Obama names health care “rationer in chief” Update

Today President Obama named Donald Berwick to the position of head of the Centers for Medicare and Medicaid Services. This is not good news for anyone who relies on either Medicare or Medicaid for their health care.

Dr. Berwick, a Harvard medical school professor, was appointed by Obama to this post in April, but no Senate confirmation hearings had even been scheduled, so the president, as is his right, simply appointed the good doctor while Congress was in its Fourth of July recess.

We told you about Dr. Berwick earlier, but some of his “beliefs” are worthy of mentioning again.

Limited resources require decisions about who will have access to care and the extent of their coverage.

Or,

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.

And finally,

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 decisions all the time. The decision is not whether or not we will ration care–the decision is whether we will ration with our eyes open.

Why were no Senate confirmation hearings even scheduled?  My guess…if hearings were held, Dr. Berwick’s radical views about health “care” would become widely know to the American public, 60% of whom (at least according to one poll) want to see Obamacare repealed.  Dr. Berwick’s sworn testimony at any such hearing would have driven the repeal Obamacare numbers even higher.

So, between now and the end of this congressional term in January, when Dr. Berwick’s appointment expires, Dr. Berwick will be charged, among other things, with drafting regulations that will reduce the government’s costs for Medicare and Medicaid by $500 billion, as “promised” by Obamacare.

This will not be a pretty picture.

Update:

And, don’t fall for “the Republicans were blocking the appointment” argument.

Even Max Baucus [D. Mt.], the Senate Finance Chairman, issued a statement critical of this end-around. President Obama claimed Republicans were stalling the appointment “for political purposes,” but Mr. Baucus hadn’t scheduled hearings and the nomination paperwork wasn’t even finished 11 weeks after he was named.

Posted in

SoundOffSister

The Sound Off Sister was an Assistant United States Attorney for the Southern District of Florida, and special trial attorney for the Department of Justice, Criminal Division; a partner in the Florida law firm of Shutts & Bowen, and an adjunct professor at the University of Miami, School of Law. The Sound Off Sister offers frequent commentary concerning legislation making its way through Congress, including the health reform legislation passed in early 2010.

23 Comments

  1. Anne-EH on July 7, 2010 at 10:13 am

    The imfamous "death panels" brought to life with this July 4th holiday recess appointment. The "culture of death" has taken hold once more of America.



  2. cherwin on July 7, 2010 at 3:50 pm

    Just what we need. The man who thinks healthcare in Europe is wonderful. Then again who else would he select. He has to has someone who has the same demented ideas that he has.

    Now they are working on taking apart the Bill and putting in the exact terms they want. A good one I recently read is how they will pay for you and your baby if you get pregnant while you are taking college classes.

    A place to live, tuition, baby furniture and supplies, child care and on and on and on.

    Super, terrific, wonderful. Just where our tax dollars should go. It pays to get pregnant while taking classes. YEAH! They will a be having babies.

    What a mess we are in and we are just going to pay,, pay, and lose good healthcare. I am already sick~~~~



  3. PatRiot on July 7, 2010 at 4:33 pm

    To those "Democrats" and "liberals"  —–   Told ya!

    Now you can pick up your jaws and ask yourselves – Do these DC folks really represent me?

    It is now obvious that they will not take care of you.  You must take charge of yourself, your future and your country.

    Next – ask yourself: What is important to me? What are my rights?  How do I protect my life, liberty and persuit of happiness? 

    The good news is,  you are not alone.  Not by a long shot… and the numbers grow every day.

    Be prudent and have a sparkling day.



    • PatRiot on July 7, 2010 at 4:40 pm

      The value of a Harvard education has just dropped significantly again in my book.



  4. Dimsdale on July 7, 2010 at 5:11 pm

    Amazing.  Even John Bolton, also a recess appointment, had to go through the hearing process.  This process was designed for emergency appointments when the Congress could not be assembled in time to get the candidate into office.

     

    Now, given this precedent, what if the next Republican president simply decided to make all of his appointments during Congressional recesses, and just skip the whole messy hearing process?

     

    I wonder why Øbama didn't just appoint an "oil spill cleanup Czar" in the same way.  The Gulf oil spill is certainly an emergency…



  5. Dimsdale on July 8, 2010 at 11:54 am

    Clearly, ?bama thinks that since “he won”, he can simply crown himself king.? Or is it dictator?



    • PatRiot on July 8, 2010 at 7:15 am

      It is the aire of entitlement that surrounds him and the elite.

      Call it the ignorance of arrogance.  Haughty to the point of ignoring fact and common sense.

      It's that Marie Antoinette "Let them eat cake" attitude that….well, you know.



