NAACOS Fall 2020: Former CMS administrator issues challenge for greater equity in health care

America’s health care system would likely become more expansive and equitable under a Biden administration than ever before, according to former CMS Administrator Donald Berwick, MD.

Berwick, who led CMS for 17 months during the Obama administration, spoke Tuesday during the first day of the National Association of Accountable Care Organizations’ (NAACOS) 2020 virtual fall conference. He challenged health care executives to address inequities in health care, noting that more than 1.4 million health care workers currently lack health insurance, and 800,000 live below the poverty level.

“The question for a compassionate society is, how do we think about this inequity?As a matter of blaming, or do we say we have a responsibility to each other, and we are wealthy enough to change the conditions that make people ill. And as healers I challenge us to do that,” he said.

Earlier this year Berwick served on a committee made up of Biden supporters and supporters of Senator Bernie Sanders (I-VT) that was tasked with developing proposals for improving health care coverage, delivery, and equity under a Biden administration. Among its recommendations:

• Providing free universal testing, vaccinations and treatment for COVID-19
• Lowering the age for Medicare eligibility to 60, and exploring ways of providing hearing, dental and vision benefits under the program
• Developing a CMS-administered public option for the ACA health plan exchanges that would include at least one plan with no copayments for primary care services and would also be open to people with employer-sponsored insurance
• Directing Medicare to negotiate drug prices with pharmaceutical companies
• Allowing people to purchase safe, high-quality prescription drugs from other countries
• Increasing the home care workforce by at least 600,000 and ensuring pay of $15 per hour plus benefits
• Doubling investments in community health centers

In discussing equity issues, Berwick said task force members agreed unanimously that these need to be addressed at the presidential level. It developed a proposed “Executive Order on Inequities and Disparities” that would direct relevant federal agencies to, among other steps:

● Document all major disparities of supports and status that currently exist amongst people of color;

●Establish a unified, data-driven baseline that gives the president and the public a starting point to measure improvement over time, and

● Identify policies needed to address inequities and disparities, along with financing requirements for them.

“Of all the components of the task force, this is the one that excites me the most, Berwick added. “It’s tone-deaf to think of health care reform without racial justice. I think it’s just time to fix it.”