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While Congress is Away, Obama Moves to Make Berwick New CMS Director
July 8, 2010
With Congress on holiday, President Obama seized the opportunity to install Donald Berwick as the new head of the Centers for Medicare and Medicaid (CMS). Using a recess appointment, the President has circumvented what would have been a lengthy appointment process focusing largely on his ever-unpopular health care reform bill.
Berwick was nominated for the position in April, shortly after Obama signed his landmark legislation. Under ObamaCare, Medicare will be expanded to cover an unprecedented number of Americans. The way Dr. Berwick manages CMS will give us “an indication of what Obamacare will look like in practice.”
The CBO and other analysts have already cautioned Obama’s health care reforms are “unsustainable” and that the Medicare savings embodied in the bill (by way of cutting reimbursements to doctors among other measures) will do nothing to reduce the deficit.
But, Berwick will do his best to shore up savings through rationing care and limiting choice. He is a self-described “romantic” for the British Health Care system (NHS) – a nationalize health care provider with a “command-and-control structure in which the nation’s physicians and hospitals have little choice but to fall in line with the government’s orders,” according to the National Review Online.
NHS is a heavily-regulated, single-payer system with a dismal record of health care outcomes, especially for those battling cancer. However, its proponents say NHS’s greatest success is not in treating patients, but rather in keeping Britain from going bankrupt.
A pediatrician, Berwick has spent the majority of his professional life not seeing patients, but rather writing and talking about health care policy. “He has spoken of the need to ration health care and cap spending, has supported efforts to ‘reduce the total supply of high-technology medical and surgical care’ and has expressed great admiration for the British health care system.”
He’s also spent time advocating for the restriction of doctors. “The more I have studied it, the more I believe that less discretion for doctors would improve patient safety,” Berwick told the Boston Globe (emphasis added). Practicing doctors, of course, argue that each patient is different; what works for one patient, may not work for another.
According to The Heritage Foundation, Berwick’s doesn’t want doctors making decisions about care by looking at individual patients; instead, he has a simple three-step process for making medical decisions:
1. Whether a health intervention is effective
2. Whether it is more or less effective than comparable treatments
3. Whether the benefits of a more effective treatment outweigh additional cost
For Berwick, medical decisions must come down to cost.
Americans will eventually hear Berwick’s radical ideas first-hand. His recess appointment will expire at the end of the next session (2011) unless the full Senate moves to confirm him. Don’t expect those hearings to be scheduled until after midterm elections.
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