    • Dimsdale on July 8, 2010 at 11:33 am

      I would say it is more of a stench.  The stench of statism.



  6. porschepete on July 8, 2010 at 2:13 pm

    Be careful the next time you need medical treatment besure you lookout for

    the "Arbiet machs frei" sign. welcome to the American version of the Wiemar

    Republic. He always said that we should be more like europe.One day the shoe will be

    on the other foot and then it will very uncomfortable.



    • philschieb on July 9, 2010 at 10:30 am

      The shoe will never be on his other foot, don't you see, he's an ex congressman entitled to all the perks of the office. That includes incredible pension and health care you will never see even if you are a millionaire.



  7. rickyrock on July 13, 2010 at 7:25 am

    I hate to break it to you geniuses ………….but health care is already "rationed."

    1.Income ….if you can't afford insurance you're currently out of luck.46,000,000 currently are out of luck..

    2.Pre-existing conditions .in my own case I have a so called pre-existing condition which is actually a variation in the heart valve that 20 % of the population has …………but still the jerky boy insurance companies call it a dangerous condition which statistically I can prove is not.  I lose …they win.

    3.My policy limits the kind and quality of care I receive ……..(.rationing again)

    4.Increase in the policy cost has really burdened my family…………….I have to raise my deductible and cancel some coverage………gee sounds like……………

    5.My daughter needed a procedure that according to 3 doctors would help her mobility …………insurance company said no…………procedure is defined as experimental…..we won't cover it gee sounds like………

    Peter Singer wrote in July 2009 new york times"

    "Health care is a scarce resource,and all scarce resources are rationed in one way or another.In the United States ,most health care is privately financed ,and so most rationing is by price,you get what you,or your employer can afford to insure you for.The federal government government makes these premiums tax deductible …which in effect is a 200 billion dollar subsidy for health care.In the public sector,primarily Medicare,Medicaid and hospital emergency rooms,health care is "rationed" by long waits ,high patient co-payment requirements ,low payments to doctors that discourage some from serving public patients and limits on payments to hospitals"

    If the Obama plan allows me better coverage for my family ,coverage with my so called pre-existing condition or saves me 1 dollar I'm all for it.



    • Steve McGough on July 13, 2010 at 9:13 am

      Insurance company said no? Are you on an employer-sponsored plan or do you buy coverage directly from the insurance company? You copied and pasted information that suggests you understand employers make the decisions about coverage, NOT insurance companies.

      I don't for one minute believe the "Obama" plan will improve my coverage or reduce my costs. As a matter of complete fact, I know my costs are going up due to changes in the way HSAs work. Rationing – in my opinion – is a specific term dedicated not to coverage limitations, rather government involvement in making decisions. It's like censorship, only the government can censor speech.

      I see that you too like to blame "jerky boy" insurance companies for high premiums and denials. I'll be the first to admit I know little about how health care insurance, underwriting and actuarial accounting work, but I know for damn sure insurance companies represent less than 5 percent of the 'outrageous' increases in health care costs and therefore premium increases.

      It's just that many need someone to blame and the "jerky boys" are a respectable target, where the realities of current health care spending, medical malpractice insurance, higher education costs, physician and other health care provider salaries, and yes, personal responsibility, is totally lost and seem to be 'off topic' to the progressive/liberal/socialists.



    • djt on July 13, 2010 at 5:10 pm

      so if a private insurance policy has coverage limitations, those limitations are just that, but if a gov't plan has the exact same limitations it would be rationing?



    • rickyrock on July 14, 2010 at 6:23 am

      Where the hell does this 5 % number come from …????: The following is a quote from the department of health and human services "

      WellPoint and others claim that the premium increases are necessary given the rise in health care costs. While rising health care costs is a known problem with our broken health care system, some of the premium increases requested by insurance companies are 5 to 10 times larger than the growth rate in national health expenditures.11 All the while, insurance companies and their CEOs continue to thrive.

      Recent economic data show that profits for the ten largest insurance companies increased 250 percent between 2000 and 2009, ten times faster than inflation.12,13 Last year, as working families struggled with rising health care costs and a recession, the five largest health insurance companies – WellPoint, UnitedHealth Group, Cigna, Aetna, and Humana – took in combined profits of $12.2 billion, up 56 percent over 2008.14 These health insurance companies’ profits grew even as nominal GDP decreased by 1 percent over this same time period.15 WellPoint accumulated more than $2.7 billion in profits in the most recent quarter alone.16

      Gee did you see that part??? increases in the premiums requested are 5-10 times the growth rate of national expenditure……….profits for the top 10 insurance companies increased 250 percent from 2000 -2009 ……………5 % ??????

