On this week’s Health Care News podcast, Avik Roy, one of the most insightful writers about health care policy today, took the time to discuss with me the White House’s decision to bypass the nomination process of the U.S. Senate to recess appoint Donald Berwick as head of the Centers for Medicare and Medicaid Services (CMS). I encourage you to listen, and then to watch this video clip one more time, an honest expression of the radical views Berwick holds:
Here’s what the new CMS administrator says in lines which, when paired with his remarks favoring wealth redistribution via health policy, certainly bear out this Baltimore Sun columnist’s hope that Berwick will become the Che Guevara of American health care:
“Please don’t put your faith in market forces. It’s a popular idea that Adam Smith’s invisible hand would do a better job of designing care than leaders with plans can. I do not agree. I find little evidence anywhere that market forces, bluntly used, that is, consumer choice among an array of products with competitors’ fighting it out, leads to the health care system you want and need.”
These two paths run in opposite directions: the path toward market based solutions, where people direct their own care with their doctors, making decisions for themselves, and the path toward bureaucracy based solutions, where unelected experts — “leaders with plans” — determine people’s care, making decisions for them. Berwick is clear about what he believes.
People have asked me over the past week why this recess appointment is such a bad thing — after all, every president uses recess appointments. But by a wide margin, the overwhelming majority of recess appointments come after hearings have been held and a nominee thoroughly vetted. Berwick has not been.
The White House claimed this week that the recess appointment was in response to “Washington game-playing”, accusing Republicans of planning to “stall the nomination.” As I’ve said on blogposts, radio and podcasts this week, this is nothing more than a baldfaced lie. Republicans could not stall this nomination even if they wanted to under Senate rules. Some commenters on the left even claimed there was a secret hold placed on Berwick — but this isn’t even possible at the stage in his nomination! — as not one hearing has been called or scheduled.
The White House’s lie on Berwick is so blatant, it’s been rejected by both sides — criticized by Ruth Marcus from the left and by the Wall Street Journal on the right. Even the New York Times didn’t buy the White House’s explanation, reporting: “The recess appointment was somewhat unusual because the Senate is in recess for less than two weeks and senators were still waiting for Dr. Berwick to submit responses to some of their requests for information.”
As I pointed out the other day, President Obama is not just circumventing the approval process, he’s circumventing the “basic vetting standards” process — Berwick is avoiding outstanding questions from the Senate, including requests for additional documentation considered standard for nominees. The Hill reports on many of the questions that have arisen about Berwick’s funding sources for his foundation.
This is all the more disturbing considering Berwick, known already for his views on “redistributing wealth” as a necessary part of health care policy, is now the most important figure in the application of the authority-grabbing Obamacare legislation. He will preside over the reorganization of Medicare and Medicaid, drive the policies of the entire health insurance marketplace (since they take their cues from Medicare), and a pile of money representing roughly 1/6th of the American economy.
As head of CMS, Berwick represents a worse step than any policy actually contained within Obamacare. I’ve said repeatedly this legislation was, more than anything, about authority — the redistribution and enhancement of Washington regulators at the loss of states, doctors, and the marketplace. The vast majority of that authority now belongs to Berwick. As Avik Roy says in our podcast, Obamacare was a decision that bureaucrats will micromanage your health care — Berwick’s position will determine how they micromanage your health care.
Thanks to the White House’s decision, Berwick now has unprecedented power, without answering one question of significance, to apply his radical views to the lives and health care of every American.