What a Recess Appointment Gets Us

Speaker Nancy Pelosi commented before the vote on Obamacare that "We have to pass the bill so that you can find out what is in it.” Similarly, since President Obama’s appointment of Donald Berwick as administrator of the Centers for Medicare and Medicaid Services occurred without a confirmation hearing, we're just now beginning to learn what Berwick is all about.

Obama skirted around the Senate to appoint Berwick by using a rare recess appointment over the Independence Day holiday break. It’s unfortunate, because Berwick’s take on rationing health care is truly frightening.

Berwick has been an outspoken admirer of the government health programs found in Britain, the British National Health Service, and its rationing arm, the National Institute for Clinical Effectiveness (NICE). Michael Tanner, a senior fellow at the Cato Institute, detailed some of Berwick’s approaches:

“’I am romantic about the National Health Service. I love it,’ Berwick said during a 2008 speech to British physicians, going on to call it ‘generous, hopeful, confident, joyous, and just.’ He compared the wonders of British health care to a U.S. system that he described as trapped in ‘the darkness of private enterprise.’

“The one thing the NHS is good at is saving money. After all, it is far cheaper to let the sick die than to provide care.

“At the forefront of this cost-based rationing is NICE. It acts as a comparative-effectiveness tool for NHS, comparing various treatments and determining whether the benefits the patient receives, such as prolonged life, are cost-efficient for the government.

“NICE, however, is not simply a government agency that helps bureaucrats decide if one treatment is better than another. With the creation of NICE, the U.K. government has effectively put a dollar amount to how much a citizen’s life is worth. To be exact, each year of added life is worth approximately $44,305 (?30,000). Of course, this is a general rule and, as NICE chairman Michael Rawlins points out, the agency has sometimes approved treatments costing as much as $70,887 (?48,000) per year of extended life.

“To Dr. Berwick , this is exactly how it should be. ‘NICE is not just a national treasure,’ he says, ‘it is a global treasure.’”

If these statements don’t give you a good enough idea on Donald Berwick’s health care philosophy, try this:

“’It’s not a question of whether we will ration care,’ he said in a magazine interview for Biotechnology Healthcare, ‘It is whether we will ration with our eyes open.’”

So, it’s Berwick’s position that rationing care may be good enough for everyone else, but what about for Berwick himself?

Byron York recently reported in the Washington Examiner that Berwick and his wife have health coverage “from retirement until death”. While most Americans are concerned with where their health care will come from, Berwick will never have to worry nor will he ever be subject to Obamacare.

Americans should be watchful to see if Berwick pushes through British-style policies in Medicare and Medicaid. But those policies aren’t the only issues in health care we should be guarding against. Senate Majority Leader Harry Reid said over the weekend at a progressive conference, as reported by Philip Klein of the American Spectator, “We’re going to have a public option. It’s just a question of when.”

President Obama explained his recess appointment saying, “I can’t play political games on these issues. I’ve got a government to run.” President Obama, this isn’t a game. Americans have a right to know more about those individuals you appoint to such lofty levels of public influence.