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In one oft-cited remark from a 2009 interview, Dr. Berwick said, “The decision is not whether or not we ration care; the decision is whether we will ration care with our eyes open. And right now, we’re doing it blindly.”

Mr. Obama’s hopes for a smooth implementation of the health care plan could face problems on another front, as the U.S. Chamber of Commerce announced Wednesday a major push to fight back against what it called a “regulatory tsunami” caused by Mr. Obama’s policies on health care, banking, labor unions and the environment.

Chamber President and CEO Thomas J. Donohue said in a policy address that the Washington-based group will create a special new unit to highlight the burden for big and small businesses from excessive regulation and promised “even greater activism” by the Chamber’s legal arm to fend off burdensome new government rules in court.