U.S. Congressman Kenny Marchant

Americans Deserve to Hear Dr. Berwick Answer the Tough Questions

The President promised Americans that health care would not be rationed. Yet, as highlighted by three members of the GOP Doctors Caucus in a Washington Times article, the President’s decision to recess-appoint Dr. Donald Berwick for Administrator of the Centers for Medicare and Medicaid Services suggests otherwise.

"Already, we have seen at least one prominent Democrat raise concerns about Dr. Berwick's recess appointment. Sen. Max Baucus, the Democratic Chairman of the Senate Finance Committee, called this recess appointment troubling and noted, Senate confirmation of presidential appointees is an essential process prescribed by the Constitution that serves as a check on executive power and protects ... all Americans by ensuring that crucial questions are asked of the nominee - and answered. To be certain, there are legitimate concerns about Dr. Berwick - concerns we and 55 of our House Republican colleagues outlined in a letter to President Obama on June 28. Dr. Berwick has been one of the most prominent advocates of denied care. He has praised England's health care system and its rationing board, which limits patients' access to needed care based on cost. In his book on health care reform, Dr. Berwick argued that patients' access to heart surgeons should be restricted according to where they live and medication costs should be reduced by limiting access to needed drugs."

Originally nominated on April 19th, the Senate Finance Committee was in the process of vetting Dr. Berwick but had not yet held a confirmation hearing. The American people – and most importantly seniors – deserve to hear Dr. Berwick answer questions about his views and how he plans to run one of the agencies tasked with implementing large pieces of the new health care law. By circumventing EVEN the committee hearings, the Administration appears to be shielding their nominee from the tough questions Senators of both parties would have likely asked.

Below, I have made available the letter I signed along with my 58 colleagues expressing our concern to the President.

Dear President Obama:

We contact you to express significant concerns about the nomination of Dr. Donald Berwick for CMS Administrator and urge you to withdraw his nomination.

The federal government is having substantial difficulty implementing the new health-care overhaul without endangering seniors’ access to care.  Medicare’s own chief actuary, Richard Foster, warns that massive Medicare cuts in the bill risk “jeopardizing access to care for beneficiaries.” CBO warns that millions of seniors who like the Medicare Advantage coverage they have will not be able to keep it.  Seniors also face new hidden taxes and premium increases included in the new law.

With seniors’ access to care already threatened by these cuts, we are especially troubled by Dr. Berwick’s history of support for government rationing of medical services.  We believe that Dr. Berwick’s recommendation for the federal government to use ration-based, cost-effectiveness research to restrict patients’ access to medically-necessary care is wrong.  In June 2009, he stated some life-saving care might be a misuse of taxpayer funds: “The decision is not whether or not we will ration care – the decision is whether we will ration with our eyes open." 

In his book on health reform, Escape Fire, Dr. Berwick argues our health-care system should reduce medication costs with “simplified formularies” that limit access to medication a patient might need.  He also promotes reducing the “total supply of high-technology medical and surgical care” available to seniors because of where they live, including treatments for heart disease and kidney failure.  Furthermore, Dr. Berwick praises Britain’s rationing board, the National Institute for Clinical Excellence (NICE), as a model for health reform.  Dr. Berwick has stated that NICE “is not just a national treasure; it is a global treasure.” Unfortunately, NICE limits patients’ access to needed care based on cost; if a treatment is found to cost more than about $30,000-$45,000 per “quality-adjusted life-year,” it is rarely covered. For example, NICE has required patients to suffer blindness in one eye before it will allow medication to treat the other eye.  

While we support efforts to ensure quality care for all, we must guarantee that unelected government bureaucrats or boards do not make one-size-fits-all judgments prohibiting treatment options on the basis of cost. Health-care reform efforts should aim to ensure that seniors who rely on Medicare have access to needed treatment options.  Seniors deserve a Medicare program that puts the individual needs of patients first and protects the doctor-patient relationship. For these reasons we encourage you to withdraw the nomination of Dr. Berwick as CMS Administrator. We look forward to working with the administration to implement solutions that lower costs while ensuring patient-centered health care.

The First Amendment vs. the DISCLOSE Act

Today, the U.S. House of Representatives is scheduled to debate and vote on the controversial DISCLOSE Act (H.R. 5175):

The measure, called the DISCLOSE Act, comes in response to a hot-button Supreme Court decision in January that lifted limits on political spending by outside groups. And top Democrats have been making the case to their rank and file that the bill, which would impose new requirements that groups sponsoring ads and other political communications identify themselves and their top donors, is a must-pass to keep hostile corporate money from flooding into the midterms.                            -Roll Call, June 24, 2010

The authors of this bill, Rep. Chris Van Hollen (D-MD) and Sen. Chuck Schumer (D-NY), are playing a questionable hand in campaign finance reform. Paying great attention to special interests, the act favors unions likely to help Democrats get elected to Congress and deters citizen engagement in the political process.

