Sebelius: Rationing Advocate is ‘Absolutely Right Leader At This Time’ to Run Medicare

By Matt Cover | May 27, 2010 | 5:55 PM EDT

( - Health and Human Services Secretary Kathleen Sebelius said on Wednesday that Dr. Donald Berwick, an advocate of health-care rationing nominated by President Barack Obama to run Medicare and Medicaid, is “absolutely the right leader at this time” to run the government’s largest health-care entitlement programs.
Under the health-care reform law signed by President Obama in March, hundreds of billions of dollars will be cut from the Medicare program over the next decade. Berwick is nominated to run the Centers for Medicare and Medicaid Services (CMS), which oversees Medicare.

Berwick, a professor at Harvard Medical School, has repeatedly indicated his support for rationing and for the single-payer, government-run health care system of Great Britain. After President Obama signed a $787-billion stimulus law that created a Federal Coordinating Council for Comparative Effectiveness Research--perceived by critics to be a first step toward creating a federal rationing system for health care--Berwick defended the program and rationing health care.
“The decision is not whether or not we will ration care--the decision is whether we will ration with our eyes open,” Berwick said in a June 2009 interview with Biotechnology Healthcare
At a Wednesday press conference on Capitol Hill, quoted this statement by Berwick to Sebelius and asked her whether she agreed with it. Sebelius responded by saying she believed Berwick is the right man for the job and is “well-suited to help increase the quality of health care.”
“I’m really pleased that the President nominated Dr. Donald Berwick,” Sebelius said. “He’s known nationally as an enormously competent physician and an enormously passionate health care provider and someone who, I think, is incredibly well suited to help increase the quality of health care delivered to the 40-plus million Americans who rely on Medicare services and also the 30-plus million on Medicaid services.
“He’s written extensively, he’s taught all over the country, and I think he’s absolutely the right leader for this time.”
Sebelius likened an insurance company not paying a benefit it has not contracted for to the government, in a government-run system, rationing care to citizens.
“There’s no question, right now, health care is being decided by insurance companies,” said Sebelius. “Part of the Affordable Care Act is to make sure that the tools are back in the hands of health care providers and patients to make their own decisions and so I think his leadership at this time is going to be critical.”
When pressed to answer the question of whether or not she agreed with Berwick’s statement about health-care rationing, Sebelius indicated she already had.
“I just gave you the answer,” she said.
In a talk he delivered in England in 2008 to mark the 60th birthday of Great Britain’s National Health Service, the bureaucracy that runs that country’s single-payer health care system, Berwick told the British that he loved their system. ““Cynics beware,” he said. “I am romantic about the National Health Service; I love it.”
He particularly drew attention to the British system for rationing health-care by using government planning to deliberately create an insufficient supply of it. “You cap your health care budget, and you make the political and economic choices you need to make to keep affordability within reach,” Berwick said. “You plan the supply; you aim a bit low; you prefer slightly too little of a technology or a service to too much; then you search for care bottlenecks and try to relieve them.”