if you are young and not a liberal you don't have a heart....if you are old and are not conservative you don't have a brain....Churchill
The Wit and Wisdom of Don Berwick.
Wall Street Journal on Berwick.
Who is Donald Berwick?
Meet your new head guy of Medicare and Medicaid. Appointed by your President during a recess and without Congressional debate.
Any health care funding plan that is just, equitable, civilized and humane must – must – redistribute wealth from the richer among us to the poorer and the less fortunate. Excellent healthcare is by definition re-distributional.
Competition makes things come out right. Well, what does that mean in health care? More hospitals so they compete with each other. More doctors compete with each other. More pharmaceutical companies. We set up war. Wait a minute, let’s talk about the patient. The patient doesn’t need a war.
I think health care is more about love than about most other things. If there isn’t at the core of this two human beings who have agreed to be in a relationship where one is trying to help relieve the suffering of another, which is love, you can’t get to the right answer here.
It is, I guess, politically correct, widely believed, that to say that American health care is the best in the world. It’s not.
The decision is not whether or not we will ration care. The decision will be whether we ration care with our eyes open.
We have really good data that show when you take patients and you really inform them about their choices, patients make more frugal choices. They pick more efficient choices than the health care system does.
Death Panels Begin As Reform Takes Shape
Posted 08/18/2010 06:42 PM ET
Medicine: After the recess appointment of a Medicare and Medicaid head, an FDA panel drops its endorsement of a widely used cancer drug. Another FDA-approved cancer therapy may not be paid for. It begins.
It didn’t take long for the health care philosophy of Dr. Donald Berwick, President Obama’s choice to head the Centers for Medicaid and Medicare Services, and an appointee we have labeled a “one-man death panel,” to have an effect.
Berwick is an admirer of Britain’s National Health Service and its National Institute for Clinical Excellence, with the Orwellian-acronym NICE.
“NICE,” Berwick has said, “is extremely effective and a conscientious, valuable and — importantly — knowledge-building system.” But NICE is really a system of rationing, through a bureaucratic formula for “cost-effectiveness,” that has rushed untold numbers of Britons to an early grave.
Avastin, the marketing name for the drug bevacizumab, is the world’s best-selling cancer drug. Used mainly to treat colon cancer, it was approved by the Food and Drug Administration in 2006 after it was found that by cutting the blood flow to tumors, it helped in treating breast cancer.
An estimated 17,500 American women are treated with the drug each year. It is effective, having been shown to extend life by at least 20 months, but it is not cheap.
Under the new “cost-effectiveness” philosophy of this administration, an FDA advisory panel has voted 12-to-1 to drop the endorsement of Avastin for breast cancer treatment. The FDA usually follows advisory panel recommendations, and a final decision will be announced Sept. 17. If approval of the drug, approved for colon, lung, kidney and brain cancer, is revoked for breast cancer, it is likely that insurers would drop that coverage.
In a joint letter sent to the FDA and key congressional lawmakers last week, Susan Komen of the Cure and the Ovarian Cancer National Alliance (OCNA) urged that Avastin continue to be approved for metastatic breast cancer patients and warned of the message this “decision sends about drug development for women with advanced breast cancer.”
Breast cancer, the second most common cause of cancer death among U.S. women, claimed 40,000 lives last year. Komen says the decision to use Avastin should be made between a woman and her doctor after a thoughtful consideration of the benefits and risks. We agree.
The Obama administration’s health care overhaul is all about cost and little about care. Berwick has opined: “We can make a sensible social decision and say, ‘Well, at this point, to have access to a particular additional benefit (new drug or medical intervention) is so expensive that our taxpayers have better use for those funds.”
In other words, the government will decide whether treating you and extending your life is worth it.
OCNA is also concerned whether Berwick’s CMS, the Centers for Medicare and Medicaid Services, will pay for Provenge, a vaccine to treat the recurrence of prostate cancer, and at what rate. The vaccine is made from a patient’s blood cells with cancer cells and an immune-boosting substance. A three-dose course of the immunotherapy is estimated to cost $93,000.
There’s a conflict in mission statements. The FDA is supposed to approve drugs that are safe and effective. The CMS statute says it must pay for treatments that are reasonable and necessary. Provenge is ominously still under review by CMS.
“The decision is not whether or not we will ration care,” Berwick says. “The decision is whether we will ration with our eyes open.”
Well, all our eyes should be wide open by now.
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