      I'm no left wing commie ………socialist……….my doctor told me what I had concerning my heart valve is a variance of the norm…………however this is all the opening the insurance companies needed to screw me……………….



    • Steve McGough on July 14, 2010 at 8:12 am

      @rickyrock: Stop with all the damn links. Instead of copying and pasting, put some thought into your comments and read the terms of use. No reason to even debate at this point, I tossed out real data from the government and you tossed out an Obama sponsored .gov site that has an agenda. Does my data have an agenda? I stand by my figures since I'm the one who dug into the research.

      I actually took the time to spell out the actual increase in expenditures directly from the HHS website. I read your stuff, did you even bother to read mine?

      Every single one of those premium increases – every one – had to be approved by state governments. I guess that means the states are out to screw you too and are in collusion with the insurance companies. Those regulators looked at the details and ran smack into a come-to-Jesus moment where they realized insurance company profit was not the concern here, and the rates were justified.

      Now, where's that ignore button…



    • rickyrock on July 14, 2010 at 6:35 am

      Where did you get that 5 % number??????

      According to the department of health and human services the increase requested by insurance companies is 5- 10 times the growth rate ………further between 2000-20009 insurance company profits rose 250 percent 10 times faster than inflation.In 2009 Wellpoint,United Health Group ,Cigna ,Aetna and Humana combined profits were 12.2 billion up 56 %over 2008…………

      Where did you get that 5 % ????
      http://seminal.firedoglake.com/diary/30417



    • Steve McGough on July 14, 2010 at 7:06 am

      From the Department of Health and Human Services. My post is here. The 5 percent is NOT the total increase, it's what can be directly associated to increased administration fees and "profit". Read the post, excellent information.



  8. rickyrock on July 14, 2010 at 6:24 am

    WellPoint and others claim that the premium increases are necessary given the rise in health care costs. While rising health care costs is a known problem with our broken health care system, some of the premium increases requested by insurance companies are 5 to 10 times larger than the growth rate in national health expenditures.11 All the while, insurance companies and their CEOs continue to thrive.

    Recent economic data show that profits for the ten largest insurance companies increased 250 percent between 2000 and 2009, ten times faster than inflation.12,13 Last year, as working families struggled with rising health care costs and a recession, the five largest health insurance companies – WellPoint, UnitedHealth Group, Cigna, Aetna, and Humana – took in combined profits of $12.2 billion, up 56 percent over 2008.14 These health insurance companies’ profits grew even as nominal GDP decreased by 1 percent over this same time period.15 WellPoint accumulated more than $2.7 billion in profits in the most recent quarter alone.16

    Where's that 5 % …………………??????



  9. Steve McGough on July 14, 2010 at 7:09 am

    @djt – It's NOT the private insurance company that makes the decisions on what to cover. It's generally the employer who chooses the coverage options. If you buy direct, you choose a plan that has a specific contract detailing what is covered, just like any other insurance policy.

    Edited to add: You're trying to do the apples/oranges thing. There is a BIG difference between scheduled rationing of care – which as far as I know insurance companies DO NOT partake in at all – and a government determining only 40 out of the 60 people who need a procedure will get the procedure this month. Totally different … and insurance companies DO NOT do that.



    • djt on July 14, 2010 at 12:11 pm

      my intent was not to challenge you steve, just ask a simple question.

      Apples and oranges? I asked the question using your words as a basis.

      "Rationing – in my opinion – is a specific term dedicated not to coverage limitations, rather government involvement in making decisions."

      so my question arose regarding the decisions the gov't  would make about coverage, and what we would call their coverage limitations  compared to employer chosen limitations. Given your quoted statement, it seems not to be apples to oranges at all, since we were in the context of discussing coverage. It is just now that you introduced "scheduled rationing of care", which has not been much, if any, of the discussion at all. In fact there is no mention of scheduled rationing in the original SOS post, but there is this, regarding Berwick's beliefs:

      "Limited resources require decisions about who will have access to care and the extent of their coverage."

      That, and your statement I quoted above, was the context of my question. I believe it was you that introduced new "fruit."



  10. rickyrock on July 15, 2010 at 12:55 pm

    Oh .I get it now .when the facts and numbers run contrary to you opinion then the facts must be wrong.These numbers are correct coming from the dept health and human services……….

    Insurance companies have literally made billions of dollars ripping off the public .these numbers don't lie.



frontpg-obama-news-conference

The website's content and articles were migrated to a new framework in October 2023. You may see [shortcodes in brackets] that do not make any sense. Please ignore that stuff. We may fix it at some point, but we do not have the time now.

You'll also note comments migrated over may have misplaced question marks and missing spaces. All comments were migrated, but trackbacks may not show.

The site is not broken.