Senate Democrats Abandon Obama Rationing Czar Donald Berwick

Bioethics   |   Steven Ertelt   |   Mar 5, 2011   |   4:09PM   |   Washington, DC

Senate Democrats have officially given up their fight to confirm Donald Berwick, the rationing advocate President Barack Obama nominated to become the administrator of the Centers for Medicare and Medicaid Services and the chief implementer of Obamacare.

Berwick has been deluged with criticism from pro-life advocates, who cite his fondness for rationing and his failure to level with a Senate committee about his pro-rationing views.

Obama previously used a recess appointment to place Berwick in the prominent position after the Senate couldn’t find enough votes to overcome a Republican-led filibuster against his nomination. A recess appointment can be used when the Senate is not in session but the appointment is temporary and Berwick, if not confirmed by the Senate, has to leave the position by the end of the year. In January, Obama renominated Berwick to his current post.

However, a Politico report today indicates Democrats have given up any hope of confirming Berwick following a letter they received signed by 42 Republican senators who said they would continue pressing a filibuster against him. A white House spokesman indicated top Democrats “can do the arithmetic” and see no way to obtain the 60 votes necessary to cut off debate and proceed to a vote on Berwick’s nomination.

Democratic Senate Finance Committee staffers, according to Politico, met with top health care lobbyists on Friday and said the Berwick nomination is officially dead and there will be no committee hearing on his nomination. They said top Democrats would eventually discuss the “next steps” for a new nomination for the post.

Finance Committee Chairman Max Baucus told Politico on Thursday that Berwick is Obama’s nominee and “it’s his choice” whether to proceed with the nominee, but he would not commit to holding a confirmation hearing.

Jeffrey Anderson of the conservative Weekly Standard responded to the news by saying he always thought Berwick’s nomination was an indication of the kind of direction Obama wanted to pursue with Obamacare.

Lest anyone think I was exaggerating, Berwick has written that the British health-care system is “more likely to succeed” than the American one; that he feels “an optimism about the [British] NHS [National Health System] that is hard to find in the UK nowadays”; that he thinks “nationalized health care was a wise choice in 1948 and that it remains so now”; that “the social budget” — the social budget! — “is limited”; and that “[t]he decision is not whether or not we will ration care — the decision is whether we will ration with our eyes open.” This is who President Obama wants to have running Medicare, Medicaid, and significant portions of ObamaCare.

It looks like the Constitution’s confirmation process will serve as a bulwark against President Obama’s desires in this instance, although it’s unlikely that his next nominee will hold views that are radically different from Berwick’s or his own. (That new nominee almost certainly will, however, have been more careful about publicly expressing those views). But Obama’s failure to get his Berwick nomination through the Democratic Senate doesn’t change the fact that Obama chose someone like Berwick in the first place, or the fact that he circumvented the usual process to install him in the short-term. Nor does it change what the Berwick nomination tells us about the direction in which Obama thinks ObamaCare would and should take American health care.

In a November Senate committee hearing, Berwick backed away from the pro-rationing positions he’s taken previously. 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.

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, whom 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.”

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.