Throughout the yearlong debate over reforming our nation's health care system, Democratic leaders, including the president, continually reassured Americans that their brand of health care reform would not mean the rationing of care. Unfortunately, by establishing new government boards to determine the necessity of care and eliminating choice for seniors in Medicare (while dramatically expanding Medicaid), Democrats willfully designed a health care system similar to those in countries such as England that have a history of denying care. Nevertheless, Americans were told that Obamacare would not make judgments based on whether a treatment made sense from a cost perspective.
Like so much with Obamacare, that promise is very quickly losing its luster.
Most recently, the Obama administration decided to make Dr. Donald Berwick, its nominee for administrator of the Centers for Medicare and Medicaid Services, a "recess appointee" - meaning that his appointment circumvents the normal Senate confirmation process and the president is simply able to hand Dr. Berwick the post. Making matters worse, this decision to appoint Dr. Berwick was not a last-resort effort by the administration after weeks of unresolved Senate debate. Truth be told, there has been no confirmation hearing before the committee of jurisdiction or even the opportunity for a single member of Congress - Democrat or Republican - to question Dr. Berwick publicly.
The administration has attempted to justify its actions by blaming Republicans - not a particularly original tactic. But such a claim belies the facts. Republicans never even had the opportunity to begin to consider Dr. Berwick's nomination or to stall it. Furthermore, Democrats have a majority capable of passing any nominee through the committee process if their fellow Democrats support that nominee. It appears the president was more worried that a full vetting of Dr. Berwick would cause some in his own party to vote against his nominee.
Already, we have seen at least one prominent Democrat raise concerns about Dr. Berwick's recess appointment. Sen. Max Baucus, the Democratic Chairman of the Senate Finance Committee, called this recess appointment troubling and noted, "Senate confirmation of presidential appointees is an essential process prescribed by the Constitution that serves as a check on executive power and protects ... all Americans by ensuring that crucial questions are asked of the nominee - and answered." Clearly, this was not the case with Dr. Berwick. To be certain, there are legitimate concerns about Dr. Berwick - concerns we and 55 of our House Republican colleagues outlined in a letter to President Obama on June 28. Dr. Berwick has been one of the most prominent advocates of denied care. He has praised England's health care system and its rationing board, which limits patients' access to needed care based on cost. In his book on health care reform, Dr. Berwick argued that patients' access to heart surgeons should be restricted according to where they live and medication costs should be reduced by limiting access to needed drugs.
Nevertheless, President Obama is asking Congress and the American people to accept blindly his handing Dr. Berwick control over an agency that annually disburses $803 billion in benefits - a budget greater than the economies of all but 15 nations - to many of our country's neediest patients.
The president has put himself in an unenviable predicament. He plans to add millions of new patients to the government health care rolls, which inevitably will cause costs to skyrocket unless he can find a way to limit health care expenditures. Hence the impetus to put Dr. Berwick - an avid promoter of rationed care - in a position of power. But we do not need a "rationer-in-chief" determining what benefits seniors, the disabled and low-income Americans are eligible to receive. We need someone who believes that every American deserves access to quality, affordable care.
As doctors, we know medicine is not always an exact science - as much as we would like it to be. It is driven by the relationship between doctors and their patients and how they collectively address challenges that arise in particular circumstances. Dr. Berwick's preferred method of medical decision-making ignores that reality. This recess appointment shows that the president is willing to endorse openly the rationing of health care. Just another indication of the Democrats' belief that their plans to alter radically our health care system require no approval from the American public.
All three authors are medical doctors. Rep. Phil Gingrey leads the GOP Doctors' Caucus. Rep. Tom Price heads the Republican Study Committee. Rep. Charles Boustany serves as Ways and Means oversight subcommittee ranking member.
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