Fireworks fizzle at CMS chief's first Hill hearing on healthcare law

Sen. Orrin Hatch (R-Utah) called the hearing "pathetic" and said the time constraints made any real questioning difficult.

"It’s like asking us to drain the Pacific Ocean with a thimble," he said. "We ought to have time to ask the most important man in healthcare sufficient questions."

But while there was little anger in the Senate, Sen. Jim Bunning (R-Ky.) warned Berwick he'd have a much tougher time in the House. There, victorious Republicans plan a number of in-depth hearings on the new law.

"I will guarantee you this: You will get open and transparent, and it will be on the other side of the House," Bunning said. "They will see to it that you are open and transparent because they are going to oversee CMS very closely."

Berwick piggy-backed off Democrats' pro-reform line of questioning to argue that repealing the new law, as Republicans have vowed to do, would increase seniors' drug costs and have other negative repercussions.

"I can't think of a worse plan" for seniors than to repeal the bill, Berwick said.

"Seniors would not be getting the 50 percent discount" for prescription drugs in Medicare's so-called 'doughnut hole,' he said. "We tell them we're not going to improve their access to preventive services like colonoscopy and mammography ... that we're not going to study and improve [hospital] acquired conditions or work on unnecessary readmissions, that we're not going to improve chronic illness care ... that we're not going to be more transparent.

"It would be a terrible plan."

Berwick, who has said the U.S. should "ration care with our eyes open," also used the hearing to lay to rest any concerns raised.

"My principle," he said, "is that every person in America, and certainly every beneficiary of Medicare and Medicaid, should be able to get all the care they want and need, when and how they want and need it."

He said the healthcare reform law helps achieve that goal, notably by allowing hospitalized patients to continue to get curative treatments even if they opt for palliative care.

He also parried Republicans' anger that his controversial recess appointment represented an "end run around Congress."

"The reason I accepted," he said, "is that the president asked me, and I want to serve this country. It's an immense privilege to be able to do this work."

Republicans also demanded an update on Berwick's finances.

"You stated in an earlier letter that you planned divesting any interests in companies you may oversee and have interaction with CMS," ranking member Chuck Grassley (R-Iowa) said. "Is this divesture complete? And if so, will you provide information and records documenting the divestiture?"

Berwick said he could no longer provide information regarding his time as the head of the Institute for Healthcare Improvement.

"I recall that conversation," Berwick answered. "When you asked for that information I intended to try to provide it, [but] as it happened it was not in my sole authority to provide it and now of course I’m recused from contact with [the Institute for Healthcare Improvement] so I cannot provide it on my own initiative. What I can assure you is that all my past activities and finances were thoroughly reviewed by appropriate ethics officers, under congressional rules."

—Hannah Brenton contributed.