J Health Polit Policy Law. 2012 Aug;37(4):709-27. doi: 10.1215/03616878-1597511. Epub 2012 Mar 30.
Michael Birnbaum interviews Donald Berwick shortly after his departure from the Centers for Medicare and Medicaid Services about the national health care landscape. Berwick discusses the strategic vision, policy levers, operational challenges, and political significance of federal health care reform. He rejects the notion that the Affordable Care Act represents a government takeover of health care financing or service delivery but says the law's Medicaid expansion and its creation of health benefit exchanges present a "watershed moment for American federalism." Berwick argues that the solution to Medicare's cost-containment challenge lies in quality improvement. He is optimistic that accountable care organizations can deliver savings and suggests that shifting risk downstream to providers throws the health insurance model into question. Finally, looking to the future, Berwick sees a race against time to make American health care more affordable.
迈克尔·拜恩鲍姆在唐纳德·贝里克离开医疗保险和医疗补助服务中心后不久对他进行了采访，内容是关于国家医疗保健领域的情况。贝里克讨论了联邦医疗改革的战略愿景、政策杠杆、运营挑战和政治意义。他否认《平价医疗法案》代表了政府对医疗保健融资或服务提供的接管，但表示该法案的医疗补助扩大和创建健康福利交易所为“美国联邦主义的分水岭时刻”。贝里克认为，解决医疗保险成本控制挑战的办法在于提高质量。他乐观地认为，责任医疗组织可以节省开支，并暗示将风险转移到下游的提供者对医疗保险模式提出了质疑。最后，展望未来，贝里克认为，要使美国的医疗保健更加负担得起，就必须争分夺秒。
