Regional news: 
Obama pulls another fast one on health reform with CMS appointment
Tony Ondrusek is founder and publisher of Insurance & Financial Advisor and IFAwebnews.com.
In the same manner that he encouraged Congressional Democrats to pass health care reform legislation, President Obama is using a loophole to make a recess appointment to head up CMS, bypassing a fight in the Senate and the likelihood that a majority of Americans would again voice their disapproval of his brazen attempt to move the U.S. toward socialized medicine.
Donald Berwick, a controversial health care expert who along with colleagues wrote in 2008 that “the simplest way to establish many of these environmental conditions is a single-payer system,” using “budgets to take care of the health needs of a defined population,” will be the next head of the Center for Medicare and Medicaid Services (CMS). Berwick has said that he is against using medical technology to keep elderly and terminally ill citizens alive, even if they or their families wish to use extra means, in favor of shifting those resources to other, more-healthy individuals.
In other words, health care rationing.
But don’t take my word for it. Last year, for a newspaper article, he said: “The decision is not whether or not we will ration care,” adding, “The decision is whether we will ration with our eyes open.”
And what kind of model would he use for America’s single-payer, rationed health care system?
None other than the United Kingdom’s National Health Service (NHS), for which he served as a paid consultant.
Two years ago, Berwick sang the praises of Britain’s government-run health system, telling a gathering celebrating the anniversary of the program, ““I am romantic about the NHS; I love it. All I need to do to rediscover the romance is to look at health care in my own country.”
His romanticism with Britain’s socialized medicine displays his affection for a more socialized society in general. He said during his remarks that health care funding “must redistribute wealth.” He further explained that, “Excellent health care is by definition redistributional.”
Nice.
Recess appointments are not rare, and they have been used by nearly every president in recent history. But this case itself is a bit rare.
President Obama had already submitted Berwick’s nomination for the post, but when he discovered that Senate Republicans would fight the nomination he took the opportunity of using the very short Fourth of July recess to make the appointment. That, in spite of the fact that the Senate would take up the issue in a matter of days.
But his forceful use of the presidential appointment powers means that Obama can begin implementing his health care reform law more quickly, and, more importantly, the move will keep confirmation hidden from public scrutiny and will avoid publicity of the health care debate. Polls have shown consistently that Americans do not approve of the law passed by the Democrat-controlled Congress.
Some Republicans have voiced something more than displeasure of the move.
“This recess appointment is an insult to the American people,” Sen. John Barrasso, a Wyoming Republican, was quoted saying in the Boston Globe. “Dr. Berwick is a self-professed supporter of rationing health care, and he won’t even have to explain his views to the American people in a hearing.”
Senate Minority Leader Mitch McConnell (R-Ky.) wasn’t so genteel in his remarks. He accused the Obama administration of sneaking Berwick through, issuing a statement in which he called the president’s actions “truly outrageous.”
“As if shoving a trillion-dollar government takeover of healthcare down the throat of a disapproving American public wasn’t enough, apparently the Obama administration intends to arrogantly circumvent the American people yet again by recess-appointing one of the most prominent advocates of rationed health care to implement their national plan,” McConnell said in the statement.
Some would say the president is being disingenuous with his power, that he is trying to implement a form of socialism that Americans don’t want. But truth be told, he said over and over during his presidential campaign that he was in favor of dismantling our current system of health care — which is second to none in the world — and replacing it with a single-payer system where the government makes the decisions for individuals regarding their health care.
Americans voted him in. Americans are getting exactly what they bargained for.
19 Responses
- Marie Says:
July 7th, 2010 at 12:50 pmI didn’t vote for this marxist, but I’m being forced into it nonetheless. I think it’s a little rude & misleading to say “…truth be told, he said over and over during his presidential campaign that he was in favor of dismantling our current system of health care…” The majority of those who voted for him didn’t exactly really know what they were in for, not that this is an excuse for poor judgment.
- jeff Says:
July 7th, 2010 at 1:16 pmexcept wasn’t US health care just ranked about 14th or so in the world? not “second to none”. i assume you take this negative position cuz real change would eat into your profiting off health care…
- Laurent Colvin Says:
July 7th, 2010 at 1:23 pmThe author seems to think that we don’t have healthcare rationing now. He also seems to miss the fact that those who pay premiums ARE PAYING EXTRA to cover the poor who go to the hospital. He also misses the point that individuals will pay less in healthcare tax than they currently pay in premiums, and get better care.
