Obama's Unconfirmed Medicare Director Who Called for Redistributing Wealth Through Health Care Won't Answer Questions From Senate

By Fred Lucas | September 24, 2010 | 4:04 AM EDT

Dr. Donald Berwick, re-nominated by President Obama to head the Centers for Medicare and Medicaid Services after getting the job through a recess appointment on Wednesday, July 7, 2010. (AP Photo/Goodman Media International, Inc.)

(CNSNews.com) – Donald Berwick, an advocate of health care rationing and redistributing wealth through the health-care system, who President Barack Obama appointed administrator of the Centers for Medicare and Medicaid Services (CMS) without a Senate confirmation hearing or vote, will not answer questions from the U.S. Senate, according to members of the committee that has overisght over his nomination.

“We’ve been trying to get him to answer questions in writing. He won’t do that,” Sen. Orrin Hatch (R-Utah), a member of the Senate Finance Commmittee, told CNSNews.com Thursday. “We’ve been trying to get him up for a hearing. He won’t do that. He has indicated he might come to a hearing. So far, it’s been unsuccessful, no matter how important these matters are.”

Bypassing the Senate to appoint Berwick during the July 4 congressional recess, Obama later re-nominated the outspoken physician to the position fifteen days later. That means the Finance Committee could hold a confirmation hearing on Berwick now and send his nomination to the full Senate for a confirmation vote. But Hatch said the Senate Democratic majority has done nothing to advance the nomination, and Berwick has not been forthcoming with answers. Hatch predicted there will not be a confirmation hearing for Berwick before the election.

“Oh no. Not that I could see. If you look at this administration, they’ve got like 500 czars down there, or people you could call ‘czars,’” Hatch said. “It’s one thing to have bright people at the White House that don’t every have to report up here, it’s another thing to have them running the country. That’s why we have Cabinet positions, so that people can be accountable in those positions and what they’re trying to do.”

Sen. Charles Grassley (R-Iowa), the ranking Republican on the Finance Committee, also expressed frustration that Berwick again declined an invitation to answer questions from the Senate.

“We invited Dr. Berwick to appear at today’s forum, but as you can see, he chose not to attend,” Grassley said. “The administration has to go out of its way to have a nominee avoid the regular committee review of their nomination. That begs the question, why did the administration go out of its way for Dr. Berwick? By avoiding the committee’s questions and refusing to share important information, the legitimacy and authority of Dr. Berwick to serve as administrator is called into question.”

The lack of responsiveness, meanwhile, did not stop Senate Republicans from holding their own hearing of sorts looking into Berwick and the entire health-care reform law.

“Dr. Berwick is now in charge of an agency that has a bigger budget than the Pentagon, with spending that amounts to more than 5 percent of our nation’s economy,” said Grassley.

“Additionally, when the new health law was signed in March, the agency that Dr. Berwick now leads become responsible for significant changes to federal health programs, including over half a trillion dollars in Medicare payments’ cuts and the largest Medicaid expansions since the program’s creation,” Grassley continued during a Senate Republican forum on Berwick, which Berwick was invited to attend.

Thanks to his recess appointment to run CMS, Berwick can until the end of 2011, under Article 2, Section 2, Clause 3 of the U.S. Constitution, unless the Senate Finance Committee called him in for a confirmation hearing and the Senate held a confirmation vote that failed.

“This may be the greatest transfer of power to a non-elected official,” said Dr. Michael Smith, with the 60-Plus Association, a senior citizens’ advocacy organization, speaking of Berwick's recess appointment.

“This is a potentially ominous sign for every senior or near senior in America,” Smith said earlier during his testimony. “Berwick’s nomination was so controversial that it was never approved by the Senate. His views were never even subject to a Senate hearing.”

On July 19, after Congress was back in session, Obama re-nominated Berwick to the Senate.

Berwick’s nomination was controversial because of comments he had made in favor of rationing and redistribution of health care.

On July 1, 2008, Berwick delivered a speech at the celebration of the 60th birthday of Great Britain’s National Health Service, the bureaucracy that runs that nation’s socialized health care system. He told his audience, “You could have had a monstrous insurance industry of claims and rules and paper-pushing instead of using your tax base to provide a single route of finance.”

Berwick continued, “You could have protected the wealthy and the well, instead of recognizing that sick people tend to be poorer and that poor people tend to be sicker. And that 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.”

He also said in that speech, “I am romantic about the National Health Service; I love it.”

An adapted version of the speech appeared in the July 26, 2008 issue of the British Medical Journal.

In an interview with Biotechnology Healthcare, Berwick said, “The decision is not whether or not we will ration care, the decision is whether we will ration with our eyes open.”

On July 7, White House Press Secretary Robert Gibbs declined to answer whether Obama agreed with Berwick’s statement that, “excellent health care is by definition redistributional.”

Even Senate Finance Committee Chairman Max Baucus (D-Mont.) was critical of the recess appointment in July.

“Senate confirmation of presidential appointees is an essential process prescribed by the Constitution that serves as a check on executive power and protects Montanans and all Americans by ensuring that crucial questions are asked of the nominee--and answered,” Baucus said. Yet Baucus has failed to convene a confirmation hearing since Berwick's renomination in July.

Robert Moffit, a senior fellow at The Heritage Foundation, found Berwick’s comments disconcerting. But he thought the main focus should be on health law itself.

“In fact, the recent media attention on Dr. Berwick and his views on rationing or the performance of the British National Health Service misses a much larger and far more consequential point. The personality of the CMS administrator or the Secretary of HHS is of secondary importance to the legal framework that Congress itself has erected over the years though thousands of pages of statutory text, which has generated tens of thousands of pages of regulatory interventions into financing and delivery of health care.”

Smith, meanwhile, said there are already signs of rationing.

“For the first time that I can ever recall, an FDA [Food and Drug Administration] advisory board recommended withdrawing government approval of a life-extending cancer drug because of what I believe to be cost concerns,” Smith said.