Health Care Should Cost Less Like Computers, Cars, TVs, Says Medicare Chief Berwick

CNSNews ^ | April 13, 2011 | Penny Starr

[jazusamo]

(CNSNews.com) – At a press conference on Tuesday to announce the allocation of $1 billion in federal funding to improve patient health in the nation’s hospitals, Donald Berwick, administrator for the Centers of Medicare and Medicaid Services (CMS), compared the new health care law, which requires more government control, to other products that have become better and cheaper over time in the marketplace, without more government control.

Berwick said health care is “just like any other important segment of our economy” and “doing it right” will cost less in the long run.

“Computers today do more than they ever have at far lower prices,” Berwick said. “The same is true for cars, and TVs and telephones – just about every other product or service that we really care about.

“And they didn’t get there by cutting or by rationing,” Berwick said. “They got there by improving the processes that make their products and services.”

However, automobiles, telephones, computers, and televisions are products that stemmed from and thrived in a relatively free marketplace, unlike Medicare and Medicaid, which are run by government, and unlike Obamacare, which represents more government intervention in the health care marketplace and mandates that people buy its product, i.e., health insurance.

Berwick joined Health and Human Services Secretary Kathleen Sebelius and guest speakers and others who are supportive of President Barack Obama’s health care law, including the head of the AFL-CIO and the president of the American Medical Association.

In her remarks at the event, Sebelius said the “Partnership for Patients” initiative “will bring together hospitals, physicians, nurses, employers, unions, patient advocates, health plans, and others to improve the safety of health care in America.”

Sebelius said the goals are to “reduce preventable injuries” in hospitals by 40 percent by 2013, a reduction she said could save 60,000 lives. The initiative is also supposed to prevent hospital readmissions by 20 percent by 2013.

“That’s why we are announcing today that we will commit up to $1 billion in new funding from the Affordable Care Act towards our two initial goals,” Sebelius said. “In addition, we are providing hospitals and physicians with an unprecedented range of resources about what other health care providers are doing to improve patient safety.”

Berwick’s remarks on Tuesday are in contrast to controversial comments he has made over the years about the rationing health care services and his admiration for the single-payer, government-run health care system in Great Britain, as reported earlier by CNSNews.com.

“The decision is not whether or not we will ration care – the decision is whether we will ration with our eyes open,” Berwick said in a June 2009 interview with Biotechnology Healthcare.

In a talk Berwick delivered in England in 2008 to mark the 60th anniversary of Great Britain’s National Health Service, the bureaucracy that runs that country’s health care system, Berwick told the British that he loved their system. “Cynics beware,” he said. “I am romantic about the National Health Service; I love it.”

He particularly drew attention to the British system for limiting the budget for and planning the supply of health care services through government planning.

“You cap your health care budget, and you make the political and economic choices you need to make to keep affordability within reach,” Berwick said. “You plan the supply; you aim a bit low; you prefer slightly too little of a technology or a service to too much; then you search for care bottlenecks and try to relieve them.”

In the June 26, 2008 issue of the British Journal of Medicine, Berwick published an article praising Britain’s government-run system and criticizing marketplace health care in the United States because it fuels competition that apparently produces an excess supply of health care.

In contrast to his current views on how competition improved and lowered the cost of computers, televisions, and telephones, Berwick wrote in 2008: “Please don’t put your faith in market forces,” he said (italics in original).

“It’s a popular idea: that Adam Smith’s invisible hand would do a better job of designing care than leaders with plans can. I find little evidence that market forces relying on consumers choosing among an array of products, with competitors fighting it out, leads to the healthcare system you want and need. In the US, competition is a major reason for our duplicative, supply driven, fragmented care system,” Berwick added.

At Tuesday’s event, Sebelius repeated her view that Berwick is “the right person at the right time” to run the nation’s largest medical entitlement program and the latest $1 billion program funded by Obamacare.

“As we move forward, we couldn’t have a better person guiding this effort than Dr. Don Berwick,” Sebelius said. “President Obama chose Don as the administrator of the Centers for Medicare and Medicaid Services and I’ve gotta’ tell you, he is the right person at the right time to lead this critical initiative.”

President Barack Obama recess-appointed Berwick to head the CMS in July 2010 when Congress was in recess. That appointment will expire at the end of this year, 2011, unless the Senate votes to confirm Berwick. In late January, Obama renominated Berwick for Senate confirmation.

As CNSNews.com reported in March, 42 Senate Republicans wrote a letter to President Obama opposing Berwick at CMS because of his support for health care rationing and Britain’s single-payer, socialized health care system.

[hedgetrimmer]

All we need is for Microsoft to come up with a software program to run a mechanical robot

They already have. Matlab running on Microsoft windows powers that robot!

[rockinqsranch]

Healthcare could be one “H” of a lot less costly today were it not for government involvement thank you T. Kennedy.

Get the government out of our health, and watch the costs go down to affordable for everyone.

[jazusamo]

Second, cars DON’T cost less

Yep, just look at the Chevy Volt. Suggested price of around $41,000 before a $7,500 taxpayer rebate and dealers have already mentioned a possible dealer markup. Plus a reliability factor that is questionable.

The issue is about WHO makes the decisions!

That's the scary part. If it turns out Obamacare is in fact socialized medicine the pencil pushers will be making those decisions, decisions of who gets treatment and who lives or dies.

