Stanley Feld M.D.,FACP,MACE
President Obama has used one trick after another to get his healthcare reform bill passed. He has also used many tricks to put control of the healthcare system in the hands of the executive branch of government. The Secretary of Health and Human Service has the power to make healthcare policy without congressional oversight.
The Secretary of Health and Human Services can delegate her powers to whomever she chooses. I was astonished that neither congress nor the Republicans made a fuss about President Obama usurping congressional power.
President Obama is moving further away from respecting the will of the people. It is clear that the majority of Americans oppose most aspects of President Obama’s healthcare plan. They do not like the implications of government control over the entire healthcare system, the specter of a public option, a single party payer,or rationing of healthcare.
Americans despise the implication of the loss of freedom to choose. They feel deceived by President Obama’s statements that if you like your physician or your healthcare plan you may keep it. In reality, this was a false promise.
President Obama nominated Dr. Donald Berwick to be Director of Center of Medicare and Medicaid Services (CMS). Dr. Berwick dedicated his life to healthcare policy. His ideas are “progressive” ideas. I disagree with many of his ideas. I also believe the congress and the American public should have been exposed to these ideas through the usual Senate confirmation process.
The Senate did not schedule the confirmation hearings because the nomination paperwork had not been completed.
During the July 4th recess, President Obama simply appointed Dr. Berwick as Director of CMS. I believe President Obama made this recess appointment to avoid a Senate debate on his choice.
Democrat Max Baucus, the Senate Finance Chairman, issued a statement critical of this end-around. Finally, an important Democratic Senator has reacted to President Obama’s usurping congressional power.
“Mr. Baucus hadn't scheduled hearings because the nomination paperwork wasn't even finished 11 weeks after Dr. Berwick was named.”
The obvious question is was the administration stalling to make the appointment without proper debate and vetting during the July 4th recess?
President Obama claims that the Republicans were impeding the appointment "for political purposes."
It is obvious that President Obama wanted to avoid restarting the healthcare debate in an election season.
Dr. Berwick's opinions agree with President Obama’s philosophy on healthcare reform. The direct appointment avoids reigniting the philosophical disagreements with Republicans.
Dr. Berwick’s philosophy is expressed in his 1996 book “New Rules” and in position papers of the Institute of Healthcare Improvement.
A primary function of health regulation is to “constrain decentralized, individual decision making and to weigh public welfare against the choices of private consumers.”
This sounds like socialized medicine to me. It sounds like a restriction of freedom of physicians to use clinical judgment and consumers freedom of choice.
He believes that "protocols, guidelines, and algorithms for care," with the common underlying notion that someone knows or can discover the 'best way' to carry out a task to reach a decision, and that improvement in medical care can come from standardizing processes and behaviors and demanding conformity.
It sounds like government control of the practice of medicine and patient choice. Sometimes there is not a single way to treat patients. Rationing should be determined by freedom of the individual to choose and not a central authority.
“In a now-notorious interview last year Dr. Berwick said, "The decision is not whether or not we will ration care—the decision is whether we will ration with our eyes open."
Since the federal government is running out of money, the bureaucracy will determine what is the best treatment at the cheapest price.
“Dr. Berwick personal view is the "public welfare" should have the power to trump the mere "choices of private consumers."
Dr. Berwick is also a believer in the value of the defective Dartmouth Atlas conclusions.
“Dr. Donald Berwick, nominated by President Obama to run Medicare, called it the most important research of its kind in the last quarter-century.”
Dr. Donald Berwick deserves a proper vetting because of the power he will wield. President Obama has pulled another trick play on the American public. He should not be permitted to get away with it.
The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone.
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