Berwick in “Race Against Time”

By Dave Andrusko

Medicare and Medicaid Administrator Donald Berwick.

Dr. Donald Berwick, who became head of the powerful Centers for Medicare and Medicaid Services via a controversial recess appointment made by President Obama, is as popular with the Washington media as he is deeply unpopular with most  Republicans and all pro-lifers.

A couple of days ago the Washington Post ran a painfully embarrassing story uncritically lauding Berwick who is, we were informed, the “Medicaid and Medicare Chief in [a] race against time.” The deadline alluded to in the headline is this December when (unless the U.S. Senate acts to confirm him, which is highly unlikely) Berwick’s temporary stint ends.

Amy Goldstein paints a picture of a “political neophyte” who started with an anchor around his ankles—Obama “chose Berwick at a time of great political hostility, weeks after congressional Democrats pushed through the health-care law that Republicans already were vowing to dismantle”—but who has soldered on—“overseeing two entitlement programs that insure nearly one in three Americans, shepherding the profound insurance changes spurred by the new health-care law and serving as chief cheerleader for better care at lower cost.”

There is a passing reference early on to one reason there was/is so much opposition: “A pioneer in improving medical quality, but a neophyte in Washington politics, Berwick ran into a buzz saw of Republican opposition over old academic writings when President Obama chose him for the task 16 months ago.”

Get it? “Old academic writings,” as in they don’t really count. But the fact is, as you read the story, Berwick is not repudiating the very statements he made that made him the focal point of opposition, including by National Right to Life.

For example, “Republicans focused, for instance, on academic writings in which Berwick had praised aspects of the British National Health Service; Republicans said his views were tantamount to support for rationing and socialized medicine,” Goldstein writes.

‘The controversy, Berwick said, caught him by surprise. But in retrospect, he said, ‘I wouldn’t take a word back. . . . My general reaction has been almost as if these people are talking about somebody else.’” He then proceeds to deny up and down that he supports rationing, which of course his writings clearly say he does.

To take just one of many examples, in an article in the May/June 2008 issue of Health Affairs, he called for “rational collective action overriding some individual self-interest” so as to “reduce per capita costs.” Lamenting that “[t]oday’s individual health care processes are designed to respond to the acute needs of individual patients,” Berwick wrote that instead government should “approach new technologies and capital investments with skepticism and require that a strong burden of proof of value lie with the proponent.”

The Post story ends with a perfect illustration of the condescension with which Berwick addresses those who disagree with him,  including the 42 GOP senators who signed a letter earlier this year, urging Obama to withdraw Berwick’s name.

“Berwick approaches the discord with a certain detachment,” Goldstein writes.

“’This will sound a little weird,’ he said, ‘but when you are a pediatrician or a father, you always are saying, what is this kid’s strength. . . . Even the people that disagree the most, they bring something to the table

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