Two leading Republican Senators provided alarming statements to Roll Call [emphasis added]:

National Republican Senatorial Committee Chairman John Cornyn (Texas) said Wednesday that Republicans are “largely united [against] ... this exercise in hypocrisy.”

Similarly, Sen. John McCain (Ariz.), who has been a prime Republican sponsor of campaign finance measures in the past, also said he opposes the bill. “I’m very disturbed. It basically gives free rein to the unions,” McCain said.

Even Sen. Frank Lautenberg (D-NJ) – the most outspoken Democrat against the bill – was quoted as saying: “It may be good for a state or two, but for our national good it doesn’t square.”

Kim Strassel of the Wall Street Journal drives to the truth behind the DISCLOSE Act in her June 18 column:

Mr. Schumer isn't arguing the new corporate rights under Citizen United; he's been forthright that his goal is rather to embarrass companies out of exercising those rights. The bill will make companies "think twice," he rejoiced. "The deterrent effect should not be underestimated." Democratic incumbents won't underestimate it.

And the unions? Carved out. The bill technically requires both corporations and unions to report donors of more than $600 a year. But that number wasn't pulled out of a hat. The average dues of the nation's 15 largest U.S. unions were $377 in 2004. And while government contractors are restricted, the bill contains no such bars for unions that receive federal money or have collective bargaining agreements with government. The AFL-CIO and SEIU can continue speaking loudly and anonymously.

The DISCLOSE Act is not about protecting the American citizen or “transparency” in campaign finance. It limits freedom of speech which impedes our fundamental right. Furthermore the act has hastily been brought to the floor for votes, and if passed, this partisan bill is required to be enacted within 30 days -- before the 2010 elections.

The DISCLOSE Act Report, which includes a review from both the Majority (page 1) and Minority (page 84), can be viewed here: http://www.rules.house.gov/111/CommJurRpt/111_hr5175_rpt.pdf

Tune in to C-SPAN this afternoon for votes on the DISCLOSE Act. I encourage you to leave me a comment about your stance on this act on my blog page, or join the discussion with others from our district at www.facebook.com/repkennymarchant. 

Europe Sets Example with Budget Cuts

Recently, I have been struck by Wall Street Journal headlines: Italy Approves Budget Cuts; U.K. Is Set to Detail Cuts to Trim Deficit; Czech Poll Sets Stage for Budget Cuts; etc. "Cuts" – a word Europe is becoming all too familiar with in responding to the declining euro, falling stock market, and worrisome deficits.

This week the Economist highlighted Germany’s new budget cut proposal by Chancellor Angela Merkel. If her plan is enacted, the country will save an estimated 80 billion euro ($96 billion) from its federal budget by 2014. While reactions have been mixed to Merkel’s unveiling, the Economist described the plan as follows:

"Its main purpose is to cut the federal government’s structural deficit—that is, the part not related to the business cycle—from an expected 2.5% of GDP this year to 0.35% by 2016, as required by a recent amendment to the constitution. That is also supposed to set an example to profligate members of the euro zone. To avoid crushing a fragile European recovery, the savings will be phased in. Growth will be dampened but, says Eckart Tuchtfeld, an economist at Commerzbank, ‘the economy seems to be pretty resilient.’ Investment in education, research and infrastructure, the sources of future growth, has been largely spared." (Link to full article)

Merkel hopes to set an example for Europe, yet Europe is already setting an example for the U.S. The Obama Administration continues to spend profligately, and House Democrats are two months overdue in presenting an FY ‘11 budget. We are taking a back-row seat in deficit reduction. I addressed this crisis on the House floor yesterday, calling for a budget so that we can have a debate on improving our fiscal condition. You can follow this link to hear my full speech: http://bit.ly/cYDOed

Trillion Dollar Deficits
as far as the Eye Can See 

According to the Washington Times today, President Obama pulled the Bush card once again in his political speech at Carnegie Mellon University. He told the audience to make a decision this election cycle to either return to "failed economic policies of the past" or continue with his vision of change. But, according to The Heritage Foundation, the Democrats deficits far exceed those of the Bush administration, and will result in "permanent deficits that top $1 trillion" per year through at least 2020.

As stated on The Heritage Foundation's website, the President's budget would also:

• "Permanently expand the federal government by nearly 3 percent of gross domestic product (GDP) over 2007 pre-recession levels," and 
• "Borrow 42 cents for each dollar spent in 2010."

http://blog.heritage.org/2010/02/05/past-deficits-vs-obamas-deficits-in-pictures/

It's time for the administration to focus on the present. We must stop Washington's wasteful spending.