He also entirely missed the point that insurance compnies compete to provide LESS service. Under a Single Payer System (where insurance companies would be relegated to high end plans that can’t duplicate services in the national plan) doctors would once again be competing to provide better service. The way things are now doctors don’t compete, there is no incentive for inovation. They are signed into a plan as slave labor. Is there any wonder why we have a shortage of doctors?
- John Says:
July 7th, 2010 at 5:30 pm“Polls have shown consistently that Americans do not approve of the law passed by the Democratic controlled Congress. ” hahaha. Notice how it fails to mention the PERCENTAGE. Of course some will disapprove. My neighbors disapprove of my Harley. BUT I SURE LOVE RIDING IT…… :)
- neopatetic Says:
July 8th, 2010 at 11:39 am@ jeff:
The healthcare systems of different countries can be ranked in various ways. If one were to speak of the number of people who come here from other countries for operations, treatments, medicines, equipment, therapies and so forth that they simply cannot find elsewhere, one would find we are far and away the world leader. One, even such a one as jeff, might ask how we became the leader.
The answer is that from its birth, this country has been all about freedom. At first, it was about escape from oppression, then it was about throwing off the yoke of colonialism, and ever since, it has been about expanding upon the concept: ending slavery, extending the franchise, and in general expanding, enforcing and making more widespread and inclusive our understanding and application of our freedom. Remember the words? “We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain inalienable rights, that among these are life, liberty and the pursuit of happiness.” If the government is making your healthcare decisions for you, how do you call that “liberty”? If the government is making your healthcare decisions for you, what power do you have to keep them from just letting you die, or even selecting you for euthanasia (i.e., taking your “life”)? If the government is taking what you have earned by the sweat of your brow, what “happiness” can you pursue?
The genius of freedom is that a free market, in which a free people freely participate by right, allows people to choose for themselves. It allows people to choose to invent. It allows people to freely decide what is best for themselves and their families. It allows each one of us to decide what we want to do with our lives, and lets brains and talent find their worth. It allows ideas to compete. It allows each of us to try and fail again and again, until we succeed. Have you any idea how rare that is in the world? Freedom allows true creativity to flourish. Extremely importantly, freedom also allows for creative destruction: the process by which the inefficient and unproductive yields to better, superior, less wasteful ways of accomplishing objectives.
The ideology of the Left, by contrast, does not have freedom at its heart. Read for yourself the very words of Karl Marx, himself, as they appeared in his work, Critique of the Gotha Program: “From each according to his ability, to each according to his needs!” — a slogan commonly appearing on the red banners of revolution that communists of that time bore aloft as they incited riot and mayhem. That particular phrasing captures the essence of redistributive socialism. It embodies the notion that the State should use its power to take (if it does not actually obliterate the very notion of private property) what is yours from you and give it to me, or vice versa. It does not do well, unfortunately, at taking into account differences in our level of effort, our relative thriftiness, or our level of contribution to the society, let alone the world. Because of that very salient failure to take simple human nature adequately into account, such societies sooner or later rob people of virtually every incentive to work hard and live on less than they make. Sooner or later, such societies also rob people of virtually every incentive to to create better computers, light bulbs, mousetraps, oil skimmers, electrical grids, air bags, artificial hearts, AIDS vaccines, and an endless list of other wonders, great and small, that large numbers of people want, need, or wish existed.
Dr. Donald Berwick has quite clearly spoken of his unstinting, enthusiastic support for the Leftist / Socialist / Marxist path. He is on videotape expressing his desire for taking us all hell-for-leather in that exact direction. That is his right. At least, and ironically, while we’re still a free country, that is his right. In marked contrast, however, the American people are continuing to tell pollsters something very different: over 50% still oppose Obamacare, months and months after it was passed. That is precisely why Mr. Barack “Transparency & Openness” Obama used the recess appointment power to install Dr. Berwick without an open hearing: he knows full well that transparency and openness do not now serve his or his party’s own, narrow political interests.
