NPR: Medicaid & Medicare Can Improve with Less Waste

Less waste in the healthcare system, including in Medicaid and Medicare, will lead to more affordable care, said Dr. Donald Berwick, the former administrator of the Centers of Medicare and Medicaid Services (CMS), during an interview with National Public Radio.

An NPR listener asked how health care reform was supposed to happen when the nation can’t even afford existing programs such as Medicare and Medicaid.

“It’s not just a Medicare and Medicaid problem,” Berwick countered. “We can afford it by taking the waste out of the care.”


The nation’s 9 million dual eligibles—those who receive both Medicare and Medicaid—take up about $320 billion of government funds for their care, he said, adding that “we don’t do well with chronic care.”

“Easily a third [of that $320 billion] is just waste,” he said. “If we get them into coordinated care, we could meet their needs much better.”

And, if the nation sticks with the Affordable Care Act, Berwick continued, “almost everybody wins.”


Berwick stepped down from his CMS post on Dec. 1, and discussed the future of Obama’s healthcare reform law and what will happen with his own efforts toward healthcare reform now that Marilyn Tavenner has taken over his former position.

“It’s sort of a thrilling time in health care right now, but it’s much more expensive than it needs to be,” said Berwick during the interview, adding that “major improvements” are possible if the nation can buckle down and “make health care perform like we want it to.”

The problem is, there’s a lot of waste in the system, he said. Hospitals make money by being full of patients, instead of by making sure those patients receive a quality of care that can return them to their homes more quickly and with less rehospitalizations.

When asked about conservative presidential candidate Ron Paul’s stance that “freedom is all about taking your own risks” in deciding whether or not to get health insurance, Berwick said that “we’re a country where we can help each other, and we rely on that.”

If someone needs healthcare but doesn’t have insurance, through their own personal decision or otherwise, that person should be able to receive care, the former CMS administrator believes, citing recent polls that show public support for Medicaid as a “very important” program.

“I think Americans want a healthcare system that’s just, reliable, available—and available to all,” he said.

Go here to listen to the entire NPR segment.

Written by Alyssa Gerace

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