"Any health care funding plan that is just, equitable, civilized and humane must, must redistribute wealth from the richer among us to the poorer and the less fortunate. Excellent health care is by definition redistributional. Britain, you chose well."
Was that a British socialist speaking in Parliament? Nope. It was Dr. Donald Berwick, a Harvard professor about to face Senate confirmation as President Obama's nominee to head Medicare and Medicaid.
Dr. Berwick has spent the last few years gushing over the awesomeness of the UK's government healthcare, including the National Institute for Clinical Excellence (NICE) which has become little more than a rationing panel for British patients.
This apparently made him a perfect fit for President Obama's healthcare agenda. With Medicare set to lose hundreds of billions in funding, someone with a knack for "cost control" needs to take the lead - and who better than a Harvard radical obsessed with Britain's socialized medicine program?
Just don't call him a radical. On Thursday, Time Magazine's Kate Pickert wrote a piece headlined "'Rationing' Is Back!" as a snarky rebuttal to Berwick's Republican critics. The fireworks took off in the very first paragraph:
If you're still mourning the loss of the health care debate's heated rhetoric, don't despair. It's about to get another lease on life thanks to the upcoming confirmation hearing for Donald Berwick, Obama pick to head the Centers for Medicare and Medicaid Services.
This dismissive tone signaled exactly how worried Pickert was about possible rationing under ObamaCare, no matter if a self-proclaimed fan of rationing boards is nominated to control spending.
If any conservatives stuck around to read the rest, they would be introduced to a "widely respected" Dr. Berwick whom Pickert clearly admired:
As he says in the video above, Berwick believes health care is a human right and systems-like taxation-are a valid means to ensure everyone gets it. He believes the NHS successfully delivers care to the UK, although it could be better. (In the speech excerpted above, Berwick also said "even at age 60, the NHS seems still immature, adolescent, searching.") Berwick believes there is a tremendous amount of waste in the U.S. health care system that can be reduced through government policies, beginning with Medicare reform. At the same time, he believes patients should have more control over their medical destinies. Marrying these beliefs together into a philosophy that's politically viable, morally defensible and fiscally responsible would be Berwick's challenge as the head of CMS- if he can get through his confirmation hearing.
What about people who don't believe healthcare is a human right? What about voters - and taxpayers - who don't think it's the government's job to seize taxes for public healthcare? Pickert had this to say in her last paragraph:
It should also be noted that Berwick, who works at Harvard Medical School, is widely respected in the health policy community. His stance that money can be saved and patients better served by rewarding performance over quantity is shared by most top policy experts consulted by the Administration in the ramp up to the vote on health reform. A community disagrees with Berwick's methods for achieving this-including most Republicans and some health policy conservatives-but he is not a radical outlier. What he is is outspoken.
First of all, of course "policy experts consulted by the Administration" conveniently agreed with the Administration's philosophy. That's what happens when a partisan president only plays ball with those who agree with him.
And notice the friendly language used to explain Berwick's potential job: rewarding performance over quantity. That's a fancy way of saying doctors would be paid according to how well the government thought they performed, and not according to how many people they attempted to help.
That was the same reason Britain established the NICE panel back in the 1990's. It started as a way to weed out waste and encourage use of the best, most cost effective methods. But Britain soon learned that draconian rationing was the only way to keep its healthcare budget in line. The Wall Street Journal introduced Americans to NICE in 2009:
NICE has also produced guidance that restrains certain surgical operations and treatments. NICE has restrictions on fertility treatments, as well as on procedures for back pain, including surgeries and steroid injections. The U.K. has recently been absorbed by the cases of several young women who developed cervical cancer after being denied pap smears by a related health authority, the Cervical Screening Programme, which in order to reduce government health-care spending has refused the screens to women under age 25.
We could go on. NICE is the target of frequent protests and lawsuits, and at times under political pressure has reversed or watered-down its rulings. But it has by now established the principle that the only way to control health-care costs is for this panel of medical high priests to dictate limits on certain kinds of care to certain classes of patients.
American women are not used to living in a world where pap smears don't happen until they're 25. But in England, that is the reality.
A month before that piece was published, Berwick gave an interview to Biotechnology Healthcare Journal, where he defended NICE and then offered a chilling quote about rationing on American soil:
NICE is extremely effective and a conscientious, valuable, and - importantly - knowledge-building system. The fact that it's a bogeyman in this country is a political fact, not a technical one.
[...]
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. And right now, we are doing it blindly.
Welcome inside the mind of an Obama nominee who is slated to make decisions about Medicare funding.
But Time would have you know he's not a radical. The hearing for Berwick's Senate confirmation hasn't even been scheduled yet, and the media are already laying the groundwork to mock conservatives who oppose "sensible social decisions" that sound eerily like rationing.
No wonder Speaker Nancy Pelosi (D-Calif.) wanted to pass the healthcare law before people learned what it was all about.
