of what happens when the things polite technocrats say to each other are made known to the American people. We will not miss him.