5. Commitment to science. Healthcare should be science-based, Berwick says. Patients should get what works and they shouldn't be subjected to what doesn't work. "All the rhetoric about death panels and rationing has distorted the important issue of whether we will commit to healthcare that works." Berwick says that will require a "reconnection of the healthcare agenda to the scientific agenda."
6. Prevention. If the US is going to pursue the storied triple aim (better care, better health, and lower costs) then it needs to invest in the causes of illness, says Berwick. "This is always vulnerable. It's the easy target, the budget you can cut." It's time, he says, to get very serious about reducing risk factors in healthcare. "This is a huge challenge to grapple with. Will our country prevent illness?"
7. Communication. "Somewhere at the beginning of healthcare reform we lost the opportunity to make the case for healthcare as a human right," Berwick said. While he contends that it's an easy case to make, he says work needs to be done to "build a bridge to public sensibility and a dialog about the healthcare we really want."
Berwick wrapped up his comments by calling for fewer pilots and a "more wholesale change" in the delivery of healthcare. He also alluded to state demands to have more say in healthcare reform and more independence in developing their own programs.
He described the states as "true laboratories of democracy. If we're smart and keep our wits about us we will learn a ton." Berwick also seemed to endorse the idea of more state independence. "If we have the wisdom to give states the license to move ahead…I think we're going to see an era of great learning."