Why Republicans Are Wrong About Rationing and Dr. Berwick

It's a sad day for health care in America now that Republican senators have refused to confirm Dr. Donald Berwick, who has been serving in a recess appointment as Administrator of the Centers for Medicare and Medicaid Services (CMS). Dr. Berwick announced that he is resigning effective December 2.

Americans could not have a better champion for good medical care. I know this for a fact. I led quality and safety initiatives at the Robert Wood Johnson Foundation for sixteen years and had the privilege of working with Dr. Berwick and his smart, dedicated colleagues at the Boston-based Institute for Healthcare Improvement.

They worked tirelessly to bring the science of improvement to hospitals, doctors' offices and other health care facilities. In case you haven't noticed, they have been extreme laggards in implementing the most rudimentary process improvements that safety critical industries such as aviation and nuclear power deploy routinely to reduce the potential for harm.

Here is one of many examples of how Dr. Berwick helped save lives. A preventable cause of hospital death is called 'failure to rescue'. It occurs when a patient's condition deteriorates and doctors and nurses miss the fact that the patient is in trouble.

With Dr. Berwick's leadership, the Institute for Healthcare Improvement identified a possible solution and taught doctors and nurses in hospitals around the country how to implement it. Called rapid response teams, many doctors and nurses who put these teams in place reported that mortality at their hospitals dropped.

Dr. Berwick and his team made this and many other life-saving improvements possible. Without a doubt, many Americans are alive today because of the work he taught, inspired and led.

If you want to see the human face of failure to rescue and why his work matters, take a look at Wall of Silence. It tells the stories of people and their families who were harmed by errors. You can also find out how to protect yourself from all kinds of mistakes.

Take a look, too, at the Consumers Union Safe Patient Project, which has organized people and their families who have been harmed by errors, infections and other causes. They advocate for public policies to make health care safer for us all.

Claims by Republicans that Dr. Berwick supports rationing of medical care are uninformed and frankly, absurd. A physician who is devoted to stopping harm and preventing death is not going to turn around and harm people by withholding needed care.

If Dr. Berwick remained as administrator of CMS, he would have continued to bring competence and passion to benefit millions of Americans covered by Medicare and Medicaid.

Republican senators won't let him do it and they will be among the losers. They will get sick someday just like everyone else. So will their parents, spouses, children, grandchildren and siblings. Being a well-known muckety-muck in Washington -- or related to one -- confers no immunity from health care harm.

Watch Donald Rumsfeld's interview with Diane Sawyer and toward the end, you'll see him get choked up when he talks about his wife who almost died from a medical error. "She was dying," he said. "I remember looking at Joyce in the hospital bed. And she looked just like her mother who'd died in her 90s. And she was that bad." She has since recovered.

The scale of health care harm in the U.S. is enormous. Arlington National Cemetery -- where about 330,000 people are buried -- would fill up in about three years with all the Americans who die every year from medical mistakes.

These numbers are based on the conservative estimate of nearly 100,000 deaths annually from medical errors reported by the Institute of Medicine. Since this report was published twelve years ago, other studies report that the number of deaths is higher.

That's not all. Arlington Cemetery would be filled up in about three years with the nearly 100,000 other people who die from hospital-acquired infections annually, according to the Centers for Disease Control and Prevention (CDC).

Dr. Berwick had the courage to acknowledge the extent of health care harm and show hospitals, doctors and nurses how to prevent it. He has performed an incredible public service yet most Americans don't know it. None of this matters to Republicans who have political fish to fry.

Whether Democrat, Republican, or Independent, everyone will get sick someday and want the best and safest care possible. The good news is that Dr. Berwick will likely continue his noble work wherever he goes. We can be thankful for that.

Rosemary Gibson is the author of Wall of Silence, which tells the human story of medical errors, and The Treatment Trap, which shines a light on overuse of unnecessary medical care. She led national quality and safety initiatives at the Robert Wood Johnson Foundation for sixteen years.