Former Medicare Chief: Wealth Redistribution a ‘Fact About Proper Health Care’

By Elizabeth Harrington | October 4, 2012 | 7:43 PM EDT

Dr. Donald Berwick. (AP Photo/Goodman Media International, Inc.)

( – Former Medicare Chief Don Berwick defended his past statements that government run health care must redistribute wealth, calling redistribution a “fact about proper health care.”

Berwick, who appeared at a Politico “Pro Health Care” luncheon at the Newseum in Washington, D.C., on Thursday, told that the Affordable Care Act, a.k.a. Obamacare, is an “amazing and important step” for the country. asked Berwick, a proponent of the government-run National Health Service in England, if the health reform passed in this country aligns with his views.

“You have said that any health care system that is civilized and humane must redistribute wealth and also that rationing would have to be involved,” asked.  “Do you believe that the Affordable Care Act does those two things?”

“Well, I never said rationing should be involved, and it shouldn’t be,” the former administrator of the Centers for Medicare and Medicaid Services said.  “I’m against rationing.  I abhor it.  I think we have plenty of resources in American health care to give all the care that people want and need. We just have to configure that care properly.”

“So, we don’t have to deny people any care at all,” he said.  “And the people that say that about my position haven’t asked me that, it’s not true.”

“With respect to … redistribution, yeah, this is a fact and there’s a relationship between poverty or income and health,” Berwick said.

“So, if you’re going to have a health care system that actually makes sure that everybody can get health care, there’ll naturally be support to people of low-income because they’re the people with more illness,” he said.   “That’s the redistributional quality of it.”

“It just, it’s not a political position,” he added.  “It’s a fact about proper health care.” then asked, “And that’s what the Affordable Care Act, does it do an adequate job of that?”

Berwick said, “The Affordable Care Act is a great step in America towards making health care a human right in our country where if you’re an American you can get health care, which isn’t true now, lots of people are left out of the system, people have to worry they’re going to lose their insurance if they get sick, or if they have a preexisting condition, they can’t find insurance.”

President Barack Obama and Vice President Joe Biden react to cheers as they arrive in the East Room of the White House in Washington, Tuesday, March 23, 2010, for the signing ceremony for the health care bill. (AP Photo/J. Scott Applewhite)

“The Affordable Care Act overcomes that -- it says, ‘No, if you’re an American you can have health care.  We’ll find one way or another,’ in partnership with the private sector to make sure that you get the health care that you need,” he said.

“That’s a very important step,” said Berwick. then asked Berwick to clarify his past statement that, “The decision is not whether or not we will ration care — the decision is whether we will ration with our eyes open.”

“That’s a mis -- that’s extracted from a longer statement,” he said.  “What I was talking about was insurance companies right now decide what benefits you get or not.  They say, ‘Well that’s covered, that’s not covered.’  And then they do it in secret.”

“Nobody’s accountable,” Berwick said.  “Nobody says, ‘Well, how did you decide that?  How did you decide I can’t have that test?’  That’s rationing.”

“And I said, look, we have a choice America,” he said.  “We can let them do that in secret or we can require them with transparency to tell us what they’re doing.  That’s a comment about accountability with these back rooms where decisions are being made about what people will and will not get.”

Berwick continued: “My own daughter needed a test a number of years ago -- I’m a doctor, a pediatrician -- and the insurance company said, ‘Oh no, we don’t cover that test.’  And I said, ‘You don’t cover that test?  She needs it, what are you talking about?  Who made that decision?’  And that’s what I was talking about there.”

“We’re either going to turn the lights on on that or not,” he said.  “I think that decision should be accountable and I think that people should get the health care that they want.”

In an interview with Biotechnology Healthcare in 2009, Berwick was asked about critics of the Department of Health and Human Services’s Comparative Effectiveness Research (CER) program, which makes recommendations for treatments, who say it will lead to healthcare rationing.

“We can make a sensible social decision and say, ‘Well, at this point, to have access to a particular additional benefit [new drug or medical intervention] is so expensive that our taxpayers have better use for those funds,’” Berwick said.  “We make those decisions all the time. The decision is not whether or not we will ration care — the decision is whether we will ration with our eyes open. And right now, we are doing it blindly.”

In a speech in England celebrating its government-run National Health Service in 2008, Berwick said:  “Any health care funding plan that is just, equitable, civilized and humane must – must -- redistribute wealth from the richer among us to the poorer and the less fortunate. Excellent health care is by definition redistributional. Britain, you chose well.”

Thursday’s event in Washington, D.C. took place one day after the first presidential debate between President Obama and his challenger Mitt Romney, of which Berwick said the president “did a great job” defending his health care law.

“I think he did a great job,” said Berwick.  “And I think that the good thing is Obamacare is, it’s an amazing and important new step for America. So, he’s got a lot of opportunity here to explain to Americans why this law is so good for them.  It makes care more available to all of us who really need it, and it makes care better.”

“There’s tremendous amount of Obamacare that’s an investment in making the quality of health care better,” Berwick added.  “So, I think he did a fine job.”