Medicare Chief Berwick Dodges Whether Obamcare Redistributes Wealth, Which He Had Praised in Britain's Health System

By Fred Lucas | January 27, 2011 | 6:26 PM EST

Washington ( – Donald Berwick, recently re-nominated as Medicare chief, praised the new health care law in a speech on Thursday.  But he declined to say if it redistributed wealth from the rich to the poor, as he has previously said a "just" and "equitable" health care funding plan must do.

President Barack Obama, who appointed Berwick in July 2010 during the congressional recess, allowing him to forego Senate confirmation, sent his name back to the Senate on Wednesday for consideration. Without confirmation by the Senate, Berwick’s job as administrator for the Centers for Medicare and Medicaid Services would expire at the end of 2011.

Berwick spoke Thursday at the Health Action 2011 Conference, sponsored by the liberal group Families USA, where he praised the Patient Protection and Affordable Care Act, which was signed into law by Obama last year.

In 2008, in a speech in England celebrating its government-run National Health Service, Berwick had 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.”

After his Thursday speech, asked Berwick if he believes the new health care law in America redistributes wealth in the way he prefers. asked Berwick, “You said that a just and equitable system requires redistribution from the richer to the poorer among us, do you believe that this system does that?”

Berwick said, “It is a fact that people who are sick tend to have lower incomes and people with lower incomes tend to be sicker. That’s something we have to face as a society and deal with it.” followed up, “Do you believe the current health care reform does that, redistributes?”

Berwick said, “I think we are providing through health-care reform security for all Americans, which all Americans really want.”

Dr. Donald Berwick, nominated by President Obama to head the Centers for Medicare and Medicaid Service. (AP Photo/Goodman Media International, Inc.)

Berwick has made a number of other controversial statements concerning health care policy. In a June 2009 interview published in Biotechnology Healthcare, Berwick was asked about rationing of health care and 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.”

Sen. Rand Paul (R-Ky.) said he is glad Berwick will have to face Senate confirmation.

“I think Don Berwick would be a great head of health care in maybe England or Sweden or something,” Paul told “He said he admires the British system, so I think maybe we should nominate him to be head of the British system. In America, we have always thought a little bit differently."

"We’ve not really liked the concept of rationing," said Sen. Paul. "We’ve really not liked that health insurance should redistribute wealth. He said explicitly that it’s not about whether we will ration care but when and how we ration care. I’m very disturbed by his appointment. It was a recess appointment.”

These comments prompted controversy around his nomination by President Obama to run Medicare last April. So, during the July 4 recess, Obama gave a recess appointment to Berwick, allowing him to ascend to the job without vetting through the Senate confirmation process.

Under Article 2, Section 2, Clause 3 of the Constitution, Berwick’s recess appointment must “expire by the end of the next session” -- meaning Berwick must leave office by the end of 2011 unless the Senate puts him through the constitutionally required confirmation process in the intervening time.

In the position of running the Center for Medicare and Medicaid Services (CMS), he will play a major role in the implementation of the new health-care law, commonly called Obamacare, which mandates that individuals carry health insurance or pay a penalty, requires employers to provide health insurance or pay a penalty, and establishes health care exchanges.

“What’s incredible about the times we face in health care is how much good we can do,” Berwick told the gathering at the Families USA conference. “The Affordable Care Act is a major step for this nation. It’s great step for this nation.”