Making healthcare better, cheaper and more coordinated for everyone is an attainable goal right now, but it won't stay that way forever, former CMS Administrator Dr. Donald Berwick told a keynote audience Monday at the annual meeting of the American Health Lawyers Association.

"It is not possible, if you know what I know, to say in America we can't do it. We can do it," Berwick said Monday in Chicago. "The issue is political will, managerial will."

Berwick served a tumultuous year-and-a-half as CMS administrator—a period he called "the whirlwind"— before resigning in December 2011 amid pressure from Republican lawmakers who were deeply skeptical of his plans to reform healthcare and implement aspects of the Patient Protection and Affordable Care Act.

On Monday, Berwick told the crowd at the health lawyers meeting that the industry's dawning recognition of the need for systemic changes have stimulated enough new developments that the Supreme Court's decision on whether to strike down or uphold the law was "not the whole game here."

Berwick said there was wide agreement on the need to pay for the value of healthcare instead of the quantity delivered, to pay for consolidated, seamless care among multiple providers, to emphasize the needs of those with chronic diseases, to realize the promises of electronic health records and health system transparency, and to stop fraud and abuse.

The alternative route, he said, is to start cutting healthcare services as a way to bring down costs. He predicted that the first people who will lose all coverage will be the poor, followed by other groups soon after. That kind of solution would fail the moral imperative of a developed nation that should instead be moving toward healthcare as a human right, he said.

Today, the race is on between those two approaches—cutting services to groups of people or introducing systemic changes—driven by the widespread realization that the unsustainable healthcare system has essentially consumed "every single nickel of wage increase" for most Americans for many years.

"The train has left the station," Berwick said. "The outcome is uncertain, but there is no question change is in store."