Ex-Medicare Chief Mulling Run for Governor

PITTSFIELD, Mass. — Dr. Donald Berwick grew up in a small rural town where if someone's car was stalled on the side of the road, you didn't drive by.

You stopped to help.

It was a general idea that he grew up with, that "we're all together and we help each other." And it is that general idea that has now led him to "strongly considering" a run for governor.

His father was doctor, making house house calls miles away helping everyone he could and Berwick followed those footsteps.

He went off to Harvard Medical School and then went on to become a pediatrician. Meanwhile, public policy was an interest of his and he received his master of public policy degree from the John F. Kennedy School of Government at Harvard.

While working in private practice, there were inefficiencies that hindered his ability to provide the best care — for example labs tests not being returned quickly.

"I got interested in quality. How do we do better?" Berwick said on Tuesday when he introduced himself to members of the Berkshire Brigades, the county's leading Democratic organization. "I became a student not just of health care but of improvement. I began studying on anything gets better."

He found the best organizations didn't "disrespect" the people working for it. But, like his younger days in Connecticut, worked together with motivated leaders in various disciplines using their own imagination and plans to work toward the common goal.

That management belief coupled with his drive to "make everything better" led him to start the nonprofit Institute for Healthcare Improvement, bringing health-care professionals from across the world together to optimize health-care delivery.

"I then started to grow a national and international organization to try to improve health and health-care worldwide. And that grew. It is now the largest and most significant of such an organization in the world," he said.

Meanwhile, he still saw patients but wanted to do more. While he could treat a virus and make the health systems better, he couldn't solve the root cause.

"What makes a kid sick is not just the germ ... it is poverty, something in the air that shouldn't be there, injustice, fear or just social circumstances," Berwick said, adding that health care extends far beyond medicine.

Berwick told a story of a child growing up in poverty who had to fight to get a bone marrow transplant. He finally received it to cure his leukemia only years later to be murdered because of his social circumstances.

He then got the taste of the public sector. In 2008, President Barack Obama selected him as a recess appointee as administrator of the Centers for Medicare and Medicaid Services. He was called on to change the system after the passage of the Affordable Care Act.

He oversaw seven of the 10 provisions put in place by the act while leading the $820 billion health insurance agency. He led that organization by forming close relationships with other agencies.

"The first rule is that we have to run CMS in the way you want health care to be," Berwick said.

But on the legislative side, the environment was often "toxic" and elected officials weren't making decisions based on what "they feel in the heart" but rather "what they saw on TV," he said, and both parties in Congress were not working together and it was hurting the government's ability to work for the greater good of the people.

"That was entry into high level government," Berwick said, adding that he was excited with the direction the administration was going in universal health care.

His term ended after 17 months when he resigned because it was clear a Republicans would oppose a Senate confirmation for full appointment. He returned full time to his home with his wife, Ann, who is the chairman of the state Department of Public Utilities.

Now, a year after his term ended in Washington, he is ready to dive back into the public sector with a run for governor.

"I want to stay in the public sector. What governments can do is phenomenally important if it is done right. By right I mean, well run and responsive to the public and in good partnership," he said. "I want to make the best possible community."

If he formally enters the race, he is planning to run on a platform aimed at improving the state's health care system, particularly lowering the costs by focusing on keeping patients healthy rather than "filling beds"; educating children; ending poverty, and solving economic problems the state faces by improving the energy policy.

"I would like to be governor to bring that kind of thinking about proper management, commitment to the poor, total commitment to children and continue swinging the bat at health care. I think I can do that and I'd like a chance to try," he said.

Berwick and Treasurer Stephen Grossman are the only two candidates so far who have indicated they may enter the 2014 race. Berwick hasn't yet announced but is going on a "listening tour" across the state to hear from the people.

Once news leaked out that he was considering a run, the Brigades invited him to speak. Grossman recently spoke at the Brigades' annual dinner.