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.
