Obama Medicare Head Bringing UK Rationing Board to US?
Medicare Head Donald Berwick will testify in front of the Senate Finance Committee Wednesday for the first time since President Obama used a recess appointment to put him into place. He’ll be facing down a host of Republicans who objected to his nomination on the grounds that he’s in love with wealth redistribution and Britains National Health Service.
Sens. Pat Roberts (Kan.), Mitch McConnell (Ky.) and John Barrasso (Wyo.) joined forces on the Senate floor shortly after the last vote of the day and urged members to review Berwick’s record before voting on his confirmation. They accused Berwick of promoting health care rationing, especially for older people, and particularly criticized his endorsement of Great Britain’s National Healthcare System (NHS). “Dr. Berwick is a huge fan of … the NHS, a system that relies on rationing health care to hold down costs,” Roberts said. “Dr. Berwick has said, ‘I am a romantic about the NHS; I love it,’ and ‘the NHS is not just a national treasure, it is a global treasure.'”
In case Americans are unaware, the NHS has a terrifyingly active healthcare rationing panel. Originally put in place to reduce healthcare costs, root out bad doctors and useless treatments and ensure that healthcare practices were at their absolute best. Over time, NICE has taken to “reducing costs”by limiting the kinds of treatments British patients are allowed to receive through government healthcare. The Wall Street Journal warned Americans last July about NICE and cost-cutting panels. They cited NICE’s rulings against providing lifesaving breast and stomach cancer drugs, blocking or restricting access to drugs to treat macular degeneration, kidney disease, rheumatoid arthritis, multiple sclerosis and myloma, and NICE’s restrictions on fertility treatments, certain surgical procedures and cervical cancer screenings, all in the name of saving money.
One of the questions Berwick will face will likely be on the subject of IPAB – the Independent Payment Advisory Board – a panel made up of fifteen unelected bureaucrats who will be charged with making drastic cuts to medicare on a yearly basis, likely limiting patient choice for Medicare recipients. The panel’s decisions are unappealable and can only be overturned by a supermajority vote in Congress. Berwick will have to explain how IPAB – termed by Sen. Tom Coburn as a “a government command-and-control bureaucracy that will dictate payment decisions and interfere with the best judgment of physicians and families” – is necessary and beneficial to Medicare patients.
The concern is obviously whether Berwick intends IPAB as a wedge for more serious healthcare rationing. In July, Republicans questioned Berwick for defense of NHS healthcare rationing practices, after news came to light that Berwick made glaring statements in favor of rationing in the healthcare debate, at one point saying that most people in serious pain “just need the morphine and counseling that have been around for centuries.” A White House spokesperson defended Berwick saying that rationing was already rampant in the system and that Berwick merely “wants to see a system in which those decisions are transparent – and that the people who make them are held accountable.”
It’s legitimate to want to know whether Berwick supports the kind of healthcare rationing done by the NHS he claims to admire, and it’s only fair to ask whether the IPAB, charged with cutting costs at the outset, will have no choice but to evolve into NICE as pressure builds to cut further into Medicare. The question of healthcare rationing has always been present in this debate, and those who value having a voice in their healthcare decisions deserve to know what the future holds for their care.