[No Truce With Kings]

Actually, there are two sectors of Health Care where prices have followed the computer cost model — much more product for much less cost. Those sectors are lasic eye surgery and elective cosmetic surgery.

Oddly, those are two parts of the medical sector that are not covered by health insurance. Might be connection between market forces and lower prices for higher quality, ya think?

[CodeToad]

Only if we can automate medicine. Whattamaroon!

[MortMan]

Apparently he doesn’t understand that the lower-cost, affordable computers are middle-to-lower-end, that they are not the best available. For the best, the price has remained remarkably high - and it should.

Who among us will NOT accept intermediate level electronics, if it will do the job we need?

Who among us WILL accept mediocre health care if excellence is available?

Who else among is believe that Berwick is an idiot?

[Minn]

If we created a new government program, with the mission of insuring that all old and poor people have flat screen televisions, what would happen to the price and quality of flat screen televisions?

[DrC]

“Oddly, those are two parts of the medical sector that are not covered by health insurance.”

Put another way, do a thought experiment. Imagine if the government regulated the supply of computers (e.g., Dell or Microsoft would need to get government permission before building any facility), the quality of computer industry workers (all workers would have to be licensed according to government standards) and all computer-related R&D (no new computer hardware or software could be released without FCA (Federal Computer Administration) approval. Moreover, the government would provide computer insurance to tens of millions of Americans who could not afford computers and it would give 30%-off coupons to people who purchased similar coverage privately. Note they would NOT give you a 30% subsidy for buying computers—only for purchasing an “insurance policy” that entitled you to buy computers etc.

Finally more than half the industry would consist of government-owned or non-profit firms. Does anyone think that under these conditions we would see Moore’s Law played out decade after decade, with ever-increasing computer power/quality at ever-affordable prices?

[Polybius]

All we need is for Microsoft to come up with a software program to run a mechanical robot to perform your colonoscopy in 15 seconds and, if a tumor is found, to perform your partial colon resection in 15 minutes.

They already have. Matlab running on Microsoft windows powers that robot!

My computer is run by Windows but Windows is not posting to Free Republic. I, a flesh and blood human, am posting to Free Republic.

Likewise, although Microsoft Windows allows the surgical robot to be run, that software does not perform the actual surgery. The guy in the green scrubs with an M.D. after his name and with many years of surgical training after he earned that M.D. is performing the actual surgery by controlling the robot controls just like we control our keyboard and mouse when we post to Free Republic.

The surgeon works at a console a few feet away from the operating table. Several controls are used while watching a magnified three-dimensional image of the surgical field on the monitor. The “patient-side cart” refers to the robotic arms and instruments that directly contact the patient.

It is silly to compare functions that can be done by mindless microchips and software (mathematical calculations, Microsoft Chess Titans playing chess, etc.) to activities that still require the human mind (performing a partial colon resection without killing the patient).

Until medicine and surgery can be totally automated, the speed of human performance will remain the rate limiting step in productivity and cost.

"So, Charlie, I heard that your uncle tried out Microsoft Partial Colectomy 2.0. How did it turn out?"

"Well, let's just say that, when the Blue Screen of Death pops up, they really mean it."

[outofsalt]

“I don’t think comparing health care to appliances that can be unplugged sounds too good.”

Remember, any “appliance” (or drug) used in medicine has to be FDA approved, often at the cost of multiple millions of $$$ and years of study.
Of course, all healthcare is HIGHLY regulated by multiple government agencies and subject to litigation if any untoward outcome occurs. What's more, consider the cost of time, effort and money it takes to become a medical professional. Berwick is an idiot!

[meyer]

All we need is for Microsoft to come up with a software program to run a mechanical robot to perform your colonoscopy in 15 seconds and, if a tumor is found, to perform your partial colon resection in 15 minutes.

I don't know - instead of the "blue screen of death", would we encounter the "brown screen of death".

Sorry - butt humor.

[Buckeye McFrog]

This coming from a man who has absolutely NO respect for or understanding of the free market.

If he were put in charge of computer technology an iPad would run you $700,000.

[hedgetrimmer]

You’re talking to the wrong person

I already helped to build that system.Key word
‘system’ not individual software package.

[Polybius]

You’re talking to the wrong person I already helped to build that system.Key word ‘system’ not individual software package.

You're also talking to the wrong person. My professional license says "Physician and Surgeon" on it.

The person in question in this article stated that medicine should have quatum leaps in efficiency just because computers have made quatum leaps in efficiency performing calculations that require no human judgment whatsoever and because steel cars can be produced at great speed.

My original post said:

"All we need is for Microsoft to come up with a software program to run a mechanical robot to perform your colonoscopy in 15 seconds and, if a tumor is found, to perform your partial colon resection in 15 minutes."

Without a surgeon, can your system - Key Word - "perform", by itself, even the most simple of surgical procedures? Can it cauterize a bleeder? Can it mobilize a caecum? Can it even recognize a caecum from from a uterus?

No. Your system functions merely as "robot-assisted surgery" and not "unassisted robotic surgery". Your system still requires human skill and judgment and the human mind is therefore still the rate-limiting step in the equation.

Without the human surgeon, your "system" is merely an expensive piece of decorative sculpture taking up space in the OR.

In the future, when and if "unassisted robotic surgery" becomes a routine reality, you will still have the frailty of the human body to deal with. Robots in an automobile factory can attack stainless steel at amazing speed and stainless steel will never bleed or die. You cannot treat a human body that way without tearing it apart.