Donald Berwick Retreats on Rationing, Republicans Complain About Hearing

Bioethics   Steven Ertelt   Nov 17, 2010   |   7:27PM    Washington, DC

President Barack Obama’s Medicare chief backed away from the pro-rationing positions he’s taken previously during a hearing today before the Senate Finance Committee.

Berwick is the man Obama appointed to implement ObamaCare and head the Centers for Medicare and Medicaid Services and he is finally testifying before Congress months after lawmakers began a concerted effort to get him to answer tough questions about the new government-run health care scheme.

Since he was appointed to the position by Obama, who relied on a recess appointment since he could not obtain enough votes in the Senate, 134 days have passed since he was asked to come to Congress to answer questions, pro-life Senate Finance Committee ranking Republican Charles Grassley noted.

“The reason I accepted is because the president asked me, and I want to serve this country,” Berwick replied when asked by pro-life Sen. Jim Bunning of Kentucky why he accepted the recess appointment rather than face a confirmation vote. “It was not my choice to be recess-appointed, or not. When asked, I came, because it’s my duty to do that.”

“With all that is changing in the healthcare system, and the sheer number of people who rely on your agency for care, you have one of the most important jobs in government today,” Grassley told him. “That is why it was so disappointing that you were recess-appointed without a hearing.”

Berwick told senators he has long opposed rationing health care and said he believed people who are near death still have a right to medical treatment.

He said his guiding principle is that patients should get “all the care they want and need, when and where they want and need it.”

Berwick also told lawmakers he doesn’t think a one-size-fits-all scheme is appropriate for the United States because it is such a large and diverse nation.

Sen. Orrin Hatch, a Utah Republican who oppose abortion and who has been calling on Berwick to testify, said Berwick’s testimony didn’t change his mind about the rationing concerns. He also said the 70 minute time allotted for questioning Berwick was too short, saying “This is pathetic.”

“Asking us to air all our concerns in an hour-long hearing with five minutes each is like asking us to drain the Pacific Ocean with a thimble,” hatch said, according to an NPR report.

Sen. Max Baucus, the Montana Democrat who headed the hearing, said it would be up to him whether or not to call another hearing in the future on Berwick, which Republicans have requested. However, Berwick may face hearings in the House of Representatives, which pro-life GOP lawmakers now control.

In fact, according to NPR, Bunning noted: “I suspect you’ll be spending a lot of time testifying before the House of Representatives.”

Republicans had only five minutes each to ask questions and they didn’t have time to get to a lot of the questions about Berwick’s rationing positions.

Tony Perkins, the president of the Family Research Council, calls Berwick “the most important man that you’ve never heard of” and he called on lawmakers to ask about “his radical plans for health care.”

“Berwick, who the President entrusted with $962 billion dollars, heads up the Centers of Medicare and Medicaid–a job he was never approved by Congress to do,” he said. “Instead, the White House, sensing that his pro-euthanasia socialist views would pose problems even for his own party, made Berwick a recess appointment.”

Perkins wanted members of the Senate panel to ask about Berwick’s “fondness for rationing and death panels.

Recess appointees can serve in their position until the end of the congressional term following the year of their appointment. That means Berwick will hold the influential position until late 2011 unless the Senate officially approves his nomination before then, which is now highly unlikely.

Berwick is an outspoken admirer of the British National Health Service and its rationing arm, the National Institute for Clinical Effectiveness (NICE).

During a 2008 speech to British physicians, Berwick said “I am romantic about the National Health Service. I love it,” and calling it “generous, hopeful, confident, joyous, and just.”

Michael Tanner, a senior fellow at the Cato Institute, wrote about the problems with Berwick in an opinion column at the Daily Caller in May.

Recalling that opponents of the government-run health care bill were blasted for bringing up “death panels,” Tanner writes: “But if President Obama wanted to keep a lid on that particular controversy, he just selected about the worst possible nominee.”

In his comments lauding the British health care system, Tanner says “Berwick was referring to a British health care system where 750,000 patients are awaiting admission to NHS hospitals.”

“The government’s official target for diagnostic testing was a wait of no more than 18 weeks by 2008. The reality doesn’t come close. The latest estimates suggest that for most specialties, only 30 to 50 percent of patients are treated within 18 weeks. For trauma and orthopedics patients, the figure is only 20 percent,” he writes.

“Overall, more than half of British patients wait more than 18 weeks for care. Every year, 50,000 surgeries are canceled because patients become too sick on the waiting list to proceed,’ he continues.

“The one thing the NHS is good at is saving money. After all, it is far cheaper to let the sick die than to provide care,” Tanner adds.

NICE is at the forefront of the rationing in the British health care system.

“It acts as a comparative-effectiveness tool for NHS, comparing various treatments and determining whether the benefits the patient receives, such as prolonged life, are cost-efficient for the government,” Tanner explains. “NICE, however, is not simply a government agency that helps bureaucrats decide if one treatment is better than another. With the creation of NICE, the U.K. government has effectively put a dollar amount to how much a citizen’s life is worth.”

Tanner points out that Berwick has already admitted health care rationing is coming.

“It’s not a question of whether we will ration care,” the Obama nominee said in a magazine interview for Biotechnology Healthcare, “It is whether we will ration with our eyes open.”

Liberal writer Nat Hentoff has also criticized Berwick’s views.