Berwick on CMS, Death Panels, and His Run for Governor

Why Run for Governor?

Dr. Topol: You go from this near year-and-a-half appointment to CMS, and shortly after that you say, "I'm going to run for governor." What was your thinking there? Hadn't you had enough of the politics inside the Beltway?

Dr. Berwick: What I came to see more than I'd ever seen before was the potential of good government, soundly led government, invested in the moral imperatives of a nation. Focused on the needs of real people, government can do a lot of good. I learned that you can't do it alone.

One of the most exciting things about CMS for me was partnering; learning; reaching out to the hospital community, the doctors, and patient rights groups; and saying, "Let's do this together and really figure out where the common ground would be." I couldn't do that with a vicious opponent. They're more interested in conversation, so that's fine. They're there. They'll be there.

I see the rule of progressive government and good partnership. It can do things nobody else can. Especially for me, it's around what Hubert Humphrey called the moral test of government.

Hubert Humphrey said the moral test of government is how it treats people in the dawn of life (children); how it treats people in the twilight of life (the aged); and how it treats people in the shadows of life (the sick, the needy, and the disabled). That's my patient population for years. That's what I care about. And boy, we cannot meet the moral test without government, and government needs to be trusted in order to be effective.

You see Washington in trouble. It's stuck, angry, and contentious. And here, back in Massachusetts, this state made healthcare a human right in 2006, 5 years before the ACA. It's very progressive, including the Energy Policy, and our schools are really improving. The people have come together. There's bipartisan work here that I think others should envy.

I've been out of CMS now almost 2 years, so it wasn't a rapid decision to run for governor. But I think for me, at this stage in my life, being able to contribute in the public policy arena and make a case for compassion and a focus on needs, service, and justice -- I want to do that.

Dr. Topol: You alluded to a lot of momentum here in Massachusetts. Can you take it to another level? Where do you see it going? It isn't just healthcare, right?

Dr. Berwick: No. I wouldn't do this if I were only interested in healthcare. I'm interested in community, in working together -- and that means small communities, not just statewide.

I've been thinking more and more about what I call thriving or flourishing, or being the kind of community we want to be. That's not healthcare alone. Healthcare's got to be right, but everything triangulates on it. It's a system. Schools matter, roads matter, talent matters, the air matters, the water matters, and one of the wonderful things I think about is that if I get to be governor, I can work at that systemic level.

Dr. Topol: Are there any precedents of physicians who have been governors?

Dr. Berwick: Right now, we have a physician governor in Oregon, John Kitzhaber, who is in his third term. John's a good friend.

Dr. Topol: That's been a very progressive state as well.

Dr. Berwick: He's done a great job. He's done it on a broader platform than just healthcare, although now he's leading some pretty exciting healthcare changes there around what they call CCOs -- Coordinated Care Organizations. I think it's great.

I've talked to him about being governor. He absolutely loves it. He had no hesitation.

Dr. Topol: We really are grateful to have had you join us for this One-on-One.

Dr. Berwick: Thank you very much.

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