Any health care funding plan that is just, equitable, civilized and humane must - must - redistribute wealth from the richer among us to the poorer and the less fortunate. Excellent healthcare is by definition re-distributional.

In this quote, Donald Berwick argues that for a health care funding plan to be truly just, equitable, civilized, and humane, it must prioritize the redistribution of wealth. Berwick emphasizes that a fair health care system requires shifting resources from the richer members of society to the poorer and less fortunate. The core of his argument is that excellent healthcare cannot be achieved without addressing economic disparities, as those with more wealth should contribute to improving the well-being of those in need.

Berwick's assertion that excellent healthcare is inherently redistributional challenges the common notion that healthcare should be purely transactional or driven by market forces. He suggests that a healthy society requires an active effort to ensure that everyone, regardless of their financial situation, has access to necessary medical care. In other words, healthcare systems must function with the understanding that fairness requires wealth transfer to ensure equal access to services.

This viewpoint aligns with Berwick's broader commitment to social justice and the belief that access to healthcare should not be dependent on personal wealth or socio-economic status. By emphasizing redistribution, he advocates for a system where the wealthier portions of society help fund healthcare for the disadvantaged, ensuring that everyone has the resources needed for quality care.

Ultimately, Berwick’s statement is a call for a fundamental rethinking of healthcare systems. He argues that, for healthcare to be truly humane, it must be framed as a collective responsibility, where resources are shared more equitably across society, particularly for those who are most vulnerable.