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Head of CMS, Don Berwick Urges Health Insurance Companies to Cooperate to Reinstate “Trust”–Role Models Needed

Posted Sep 13 2010 5:14pm

My translation of some of this is to work together like humans and ease up on the hard core algorithms that have been the bottom line decision making methodologies.  image We all use computers and software for most of our intelligent decision making processes today and along with ethics need to be taken into consideration.  We have all seen much of this played out in the news over the last couple of years with insurers basically stating “our numbers (aka algorithms) say that not a good decision.  When you have someone in desperate need of care, that’s not real popular with anyone, but it is how the game has been played. 

Health IT will save money and physicians and patients will fall into the fold in time, and we have that daily left curve from technology that keeps up spinning through all of this too, so put all that together and it’s a daunting task.  We can’t force people to embrace change but rather it’s better through education for cooperation. 

Healthcare is never going to 100% satisfy the CFOs in healthcare and others who are tied to the purse strings and thus some new business models and ideas are certainly worth looking at and considering.  Nobody has the perfect answer and one doesn’t exist today. 

I am a geek like technology, but I leave out those who are not up to speed with general consumer IT, much less without trying to share and educate and we fall short here and have no role models as what is professed today seems like it is always “for those guys over there” and that path is a loser without role models no matter what you do. 


You can twist this any way you want and we still come back to the same cross road, so my challenge as it has been on this blog for the last 2 years is to bring the leadership of Congress, the White House and Corporate Office Executives into the fold, the only way it can become believable and reinstate trust, role models.  BD

Donald Berwick, the new administrator of the Centers for Medicare and Medicaid Services, issued an invitation to health insurance representatives, saying he hopes insurers will work with regulators trying to rebuild U.S. health care.

"All of us have to change the way we do business," Berwick said to a Washington, D.C., conference hosted by America's Health Insurance Plans. "The government can't do this alone."

Berwick has been in the job for two months since his Senate-bypassing appointment during a congressional recess. He was asked by an audience member -- who pointed out the "villain" status the health insurance industry was put in during the reform debate -- what he is going to do "to affect the culture inside CMS so we have the acknowledgement that there are forces of good within the insurance industry."

Most of the administrator's speech centered on potential gains from the industry working with regulators. "We need your help," he said. "Our nation needs your help. You can be among the keys to our success as a country."

But he also offered a stick to go with the carrots: "When we need to, we can and we will play tough," he said. "We will establish and we will enforce accountability."

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