Berwick was brought on as a person who has intimate knowledge of how healthcare works—and doesn’t work. Through his previous longtime stint as the head of the Institute for Healthcare Improvement, he’s spent a career pointing out the myriad ways healthcare could be made better and less costly. Some of it has to do with simple blocking and tackling. By that, I mean treating the patient as a customer who needs to get well and whose care needs to be coordinated. Too often, enough healthcare providers—certainly not most—appear to treat patients as money-printing machines who belch cash—by virtue of being covered by a number of government and nongovernment
payers—whenever something is “done” to them. That may sound like a cynical statement, but cost to the patient and to the taxpayer has been absent from the treatment decision-making process for too long. In the past, Berwick and IHI have suggested ways healthcare can operate more efficiently, and now he’s in a position to actually do something about it.
I’m sympathetic to the AHA’s position. If my boss sat me down and told me I was going to take a 2.9% pay cut, I could either accept it or leave. Hospitals don’t have that option, for various reasons, but they also have a powerful ally in their corner that I don’t have—and neither does any individual patient. They can pressure Congress to make this problem go away.