Senate Republicans on Tuesday took aim at President Obama's appointee to oversee a major component of his health care overhaul plan, complaining about the way the nomination was made and the lack of time given to lawmakers to question him.
The Senate Finance Committee hearing was the first Capitol Hill public appearance for Donald M. Berwick, the Harvard Medical School pediatrician who now heads the Centers for Medicare and Medicaid Services. A lightning-rod for conservative criticism for some of his past comments on health care rationing and economics, Dr. Berwick was named to the post this summer by Mr. Obama as a "recess appointment" - short-circuiting an expected Senate confirmation fight.
The hearing also marked an opening skirmish in what could soon be a full-scale war in Congress over the fate of Mr. Obama's signature reform. Top Republicans, backed by an incoming majority in the House and an expanded minority in the Senate, have vowed to repeal some or all of the law in the coming Congress.
Republicans at the packed hearing complained that, having finally gotten a chance to interrogate Dr. Berwick, the session was limited to an hour and each senator was only give five minutes for questions.
"This is pathetic," said Sen. Orrin G. Hatch, Utah Republican "My gosh, we ought to have time to ask the most important man in America on health care some questions."
Sen. Charles E. Grassley, of Iowa, the ranking Republican on the Senate finance panel, noted that it had been 134 days since Dr. Berwick was appointed to the job, and Wednesday was the first day to question him in public session.
Trying to learn about implementation of the massive health care overhaul in a one-hour hearing "is like trying to drain the Pacific Ocean with a thimble," Mr. Grassley said. "This can't just be a check-the-box exercise."
Republicans said the abbreviated hearing was particularly egregious because Dr. Berwick, as the administrator for the government's primary health programs for seniors and the poor, effectively runs the nation's largest health insurance concern with a budget -- more than $800 billion -- that is larger than the Pentagon's.
Sen. Jim Bunning, Kentucky Republican, said the new administrator should get accustomed to testifying on Capitol Hill, predicting the new GOP-led House of Representatives will be closely following his agency's work next year.
Asked why he agreed to a recess appointment from Mr. Obama, Dr. Berwick said it was "because the president asked me, and I want to serve my country." He said he had responded to lawmakers' requests for information and clarity and had accepted every invitation from individual legislators for one-on-one briefings.
His opening statement referred only in passing to fears that he favored government "rationing" of health care as a way to constrain costs and expand coverage. The Affordable Care Act, as the new law is known, does not prescribe a "one-size-fits-all" approach to care, he said.
The law "explicitly protects the guaranteed Medicare benefits on which so many seniors and individuals with disabilities rely," he told the committee. "It will not cut these guaranteed benefits, nor will it ration care."
He said the law had already delivered a number of benefits, including financial aid for seniors facing the dreaded "doughnut hole" gap in purchasing prescription drugs under Medicare and employing more investigators and resources to root out Medicare fraud.
Asked by Sen. Debbie Stabenow, Michigan Democrat, about efforts to overturn the health care law in 2011, Mr. Berwick replied, "I can't think of a worse plan than repealing this law."
Dr. Berwick, who earned a national reputation as a health care specialist during his time at Harvard and at a Cambridge-based medical think tank, attracted critical fire almost immediately after Mr. Obama announced plans in April to nominate him to oversee Medicare, Medicaid and the health care plan for lower-income families with children known as SCHIP. A series of comments he made praising Britain's nationalized health system and on the need for cost controls and rationing of care sparked a conservative revolt against his nomination.
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.
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