Healthcare Reform: Obama Speeds It Up

How do you make this historical reform an asset for the midterm elections when no American will have seen it benefit him or her by November? Announce the nomination, without a Senate vote, of an expert, uncontested man-of-action, Dr. Donald Berwick, to manage the federal health insurance. Is Obama taking the bull by the horns?

This nomination by the president is constitutional, and Dr. Berwick will have full power until the end of the next session of Congress, at the end of 2011. The president had already named Dr. Berwick administrator of the large public service programs Medicare (federal health insurance for those ages 65 and up) and Medicaid (federal health insurance for the poor) in April of this year after the position had been vacant since 2006. Berwick knows the drill therefore, and he’s ready to make this work.

In fact, the president has been constrained by this nomination without a Senate vote. The Republican senators have known for several weeks that they would drag their feet as long as they could in a purely political move. And, as the Senate vacations are close, the auditions would’ve been put off until after summer, preventing the game plan of the job that is key to the success of this new system.

Obama has made a big decision therefore, in appointing this visionary pediatrician, co-founder of the Institute for Healthcare Improvement — an NGO in Cambridge, MA —and renowned professor of medicine at Harvard. He’s a defender of both the sick and of consumers, and also a “business head” of health, conscious of the financial ratios and the cost of care. He’s a thinker of the system. He has expressed his theories on the good level of technological health and the struggle against the many types of surgery largely practiced in the U.S. His preferred health care model is that of Great Britain.

This nomination is symbolic of Obama’s reform and can be used in proactive communication. This makes Medicare (the existing medical protection) a terrain of experimentation for the selection of high-quality health care, to the detriment of what is already criticized in our current system: its mediocrity, to say the least.

What does this nomination do? It shows to the country the president’s concrete sense and his concern for disenfranchised populations, and proves that this new head of the Medicare and Medicaid systems is already in action. He’s going to communicate what is working and what he’s doing. This won’t be easy, especially when the Huffington Post announced this week that the first million of newly insured people were to be expected in 2011 and then 30 million more would follow by 2014. He’s going to have to hold his own in an America that has once again let go 125,000 employees this month alone, with the unemployment rate teetering on 10 percent. He must do this in an America that had refused, just this past spring, to prolong the health coverage of unemployed workers in the businesses where they had their insurance plans. The president’s “tool box” of communication is going to have to be extremely creative.