Dr. Berwick, we hardly know you

What can the American people expect from their new Centers for Medicare and Medicaid Services (CMS) administrator? We don’t know, thanks to the president’s recess appointment of Dr. Donald Berwick.

In fact, the Chairman of the Finance Committee, Sen. Max Baucus (D-Mont.) said, “I’m troubled that, rather than going through the standard nomination process, Dr. Berwick was recess appointed. ... Senate confirmation of presidential appointees is an essential process prescribed by the Constitution that serves as a check on executive power and protects Montanans and all Americans by ensuring that crucial questions are asked of the nominee — and answered.”

Without a public confirmation hearing on Dr. Berwick’s nomination, the Senate and the American people do not have the opportunity to learn about the man who will control one-third of all healthcare spending in America.

In announcing this recess appointment, the White House said it wanted to immediately act to fill the critical post before Republicans could block the nomination.

Really? It took the president more than a year just to put forward a name. It was Democrats who had yet to schedule a hearing in the Finance Committee on Dr. Berwick’s nomination. Republicans do not have the ability to stall or block a nomination in committee. As one of those most concerned with this nomination, I welcomed committee debate.

The truth is, this nominee is so controversial, he may not have gotten the support of Democrats or the American people. Once again, the Obama administration is going behind closed doors out of fear the American people will learn of the real plan — that Dr. Berwick wants to use government rationing as a cost-cutting tool to achieve the billions of dollars in cuts to Medicare called for in the healthcare reform bill.

Since President Obama and Senate leadership were afraid to allow the truth about Dr. Berwick to come out, we are free to draw our own conclusions about his plans.

Some fear Dr. Berwick will use this position to redistribute the wealth, cementing Obamacare as a giant transfer of income. Dr. Berwick has said, “any healthcare funding plan that is just, equitable, civilized and humane must — must — redistribute wealth from the richer among us to the poorer and less fortunate.”

Dr. Berwick, has spoken very favorably about the British National Health Service (NHS), calling it “not just a national treasure, [but] a global treasure” as well. He has advocated for the NHS to be an example for the U.S. healthcare system and have characterized the NHS as “an example of a health system that is universal, accessible, excellent and free at the point of care — a health system that is, at its core, like the world we wish we had: generous, hopeful, confident, joyous and just.”

Unfortunately, NHS rations care to contain costs. It assigns a dollar value to a treatment’s benefit to a patient’s life and then makes a bureaucratic calculation as to whether or not the treatment is worth the cost to the government relative to the value of the benefit. Typically, the NHS will pay a maximum of $22,000 to extend a life by six months. Drugs and treatments that exceed these costs are deemed not cost-effective and denied.


Dr. Berwick has proposed similar rationing ideas for the American healthcare system saying, “It makes good sense to at least know the price of an added benefit, and at some point we might say that we wish we could afford it, but we can’t”; and: “the decision is not whether or not we will ration care — the decision is whether we will ration with our eyes open.”

Americans will never know how much saving a life is worth to Dr. Berwick until he is calling the shots. Who does Dr. Berwick think should make medical decisions? The doctor? The patient? The government? Which treatments should be denied?

Too bad the American people won’t know what Dr. Berwick has to say about this until it is too late.

Sen. Roberts serves on the Finance Committee and the Health, Education, Labor and Pensions Committee.