OP-ED

Op Ed: Dr. No to Run CMS

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.

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J.S.spikeGary LampmanMedicalMindDaspm Recent comment authors
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J.S.
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J.S.

INCONVENIENT FACT ” .. There might even be numbers on it right now, but I doubt anyone will remember any of this this in 2 months anyway… except for right-wing reactionaries and people who would never vote for Obama anyway ..” Dear Left-Winger and anti-fact reactionary, Max-term on recess appointment is 24 months .. http://www.senate.gov/CRSReports/crs-publish.cfm?pid=%270DP%2BP\W%3B%20P%20%20%0A It will come back to haunt OWE-bama. Even the FBI check hadn’t been completed. Max Baucus (D-Mont.) will give Berwick a haircut, he’ll never forget. We’re our brother’s keeper. And stupidity, incompetence, waste, fraud, theft, feather-bedding, and BLANK CHECKS do NOT have to be involved.… Read more »

spike
Guest
spike

Nate, I didn’t see a poll number regarding people’s opinions on the fact that Berwick’s appointment was a recess appointment. There might even be numbers on it right now, but I doubt anyone will remember any of this this in 2 months anyway… except for right-wing reactionaries and people who would never vote for Obama anyway.

Nate
Guest
Nate

“.This is not a Hand out but a Hand up for some 30 MILLION Fellow Americans. So what don’t you understand?”
Gary we don’t understnad where your getting your numbers. Only 5-7 million Americans can’t get insurance. The others CHOOSE to not have it. So who are these 23-25 Million people we are supposedly helping that don’t exist?

Nate
Guest
Nate

don’t get out much spike do you?
http://www.cbsnews.com/stories/2010/07/13/opinion/polls/main6675137.shtml
How Have Barack Obama’s Economic Programs Affected you Personally?
Now 5/2010
Helped 13% 13%
Hurt 23 18
No effect 63 68
48% plan to vote R while D is down to 44%. Sorry spike ain’t no one buying what your selling.
Maggie and Matt you might want to discredit this before claiming support for reform is growing again.
http://www.cbsnews.com/8301-503544_162-20010453-503544.html?tag=contentMain;contentBody

spike
Guest
spike

Luckliy nobody cares how Berwick got there except for people who would never approve him and would never vote for Obama.
Elections have consequences. For the country, Berwick’s appointment happens to be a good one. For far-right reactionaries, it’s a reminder that your beliefs are far outside the mainstream.

Gary Lampman
Guest
Gary Lampman

It is more important to harvest our children for wars of want and glutteny than to bring HEALTH Care to our fellow Americans.
I love the Christain View on this Priviledge Health Care Proposal that everyone seems to whine about. You said it was a privledge and so Now; everyone is privledged to contribute to the cost of sky rocketing Health Care.
Our ForeFathers would be ashamed of such selffish and unchristain Behavior.This is not a Hand out but a Hand up for some 30 MILLION Fellow Americans. So what don’t you understand?

ExhaustedMD
Guest
ExhaustedMD

My final comment for the summer, as I have better things to do than read the pontifications from the usual suspects who are just interested in their own welfare in the end. Per Stella Fitzgibbons, in a column from the LA Times I will link below, but I found THE WEEK summarized perfectly and will replicate here for your reading pleasure (note I will not be returning to read the pathetic dissentions that will just be rationalizing and minimizing what a DOCTOR has written below): “I am one of the people responsible for the country’s ever escalating cost of health… Read more »

MedicalMind
Guest
MedicalMind

The Berwick appointment reminds me of: The Federal Reserve Act of December 23, 1913. 103 congressional votes were absent for the holidays when the Federal Reserve became law. The American dollar, along with the reins to our economy, were handed to the bank-families of the Federal Reserve. Not only was the vote to enact the Federal Reserve illegal, the act was also unconstitutional, in direct defiance of our constitution. This was the first major coup d’état by the international banking moguls that would directly impact the economy of the United States. Well, due to the partisan controversy created by the… Read more »

Mg
Guest
Mg

Nate- executive appointments that weren’t confirmed and had huge power over Americans was an issue dating back to Andrew Jackson’s administration. It is nothing new at all.

Daspm
Guest

Wow these debates are fun. Especially when this new health care guy comes in the picture. I wonder what kinds of things he will be doing in order to get his vision of the Health Care system running.
Only time will tell.

ddaveve
Guest
ddaveve

Theyre all the same basically. 1 they dont care about what the public wants or thinks. 2 they glorify in their own wisdom. 3 they are incapable of making substantive changes. 4 they serve the status quo.
5. they are usually hypocritical and are never frank with the public.

Nate
Guest
Nate

” What is funny though is that most executive appointments such as this didn’t have to go through Congressional hearings until well into the late 19th or 20th century depending upon the agency or position level.”
Until the late 19th or 20th century these potitions didn’t exist that had so much power over our every day lives and futures. If we still had a limited federal government that stuck to its roll as defined by the constitution these positions would not exist let alone need scrutniy.

physician
Guest

a great blog
We can have a rational debate about cross-national comparisons and who gets better value for money from their health care systems”

MG
Guest
MG

Petty name calling – Check. One-sided partisan hackery – Check. Far-reaching conclusions that are generally non-supported by any checks in the piece? – Check. Check. Check. It was a lousy tactic to push through Berwick through the way Obama did. What is funny though is that most executive appointments such as this didn’t have to go through Congressional hearings until well into the late 19th or 20th century depending upon the agency or position level. I am more interested in hearing more about Berwick and his previous experience in dealing with large bureaucracies, his leadership style, and any experience he… Read more »

Nate
Guest
Nate

Matt need help with those goal post? “We can have a rational debate about cross-national comparisons and who gets better value for money from their health care systems” When has the US ever been about value? When liberal trial lawyers sue to force insurance to pay for experimental treatments they aren’t after best value. When Obama removes annual and lifetime caps and requires coverage for experimental treatment there is no value. Liberals states requiring fertility treatment and other lifestyle coverage had minimal value. After 45 years of legislating value out of US healthcare the Liberals now want to complain about… Read more »