Now that obama has put his little signature on his healthcare bill itis up to the bureaucracy to really screw it up...remember obamaknocking the US Mail Service?

Bureaucratic heads make up the rules of the game to attempt to meet the goals and intent of the legislation.

Chosen as bureaucratic head of the Medicare and Medicaid services unit of thefederal government and thus a major portion of obamacare is DonaldBerwick.

Like many on obama's team, Berwick comes from the private sector as head of a non-profit in MA (Institute For HealthcareImprovement) that consults with hospitals and such on how they cancontain costs.

He has received criticisms as head of this organization for apparently not worrying about containing his ownsalary...which I assume is passed onto hospitals who hire hisconsulting firm.

The medical journal Modern Healthcare criticized Berwick for making $769,000 in 2003, $630,000 in 2004, andtax filings for 2008 show he earned $637,000 (so reported the BostonGlobe 3/31/2010).

Facts released by his consulting non-profit but personally profitable institute have also been criticized.

In 2006 researches found problems with his institutes claim that they had"averted" 122,000 deaths through a program focusing on better controlof hospital errors and infections.

The researches allege that 14% of hospitals never submitted data about the program and not all ofthe data submitted was audited (same Globe story).

If you listen to the 2008 documentary Money Driven Medicine you will hear Berwickbemoaning the culture of competition in the healthcare industry...he'sagainst competition in the healthcare field.

Has obama not repeatedly told us that his healthcare plan would promote competition?

If Berwick sets the rules according to this ideology then how willnon-competitive Medicare/Medcaid progams look to future members?

Berwick likes to take a business approach to medical care; such as qualitycontrol programs, "lean manufacturing," and "optimizing flow" ...whichmeans sort of like having checkout times from a hospital like they doin motels.

Berwick was made an honorary knight from the UK for his great help in revamping their healthcare system.

The HealthCare Economist on 4/28/2008 did a piece on healthcare plansaround the world and included this information on the Berwick-revampedGreat Britain system based on the Michael Tanner book, The Grass Is NotAlways Greener: A Look at Healthcare Systems Around the World:

- Great Britian spends 7.5% of GDP on healthcare (at what cost?);

- long waiting lists for treatment are "endemic;" there are 750,000people on admissions waiting lists; 40% of cancer patients never see anoncologist; "minimum" waiting times are mandated so that hospitals willcut costs and must be followed or they lose funding;

- rationing "pervades" the system; rationing is "explicit" for services such askidney dialysis, open heart surgery and terminal ill care;

- patients have little choice of providers;

-there is little access to specialists;

- physicians and nurses are basically government employees;

- due to contract negotiations over pay and work hours, few physicians are available nights and weekends;

- due to low pay there is a shortage of specialists.

Berwick must be confirmed by the Senate.
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