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President Obama's candidate for the leadership of the Centers for Medicare and Medicaid (CMS) is a Harvard physician named Dr. Donald Berwick. If you have not heard of him, you will soon. He is waiting for the confirmation and the agencies he will have his head, waiting for a leader for over four years. Who is this man calling for a radical Republicans, but nearly every doctor seems to love? (And who says we do not need a radical CMS anyway!) One of the biggest allegations that he "loves" of the NHS, Britain's National Health Service. Ergo, he loves socialism, ergo he is a Marxist. It is true that the NHS Berwick admired. He does it from having studied it and worked with him to improve on care. But most people, the British National Health Service do not criticize too much about it. They base their opinion on a few headlines or stories of someone to wait to have had knee surgery. In the late 1980s, I took a team of medical examiners to Britain to study the quality of care in the National Health Service. We concluded that the quality of care equivalent to or better than in the U.S., in spite of some outdated equipment and half the money the U.S. spends on medical care. I came to admire the NHS for what they were able to achieve, despite some significant fiscal challenges. Admire what the NHS has managed not seem to be that all radical to me. However, admiration for the NHS to kill the nomination by this incredibly innovative and well-qualified doctor? I hope not. Despite professed Berwick's respect for the NHS, he is not blind to his mistakes and is no central planning or top-down person. He understands that the revolution we need in health care, in fact, can not start at the top. And not even in the middle. There must be at the bottom, where individual doctors and hospitals fight the best care begin to care for the patient. Doctors and hospitals need a leader who not only understands their dilemmas and challenges, but knows how to help them do better. Berwick's Institute for Healthcare Improvement 100,000 lives campaign began in 2004, moved to the obligations of more than 3,100 hospitals with 100,000 the number of deaths from medical errors to June 2006. show because of his ability, his fellow doctors about how to improve the quality of care, without service, he received praise and support from the AMA, the AHA and health professionals across the spectrum, including conservatives. This article give Media Matters offers many examples of health care leaders, their support for Berwick and his work. And Maggie Mahar health blog sums up why …. Most of those who describe him him as a "visionary" and a "healer know," a man capable of the fragments of a broken health care survey and imagine how they could be made whole. He is a revolutionary, but he does not know Rattle cages. He is not arrogant, and he not pleading for a takeover of the U.S. government in health care. If you want to know a bit more about the personal Berwick, but here's an anecdote that may never come into this crazy discussion. When Dr. Berwick was his own wife in the hospital a few years ago he was at her side, day and night. But even with that vigilance - even with his knowledge of health care - it caught errors in their medication several times. Without his supervision, she could have died. Here is part of the story: There were errors in the medication. One morning, a neurologist warned that Ann should not be a certain type of drugs. By that afternoon, someone had given her. Another drug has been discontinued by their physician on their first day of admission, but bring it every night, the sisters continue for the next two weeks. Later, her doctors decided to put her through chemotherapy to try to stop a worsening of their condition. "Time is the essence," her doctor told her. The first dose was 60 hours. She was a single dose of the extremely dangerous chemotherapy given daily for five Tage.Am third day, the nurse came and hung the infusion bag and started it in. "The sack," said number two, '"recalls Berwick. "But it was the third dose. I was there. I had seen the others. I told the nurse. She simply I was wrong. If I had 10 years old, she would have patted me on the head and said, `I know, I know, do not worry, sweetheart." I almost wanted to grab the lapels and say, listen, `I know what!" , "(The nurse finally checked the record and agreed.) It was this experience, as well as many others, that the pulses can reduce the trip to Berwick for excellence, and its intention to medical errors in hospitals. And that has become his life's work. I am sure you have the oft-cited "one fact" that more people die from preventable medical errors, as in hundreds of airplane crashes, die each year. This study Health Grades, back in 2004, comes to the conclusion: The Health Grades study shows that the IOM (Institute of Medicine) report (from 1999), the number of deaths due to underestimated by medical errors, and beyond that there is little evidence that patient safety has improved in the last five years, "said Dr. Samantha Collier, Health Grades' vice president of medical affairs. "The equivalent of 390 jumbo jets full of people die every year due to preventable likely in hospital, medical errors making this one of the leading causes of death in the United States and in the Medicare population, the data are even more shocking: - About 1.14 million patients Security incidents occurred among the 37 million hospitalizations in the Medicare population in the years 2000-2002 .