Berwick’s rationing claims are nothing new in Washington

Among the biggest concerns from Republicans wary of Donald Berwick’s appointment to head Medicare is around Berwick’s 2009 observation that healthcare in America is rationed based on a patient’s — or the government’s — ability to pay. 

“The decision is not whether or not we will ration care,” Berwick said in an interview with Biotechnology Healthcare on the topic of comparative effectiveness research. “The decision is whether we will ration with our eyes open. And right now, we are doing it blindly.”

It’s hardly a new contention. In 1993, Hillary Clinton made the same argument before the House Ways and Means Committee, after then-Rep. Dennis Hastert (R-Ill.) claimed that the Clinton health reform proposal would lead to rationed care.

“I would argue that right now we have rationed care throughout this country,” Clinton responded. “There are literally millions of Americans who don’t have access to the same quality or quantity of healthcare as millions of others.”

Clinton noted that C. Everett Koop, the surgeon general under the Reagan White House, had said “that an uninsured person who enters a hospital with the same problem as an insured person is three times more likely to die than the insured person.”

“So right now,” Clinton said, “because of our non-system of healthcare, we are rationing care all the time, every single day.”

This won’t do anything to appease the Republicans critical of Berwick’s comments. But it’s worth noting that this debate has endured for decades.