Monday, September 19, 2011

The Choice is Ours

Today, along with other public hospital and health system leaders across the nation, I had the opportunity to hear our CMS Administrator, Don Berwick, speak concerning our options when considering the rising cost of health care. He noted that there are two choices before us that will result in cost savings:

we can cut services and care, or we can improve them.

While cutting services and staff, or withholding benefits may seem like an easy way to reduce costs, Berwick discussed a "better" approach: remove defects, duplication, inefficiencies and rework from our health care systems; provide the care that people want and need; produce health. He urged health leaders to pursue continuous improvement and innovation. Pointing to a cell phone in the room, Berwick noted that personal communication devices have not only vastly improved in functionality over the last five years, they have decreased in cost at the same time. In contrast to cutting service as a cost containment strategy, improvement, isn't easy: it takes time, it can be difficult identify which specific changes led to improvement and it requires skill and discipline in improvement methods.

We are at a critical crossroads in health care in America. We can pursue the historically unsuccessful and unsustainable approaches to cost containment we have typically applied in health care, or we can become better. We can cut service in our country, increasing human suffering and despair, or we can improve our health systems and provide the care our communities want, need and deserve.

The choice is ours.


  1. I choose improvement in partnership with patients, families, front line staff and leaders. Thank you for this post and the great picture of you and Dr. Berwick. Love it!

  2. Exactly! Here's some more on this topic:

    Congratulations on what you are doing!

  3. Thank you Teresa and Paul for your comments.

    Paul: Your post is an incredibly clear presentation of the complex challenges we are facing. Well worth the read.

    Teresa: Well said! I am with you.