- Of the total 323 993 deaths among Medicare patients in those years, one or more patient safety incidents, 263,864 or 81 percent , of these deaths directly to the incident (s were developed). We do not have a perfect health system. The U.K. not. But we will not get a person at the head of Medicare, which does not shy away from other systems still knows how to work effectively within our own? Now that would be radical. If you look in front of a company health insurance benefits, pulled himself ready for a change in the next few years. Many employers have cut pension benefits cover all or shed in recent years due to skyrocketing health care costs. Only 29 percent of large companies in 2009 provided coverage, compared with 66 percent in 1988, according to the Henry J. Kaiser Family Foundation. Now the new health reform law is fueling that further changes to start ads in retiree plans will ensure that by the year 2013. Medicare beneficiaries, the employer-funded prescription drug coverage is to feel an immediate effect. Employers currently receive on federal subsidies, that the coverage and the dollar is not counted as income for tax purposes. The idea was to encourage employers to continue to provide coverage, which in turn reduce the cost of the new Part D plan. But the new law raises the health care tax break, a move that will provide money to fund reforms. This led the employer to re-evaluate their options for retirees cover. One of these options is to move to Part D pensioners, which is still valuable in the context of health reform. The big change is the closure of the notorious donut hole coverage gap that, if a beneficiary's annual out-of-pocket spending hits $ 2.830 begins, and takes on the catastrophic level ($ 4,550 out of pocket). This year, patients who had donut hole will get a $ 250 bonus. In 2011, pharmaceutical companies offer a discount of 50 percent on brand-name drugs to low-and middle-income beneficiaries who are in the gap. Then the donut hole itself will shrink a little every year, and finally disappears completely in 2020. "Employers are hard look at the alternatives," said John Grosso, a principal with Hewitt Associates' health management consulting practice. "Now that is the tax situation is less favorable, and the government is closing the donut hole, most employers seek employees get in Part D." Grosso, some employers, the employee says in the individual market for sending Part D coverage-perhaps with a cash subsidy. Others, he thinks, is planning to Part D coverage for retirees through the purchase of their group. Most companies are the changes in 2013, says Grosso, who at the company in the first year not in a position to the tax bill on their books. Employers also are less likely to offer Medicare Advantage group their retirees, "says Grosso. The health reform law gradually reduced to use federal financial plans, currently at 114 percent of regular prices Medicare - a payment scheme, which was created to stimulate the market Advantage will be refunded. The new law freezes Advantage payments at current levels until 2011, then reduced from 116 billion U.S. dollars over a period of years, ultimately equalizing refunds with traditional Medicare. "Companies that had with Medicare Advantage coverage is for the group less likely to see it as a good solution because of the cuts in reimbursements," says Grosso. Meanwhile, early retirees who are too young for Medicare and group coverage through their former employers may see some changes in its reporting,. Pre-Medicare retirees have had a hard time finding affordable coverage in the individual insurance market. Some employers offer these early retirees access to group plans as a way to bridge to Medicare eligibility. The health reform law aims to bridge the gap through the creation of public insurance to private individuals for the exchange of affordable, quality plans Shop Plug. But the exchange will not begin until 2014. In the meantime, the Obama Administration a $ 5000000000 federal grant, has that employers can use to create the cost of early retirement plans in balance. Grosso says, employer interest in the new subsidy is running high, although, that can not fund the concerns 5000000000 $ in 2014. "It may slow the flood of cancellations," he says. "But this is a last resort, to be created by the public exchange, it is a way to keep employers in the game until then."

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