Stanley Feld M.D.,FACP,MACE
Sen. Max Baucus (D-Mont.), chairman of the Senate Finance Committee announced on March 8,2011 that “The Senate will never vote to confirm Dr. Donald Berwick as CMS administrator.” Dr. Don Berwick is currently serving through a temporary one year appointment made by President Obama while congress was in recess last summer.
Mr. Bacus did not call for confirmation hearings before the recess because of fears that Dr. Berwick’s views would be too controversial for him to be confirmed. He and President Obama feared the Senate and the American people would reject Dr. Berwick’s nomination.
Last week 42 Republican Senators sent a letter to President Barack Obama requesting that he withdraw Berwick from consideration. The Republican Senators said they would not vote for Dr. Berwick under any circumstances.
Senator Bacus said the “Republicans won”. He said alternative nominees to the post are "up to the president."
President Obama has announced, after receiving the Republican Senators letter, his support of Dr. Berwick’s nomination. President Obama declared Dr. Berwick is the most qualified candidate to lead CMS. Dr. Don Berwick told reporters that he “was grateful for the White House support.”
The 42 no votes would block confirmation because 60 votes are needed. Dr. Berwick was asked if he has met with any of those Republican senators to address their concerns about him. He said he would “meet with anyone in Congress who wants better healthcare.”
His answer implies Senate Republicans do not want better healthcare. It also implies that Republican Senators have no interest in meeting with him and that he knows the answers and they do not.
Republican Senators have expressed many concerns. One concern stems from Dr. Berwick’s praise of the British single-payer system which is failing and the sense President Obama’s healthcare reform act is heading toward a single party payer system.
The concerns are deeper than these. There has been little coverage of the Republican Senators’ letter to President Obama in the traditional media.
The Republican Senators wrote; “Withdrawing Dr. Berwick’s nomination would be a positive first step in rebuilding the trust of the American people.”
The letter says; “CMS is in charge of both Medicare and Medicaid, and will oversee most of the implementation of the recently-enacted health law.”
The Republican Senators letter lists the reasons for their request in a civil way.
1.“Don Berwick is a contentious choice to head an agency with a budget larger than the Defense Department’s and implement the vast majority of the $2.6 trillion health law.
2. “ The White House’s handling of this nomination – failing to respond to repeated requests for information and circumventing the Senate through a recess appointment – has made Dr. Berwick’s confirmation next to impossible,”
3. “In the spirit of cooperation, the President should withdraw his nomination and choose a different candidate who has the support and confidence of the American people.”
4. “Both Congress and more than 100 million Americans that will be affected by this partisan health care reform plan need to know who is minding the store at CMS.
5. There are just too many questions about what Dr. Berwick and CMS are doing or will do with the unprecedented power they have been given to reshape our health care system,”
6. “The President should start with a clean slate and send the Senate a nominee who is willing to answer our questions and seek our bipartisan support as he or she leads CMS in implementing the new health care law.”
7. “ The occupant of this important position, which affects the health care of so many Americans on a daily basis, requires an individual with the appropriate experience and management ability. Our seniors and those who rely on Medicaid deserve no less.”
The letter questions Dr. Berwick’s experience and management ability to handle large organizations. There has not been evidence presented to the congress verifying that Dr. Berwick has experience in running large organizations with multiple competing vested interests.
The healthcare system is dysfunctional. Only a consumer driven healthcare system with consumers in charge of their healthcare dollars will repair the healthcare system. Consumers must have access to appropriate information and appropriate incentives to make wise health decisions. This is the only way to control the costs of the healthcare system. A complex bureaucracy will not do this.
Mistrust of President Obama is rampant among Americans. President Obama must regain the trust of the American people and stop his trick plays.