During
President Obama’s first term Don Berwick was the Acting Administrator of The
Centers for Medicare and Medicaid Services. I got to know him through Share Our
Strength supporter (and former president of Wellesley College) Diana Chapman
Walsh. Earlier this year Don gave the
commencement address at Harvard Medical School. It’s one of the most powerful
statements I’ve read about the need for all of us to be a voice for the
voiceless, and about the connection between poverty and other national
priorities.
The entire speech can be found @
http://thomas.loc.gov/cgi-bin/query/z?r112:E17JY2-0020:/ I’ve excerpted portions below. As we advance our
strategy of “broadening the base”, and helping others see how poverty is tied
to issues like health care, education and economic growth, Berwick’s remarks to
young doctors are an eloquent reminder.
Isaiah,
my patient. Cured of leukemia. Killed by hopelessness.
I bring
Isaiah today as my witness to two duties; you have both. It's where your
compass points.
First,
you will cure his leukemia. You will bring the benefits of biomedical science
to him, no less than to anyone else. You are a physician, and you have a
compass, and it points true north to what the patient needs. You will put the
patient first.
But
that is not enough. Isaiah's life and death testify to a further duty, one more
subtle--but no less important. It is to cure, not only the killer leukemia; it
is to cure the killer injustice.
In our
nation--in our great and wealthy nation--the wages of poverty are enormous. The
proportion of our people living below the official poverty line has grown from
its low point of 11% in 1973 to more than 15% today; among children, it is
22%--16.4 million; among black Americans, it is 27%. In 2010, more than 46
million Americans were living in poverty; 20 million, in extreme
poverty--incomes below $11 000 per year for a family of four. One million
American children are homeless. More people are poor in the United States today
than at any other time in our nation's history; 1.5 million American
households, with 2.8 million children, live here on less than $2 per person per
day. And 50 million more Americans live between the poverty line and just 50%
above it--the near-poor…
Let me
be clear: the will to eradicate poverty in the United States is wavering--it is
in serious jeopardy.
In the
great entrance hall of the building where I worked at CMS--the Hubert Humphrey
Building, headquarters of the Department of Health and Human Services--are
chiseled in massive letters the words of the late Senator Humphrey: ``The moral test of government is how it
treats people in the dawn of life, the children, in the twilight of life, the
aged, and in the shadows of life, the sick, the needy, and the handicapped.''
This is
also, I believe, the moral test of professions. Those among us in the
shadows--they do not speak, not loudly. They do not often vote. They do not
contribute to political campaigns or PACs. They employ no lobbyists. They write
no op-eds. We pass by their coin cups outstretched, as if invisible, on the
corner as we head for Starbucks; and Congress may pass them by too, because
they don't vote, and, hey, campaigns cost money. And if those in power do not
choose of their own free will to speak for them, the silence descends.
Isaiah
was born into the shadows of life. Leukemia could not overtake him, but the
shadows could, and they did.
I am
not sure when the moral test was put on hold; when it became negotiable; when
our nation in its political discourse decided that it was uncool to make its
ethics explicit and its moral commitments clear--to the people in the dawn, the
twilight, and the shadows. But those commitments have never in my lifetime been
both so vulnerable and so important.
Leaders
are not leaders who permit pragmatics to quench purpose. Your purpose is to
heal, and what needs to be healed is more than Isaiah's bone marrow; it is our
moral marrow--that of a nation founded on our common humanity.
If Isaiah
needs a bone marrow transplant, then, by the oath you swear, you will get it
for him. But Isaiah needs more. He needs the compassion of a nation, the
generosity of a commonwealth. He needs justice. He needs a nation to recall
that, no matter what the polls say, and no matter what happens to be
temporarily convenient at a time of political combat and economic stress, that
the moral test transcends convenience. Isaiah, in his legions, needs those in
power--you--to say to others in power that a nation that fails to attend to the
needs of those less fortunate among us risks its soul. That is your duty too.
This is
my message from Isaiah's life and from his death. Be worried, but do not for
one moment be confused. You are healers, every one, healers ashamed of miseries
you did not cause. And your voice--every one--can be loud, and forceful, and
confident, and your voice will be trusted. In his honor--in Isaiah's
honor--please, use it.