Let’s do a thought experiment. Suppose you were a U.S. Senator and the President’s nominee to head CMS appeared at his confirmation hearing:
- Wearing a Che Guevera t-shirt, sporting the image of a psychopath who apparently enjoyed killing people, or
- Fondly clutching a copy of Quotations from Chairman Mao, written by a man who presided over the genocidal murder of more people than any other person in the history of the world.
When I was at Columbia University, my fellow students did these sorts of things. I soon learned they were not evil. They simply could not think clearly about moral issues involving collectivism. I view Don Berwick in much the same way.
President Obama took advantage of a short Congressional recess to appoint him to run Medicare and Medicaid without even a hearing. Although the President blamed Republicans, even some Democrats were unhappy with his snubbing of normal Senate prerogatives — something Obama criticized George Bush for doing with the appointment of John Bolton as UN Ambassador.
Ordinarily, I think Congress should defer to the President in choosing his own team. Berwick was definitely a poor choice, however.
Berwick’s praise of the British National Health Service (NHS) is similar to the antics of my Columbia classmates. Those who don’t know any better (people who, say, only read the socialist press) believe that patients routinely die in the United States because they cannot afford the health care they need, whereas in Britain they get such care for free.
The reality is exactly the reverse! Britain is the country where people routinely die because they cannot get the care they need and cannot afford to pay for it on their own, while this almost never happens in the United States.
- Research by Brookings Institution economist Henry Aaron and his colleagues confirms that tens of thousands of Britons die prematurely because they do not get the care Americans tend to take for granted.
- According to the World Health Organization (WHO), 25,000 British cancer patients die every yearbecause they do not have access to drugs that are routinely available in the United States and on the European continent.
- Those who can afford to so go private: about 6 million have private health insurance and roughly 12 million get private health services of some sort every year, paying with their own funds for care that is supposed to be theirs for free.
- When one cancer patient paid out of pocket for an expensive drug she was being denied, the NHS retaliated by threatening to make her pay for all of her other care out of pocket.
What makes the NHS immoral in my view is that it forcibly takes peoples’ money and spends it on health care services they easily could have purchased on their own, while denying them access to the expensive care for which people really need insurance.
I don’t mind Berwick’s view that rationing of health care is inevitable. I do mind his unwillingness to allow individuals to make their own choices between health care and other uses of money when they are able to do so. I also mind his desire to force people into a system that collectively rations care on a daily basis and allows them to escape only if they have political connections or the ability to pay.
The fact that Berwick thinks the British system is morally superior to our own does not mean that he is a bad person. It means that he is simply incapable of clear thinking on such matters.
What is frightening is that he is going to be making decisions affecting access to care of in excess of 100 million people.
John C. Goodman, PhD, is president and CEO of the National Center for Policy Analysis. He is also the Kellye Wright Fellow in health care. The mission of the Wright Fellowship is to promote a more patient-centered, consumer-driven health care system. Dr. Goodman’s Health Policy Blog is considered among the top free-market health care blogs on the internet where pro-free enterprise, private sector solutions to health care problems are discussed by top health policy experts from all sides of the political spectrum.