Constitutional Responsibilities and ObamaCare

One of the chief responsibilities of the Congress is the provide oversight of the executive branch — a responsibility that the Democrat Congress has punted. The president nominated Donald Berwick to head the Centers of Medicare and Medicaid, a proponent of rationing for the poor and elderly. Not only did the Congress not hold a single hearing about Berwick’s support for a government-run health care system, they never voted on his nomination. Berwick now heads an agency bigger than the Department of Defense without so much as a question being asked about his qualifications and extreme views.

Berkwick’s support for the imposition of a British-style health care system complete with its rationing regime is clear. “The decision is not whether or not we will ration care–the decision is whether we will ration with our eyes open,” Berwick said in a June 2009 interview with Biotechnology Healthcare.

In an interview last June, Dr. Berwick said, “NICE is extremely effective and a conscientious, valuable, and — importantly — knowledge-building system.” He added that NICE has “developed very good and very disciplined, scientifically grounded, policy-connected models for the evaluation of medical treatments from which we ought to learn.” Moments later, the interviewer asked, “So you are saying that the federal CER [Comparative Effectiveness Research] agency should get involved in cost determinations?” Berwick replied, “You can say, ‘Well, we shouldn’t even look.’ But that would be irrational. The social budget is limited.” NICE is the government agency in Britain that rations care on a daily basis. Professor Mike Rawlins, the chairman the British National Institute for Health and Clinical Excellence (NICE) who said: “The question is not whether care is rationed but how.”

Sen. Chuck Grassley and Sen. Orrin Hatch decided to call their own oversight hearing. Berwick was asked to attend twice but never responded to the invitation. Others did testify including Dr. Michael Smith, a board certified specialist in both Internal Medicine and Pediatrics from Wisconsin. Smith outlined the threat and ramifications the health care reform bill will have on doctors and patients:

Mr. Chairman, my fundamental opposition to a government takeover of our health care system stems from the fact that it destroys the doctor patient relationship, encourages non-participatory rationing of medical care and will adversely affect access to care for patients. I will leave the economic discussion of the impact of this bill to others, however I am skeptical there as well. When the government attempts to “bend the cost curve,” as President Obama likes to say, it is seniors, the sick and the weakest segment of our population that will suffer. That is not to say we should not be concerned about waste and fraud. We should. But when government is making decisions about how to cut costs, patients will be harmed. Period. To this I can already provide examples. Prior history has demonstrated that rapid changes in the reimbursement to hospitals have resulted in higher post surgical mortality, something none of us want to see again.

Smith also highlighted the outrage that a trillion dollar health care plan was being implemented by a supporter of the British Health care system and was never even subjected to a hearing:

Besides Social Security, there is no position in government that has a bigger impact on America’s seniors than Medicare and Medicaid. President Obama has appointed passionate rationing advocate and defender Dr. Donald Berwick to head the head the Centers for Medicare and Medicaid Services. This is a potentially ominous sign for every senior or near senior in America. Berwick’s nomination was so controversial that the Senate never approved it. His views were never even subject to a Senate hearing I don’t need to tell you that, you would have been talking to him. Ignoring the advice and consent responsibilities of the Senate, the president gave Berwick a recess appointment. Berwick is running an $803 billion agency – and will be responsible for implementing another $500 billion in funds from the new health care law – without Senate confirmation.

Sen. Grassley and Hatch deserve kudos for trying to bring some sanity to the debate. We look forward to more hearings, especially if Republicans manage to gain a majority in the Senate this November.

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