Health Roundup: Berwick walks a tightrope

Berwick haunted by past statements: For months, Republican opposition researchers have been floating a 22-page compendium of Berwick quotes from his decades-long career. Expect lawmakers to read at length from the voluminous record as the Senate Finance Republicans grill the Medicare administrator and vent their frustration at having been circumvented during his recess appointment to head the Centers for Medicare and Medicaid Services (CMS) — and more fundamentally during passage of the healthcare reform bill.

A few choice statements that could come back to haunt him during this morning's hearing:

"Cynics beware: I am romantic about (Great Britain's socialized) National Health Service; I love it. All I need to do to rediscover the romance is to look at health care in my own country."

"I would trade the UK's NHS, warts and all ... for my nation's health care chaos any day."

"The decision is not whether or not we will ration care — the decision is whether we will ration care with our eyes open."

Republicans will predictably accuse Berwick of wanting to cut costs by rationing seniors' care. Berwick can be expected to answer that he's merely open to learning from countries that cover a greater portion of their populations more effectively and at a fraction of the cost of what the U.S. spends. But while he's got the intellectual heft — and widespread support in the medical community — to make a strong case for Democrats' healthcare reform law, he'll also be doing a balancing act of answering Republicans' questions and concerns without antagonizing them if he has any intention of seeking to be confirmed in his post past the end of the year.

Medicare error rate down: The testimony comes as the error rate for Medicare payments dropped in 2010 and is on track for a 50 percent reduction by 2012. The Department of Health and Human Services (HHS) chalks this up to the administration's investments in fraud prevention. http://bit.ly/adRm3B

Medicare reviews coverage of prostate-cancer drug: Dove-tailing with Republican accusations that Berwick wants to ration care, CMS on Wednesday is reviewing its coverage of the prostate-cancer drug Provenge. The Food and Drug Administration (FDA) approved it in April as the first therapeutic cancer vaccine, but its high cost ($93,000 for three treatments) and short addition to life expectancy (four months) is prompting the review, reports the Pittsburgh Post-Gazette. http://bit.ly/b9E1LJ

Food-safety bill teed up: The Senate is expected to hold a cloture vote on food-safety legislation later today. The vote comes as Sen. Jon Tester (D-Mont.) has been getting increased support for his amendment exempting small farmers from some of the regulations. http://bit.ly/dvSpxa

Tester's office says food-policy writers Michael Pollan (The Omnivore’s Dilemma, In Defense of Food) and Eric Schlosser (Fast Food Nation) sent the following joint statement late Tuesday afternoon: "S. 510 is the most important food safety legislation in a generation. The Tester amendment will make it even more effective, strengthening food safety rules while protecting small farmers and producers. We both think this is the right thing to do."

The bill would give the FDA the power to recall tainted food, quarantine geographical areas and access food producers’ records. The House passed its version in July 2009.

Boehner joins healthcare reform lawsuit: House Speaker-in-waiting John Boehner (R-Ohio) on Tuesday filed an amicus brief in support of the 20-state lawsuit against the reform's individual mandate.

"I’m proud to join these states and the (National Federation of Independent Business) in their ongoing effort to overturn this job-killing health care law and protect American workers from its devastating impact," Boehner said in a statement. "ObamaCare is a job-killer, and our economy simply cannot afford this unprecedented, unconstitutional power grab by the federal government. That is why Republicans will continue standing with the American people and fighting to repeal ObamaCare and replace it with better solutions put forth in the Pledge to America to lower health care costs and protect American jobs."

Groups square off over birth-control coverage: Supporters and opponents of birth control squared off Tuesday as the Institute of Medicine's Committee on Preventive Services for Women debated what to recommend for coverage under the new healthcare law. Spokeswoman Deirdre McQuade urged the committee not to recommend contraception or sterilization as mandated "preventive services" to be announced next August by HHS. Other groups, including Planned Parenthood, argued for easier access to birth control as a way to avoid unwanted pregnancies.

"The Conference has a particular concern that contraceptives and sterilization not be mandated as 'preventive' services," McQuade said. "To prevent pregnancy is not to prevent a disease — indeed, contraception and sterilization pose their own unique and serious health risks to women and adolescents. In addition, contraceptives and sterilization are morally problematic for many stakeholders, including religiously-affiliated health care providers and insurers." The testimony closely tracks an earlier letter to HHS from the Office of the General Counsel. http://bit.ly/bVj7YH

Rep. Blackburn wants broader medical-loss ratio: Rep. Marsha Blackburn (R-Tenn.) wrote to HHS Secretary Kathleen Sebelius this week asking her to count fraud prevention efforts — such as investments in technology — as quality improvements for purpose of calculating the medical-loss ratio (MLR) that health plans must meet to avoid paying rebates to customers. Fraud prevention was not included as a legitimate quality improvement under the MLR regulations adopted last month by the National Association of Insurance Commissioners, which HHS is expected to certify any day now. 

"To not include fraud prevention costs in the MLR calculation," Blackburn's letter says, "would not only be inconsistent with Congressional intent but would represent a missed opportunity to generate significant system savings — savings that are far greater than those delivered under traditional 'pay-and-chase' methods."

Report card faults U.S. diet: A new report card released today by the Centers for Disease Control and Prevention and the Produce for Better Health Foundation will explain why most Americans don’t eat enough fruits and vegetables and how this impacts the nation's health and economy. In the report card, nutrition and health experts will rank the best and the worst fruit and veggie influencers: restaurants score above average, the federal government gets a failing grade, and school cafeterias rate poorly on making healthy eating possible.