No matter how the Supreme Court rules this week on the Affordable Care Act, a former federal health official said Tuesday the health care system can follow proven methods to make care safer, more effective and less expensive.

“It almost doesn’t matter what the Supreme Court does,” said Dr. Donald Berwick, former administrator of the Centers for Medicare and Medicaid Services. “It’s a very tough time, but it’s not because there isn’t an answer.”

Berwick addressed 400 public health officials at the opening of the American Public Health Association’s midyear conference at the Westin in uptown Charlotte.

Examples cited

He cited multiple examples of practices that have been shown to improve care and reduce cost.

For example, doctors and nurses long thought it was inevitable that some patients would contract bloodstream infections when they received central lines, which are narrow tubes inserted into veins to deliver medicines. But studies show central-line infections can be reduced to zero if health care providers consistently follow a list of protective actions, starting with routine hand washing.

Holistic medicine

Berwick also singled out the Nuka System of Care in Alaska, where doctors, nurses, social workers and others work as a team to deliver holistic care. The result has been reduced use of emergency rooms and hospitals and improved outcomes for patients.

“Better care, better health and lower cost,” said Berwick, a Harvard Medical School professor who founded the Institute for Healthcare Improvement in Cambridge.

Last month, Berwick co-authored an article in the Journal of the American Medical Association that focused on waste in health care, including overtreatment, such as prescribing antibiotics for viral illnesses.

“At minimum, 21 percent of the health care dollar is pure waste,” he said.

Wasteful spending

He complimented the work of nine medical societies that recently announced agreement on 45 tests and treatments their members should no longer automatically order. Their goal is to reduce wasteful spending without harming patients.

Berwick also noted that multiple studies have shown the wide variation of money spent on health care in different regions of the country and how more money doesn’t necessarily mean better health. Low-cost communities “often have better outcomes,” he said.

The Affordable Care Act “tries to make health care a human right in America,” Berwick said. “…The big risk for health care today is that we’ll fail the moral test.”