The article, published in the July 26, 2008 issue of the BMJ, compared the U.S. health care system unfavorably to the British system, which Berwick said he was “romantic about.”
The article included a list of 10 suggestions for Britain’s National Health Service (NHS). One of these suggestions was:
“Please don’t put your faith in market forces [emphasis in original]. It’s a popular idea: that Adam Smith’s invisible hand would do a better job of designing care than leaders with plans can. I find little evidence that market forces relying on consumers choosing among an array of products, with competitors fighting it out, leads to the healthcare system you want and need. In the U.S., competition is a major reason for our duplicative, supply driven, fragmented care system.”
Berwick also outlined his 10 suggestions for Britain’s National Health Service at a speech he delivered in Wembley, England, on July 1, 2008. In the speech, Berwick said that the health care choices made by “leaders” will be better than the choices that individuals make for themselves.
“I cannot believe that the individual health care consumer can enforce through choice the proper configurations of a system as massive and complex as health care. That is for leaders to do,” Berwick said.