Obama's Nominee to Run Medicare: 'The Decision is Not Whether or Not We Will Ration Care--The Decision is Whether We Will Ration Care With Our Eyes Open'

Obama's Nominee to Run Medicare: 'The Decision is Not Whether or Not We Will Ration Care--The Decision is Whether We Will Ration Care With Our Eyes Open'
Monday, May 24, 2010
By Fred Lucas, Staff Writer

Sen. Pat Roberts (R.-Kan.) sponsored an amendment to the health-care reconciliation bill that would have repealed the new tax on medical devices included in the health care law signed by President Obama. (Congressional photo)

(CNSNews.com) – President Barack Obama's nominee to head the Centers for Medicare and Medicaid Services, which runs Medicare, is a strong supporter of the government-run health care system in Britain, who said in a 2009 interview about Comparative Effectiveness Research: "The decision is not whether or not we will ration care--the decision is whether we will ration with our eyes open."  

The $787-billion stimulus law signed by President Obama created a Federal Coordinating Coucil for Comparative Effectivieness research in health care that some critics argue was a step toward rationing of heatlh care in the United States. 
 
Donald Berwick, a professor of pediatrics at Harvard Medical School and the head of the non-profit Institute for Healthcare Improvement, was nominated by Obama on April 19, 2010.
 
In choosing Berwick, the Obama administration is implicitly admitting that the health care law passed by the Democrats in March will lead to the rationing of health care, said Sen. Pat Roberts (R-Kan.) in a May 19 press release.
 
Concerning Berwick's 2009 comment about the rationing of health care, the White House released a statement to several news organizations in which spokesman Reid Cherlin said the following:
 
"No one is surprised that Republicans plan to use this confirmation process to trot out the same arguments and scare tactics they hoped would block health insurance reform. The fact is, rationing is rampant in the system today, as insurers make arbitrary decisions about who can get the care they need. Don Berwick wants to see a system in which those decisions are transparent– and that the people who make them are held accountable."
 
The White House statement, according to Roberts, seemed to acknowledge that the new health care law would simply ration care in a transparent way.
 
"This is really a fascinating response. Instead of flat out denials of government rationing we have excuses," Roberts said on the Senate floor on May 19.
 
"And if you read between the lines you will notice that for the first time ever in this debate the Obama White House is admitting that their health care plan will ration health care," the senator said.
 
Roberts made it clear that he does not accept health care rationing "transparent or otherwise."
 
"I am opposed to rationing whether it is done by the government or by an insurance company," said Roberts. "I am not defending any of the practices of insurance companies who have unjustly denied claims. But the Obama Administration's response does nothing to address my concerns that our government will ration care. Instead, we finally have an admission from the White House that this is what they plan to do."
 
In a June 2009 interview in Biotechnology Healthcare, Berwick was asked: "Critics of CER (Comparative Effectiveness Research) have said that it will lead to rationing of health care."

He answered: "We can make a sensible social decision and say, 'Well, at this point, to have access to a particular additional benefit [new drug or medical intervention] is so expensive that our taxpayers have better use for those funds.' We make those decisio all the tim. The decision is not whether or not we will ration care--the decision is whether we will ration with our eyes open."

In the same interview, he also said, "The social budget is limited—we have a limited resource pool. It makes terribly good sense to at least know the price of an added benefit, and at some point we might say nationally, regionally, or locally that we wish we could afford it, but we can't."
 
Berwick also talked about his romantic view of Britain's socialized health care system on page 213 of a report he wrote entitled, "A Transatlantic Review of the NHS at 60," published on July 26, 2008. 
 
"Cynics beware: I am romantic about the National Health Service; I love it," Berwick wrote. "All I need to do to rediscover the romance is to look at health care in my own country."
 
In the same article, he wrote, "The NHS is one of the astounding human endeavors of modern times. … It's easier in the United States because we do not promise health care as a human right."
 
He further wrote, "Any health care funding plan that is just, equitable, civilized, and humane must – must – redistribute wealth from the richer among us to the poorer and less fortunate."
 
Roberts said he personally did not understand this romantic view of socialized medicine.
 
"With cancer survival rates for women 10 percentage points higher in the U.S. than in England, and over 20 points higher for men, why does he think that their government-run system is superior to our system?" said Roberts.
 
"Limited resources require decisions about who will have access to care and the extent of their coverage," Berwick wrote in the Jan. 27, 1999 edition of Nursing Standard.
 
"The complexity and cost of healthcare delivery systems may set up a tension between what is good for the society as a whole and what is best for an individual patient," Berwick wrote in an article entitled, "A Shared Statement of Ethical Principle."
 
"Hence, those working in health care delivery may be faced with situations in which it seems that the best course is to manipulate the flawed system for the benefit of a specific patient or segment of the population, rather than to work to improve the delivery of care for all. Such manipulation produces more flaws, and the downward spiral continues."
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