Congressman Charles Boustany (R-LA), Ranking Member of the Ways and Means Oversight Subcommittee, Congressman Phil Gingrey (R-GA), Co-Chair of the GOP Doctors Caucus, and Congressman Tom Price (R-GA), Chairman of the Republican Study Committee, all medical doctors, sent a letter signed by 58 House Republicans calling on President Obama to withdraw his nominee for Centers for Medicaid and Medicare Services Administrator. Dr. Donald Berwick, Obama’s nominee, has openly advocated rationing of care, arguing in his book on health care reform that medication costs should be reduced by devising formulas that limit a patient’s access to the medication that they might need. Additionally, Dr. Berwick has praised Britain’s rationing board, which limits patients’ access to needed care based on cost, as a model for health reform.

“Dr. Berwick’s views on rationing health care for seniors deeply disturbs me, and I urge the President to reconsider his nomination,” said Dr. Boustany. “Many seniors with Medicare coverage already struggle to find access to a quality doctor. Unfortunately, the newly-passed, massive health care law only complicates seniors’ access to meaningful health care. As seniors learn of Dr. Berwick’s writing, I think they will agree that we need someone committed to improving Medicare rather than rationing access to heart surgeons and other specialists.”

“It is deeply concerning to me that on the heels of forcing through Obamacare, which is the precursor to a single-payer, national health care system, the President has nominated for CMS Administrator an individual who models his health reform beliefs after Britain. The effects of implementing rationed care are clear – longer wait times, higher death rates from treatable illnesses, and an overall decreased quality of care – particularly for seniors. As a doctor, that is not the standard of care by which I treated my patients, and not the care I will accept for this country,” said Dr. Gingrey. “I strongly urge the President to withdraw this nominee and prove he is serious about preventing the rationing of care in the United States.”

“An avowed admirer of England’s socialized National Health Service and strong supporter of rationed care, Dr. Berwick brings a perspective to health care that accepts the notion of diminished access and lower quality for our nation’s senior citizens,” said Dr. Price. “President Obama’s choice of Dr. Berwick for CMS Administrator only goes to confirm the concerns shared by the majority of Americans that the President’s recently enacted government takeover of health care will go far to empower bureaucrats at the expense of patients and their doctors. I call on the President to remove Dr. Berwick from consideration for this post and pledge to take no further steps that undermine the quality, affordability, and accessibility of health care in this nation.”

The text of the letter is as follows:

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.