See:
http://www.realclearpolitics.com/epolls/other/obama_and_democrats_health_care_plan-1130.html
Dr. Donald Berwick, whether or not he is willing to admit it, is anti-freedom and in favor of the government expanding its control over your life, my life, everyone’s lives. He sees that as a good thing. It isn’t. Remember: any government powerful enough to give you everything you want is powerful enough to take everything from you.
Stalin, an infamous redistributionist, killed millions. He took the land and deported or killed the farmer-owners (known as kulaks, they and their families, numbering an estimated five million people, were simply “never heard from again”). Stalin then turned the land over to peasants who had no idea as to how to do all of the things that the former farm owners knew how to do and had done for generations. In short, he put into practice that very redistributionism of which Dr. Berwick is so enamored. When the peasants were unable to meet their grain production quotas, they were allowed to keep little or nothing of what they produced. The result, predictably, was severe, widespread famine: “The death toll from the 1932-33 famine in Ukraine has been estimated between six million and seven million.” Like President Obama, Dr. Berwick and perhaps even jeff, Old Joe was thin-skinned, a tad paranoid, thirsted for power and acted with revolutionary zeal to bring about disastrous, wrenching social and economic change, grounded in nothing more than ideology.
See:
http://history.hanover.edu/courses/excerpts/111famine.html
http://www.historyplace.com/worldhistory/genocide/stalin.htm
- Chris Says:
July 8th, 2010 at 12:58 pmNeo,
Nice response but you’re wasting your breath on these MENSA members. History began on the day they were born, just like all lib/socialists. - Laurent Colvin Says:
July 11th, 2010 at 1:37 pmAmericans make up the vast majority of people in Medical Tourism. Far more Americans leave the US for medical treatment elsewhere, more than other people from other countries coming here for treatment. http://www.discovermedicaltourism.com/statistics/ , http://www.medretreat.com/. With the cost being lower IN EVERY OTHER COUNTRY the assertion that more people come to the US for medical tourism compared to other countries just doesn’t stand up to scrutiny.
FREEDOM is NOT available in the for-profit-health-insurance system. The doctors do not have freedom, because they are mandated by contract to do unnecessary reports to validate continuing care for a patient, they are expected to see a certain number of patients per hour, and while they might prescribe a drug or treatment the insurance company can choose not to cover it.
The patients do not have FREEDOM in a for-profit-healthscare system, because; plans limit access, number of visits, level of care, type of prescriptions/treatment/length of hospital stay/in home care/ or skilled nursing facilities.
Under a Single Payer healthcare system, everyone who works pays a modest 3% increase in taxes, which (for the VAST MAJORITY) would be LESS than half of the average health insurance premium. You can see any doctor you want, (because there are no designated plans) the bill is paid for by the government according to set rates according to region. Since the insurance companies are no longer competing to provide LESS service, the doctors and hospitals must now compete to provide BETTER service. While their rates are set, the number of patients they see will be a reflection of how well they help their patients, not what plan they’re in.
FREEDOM, under a Single Payer system is measured in; unrestrained access to healthcare professionals for EVERY American (not just those with money)/ healthcare dollars being used for healthcare (not-shareholder profits)/ and doctor’s freedoms.
The respondent who thinks that Single Payer represents Socialism is uninformed. In England, where they have socialized medicine, the government both pays the bills & owns the hospitals and clinics. Under Single Payer the goverment pays the bills (via a 3% tax) but all the hospitals and clinics are privately owned and operated.
What do you want? To pay a HIGH premium that covers you and the poor that go to the hospitals and pay nothing, just so shareholders can get a cut, or pay a lesser amount that everyone pays, so everyone can be covered?
If you answered, “Iwant to pay more to a private insurer,” then you accept that they can change your plan at anytime for any reason, just to squeeze you for even more money for ever less service.
If you answer, “Pay no expensive premium, but pay a smaller amount as an increase in taxes, so that everyone can be seen at a reasonable rate,” then you recognize fraternal responsability that you have with the larger community, you are a fiscal conservative with liberal agenda, and you recognize the value in competition between the healthcare service providers, not the insurance middle-men.
- Chris Says:
July 12th, 2010 at 2:07 pm“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 healthcare is by definition re-distributional.”
Donald Berwick
But don’t dare call it socialist. Come on LC.
As to the medical tourism, who cares? That is freedom. If you want to go to Costa Rica for a cheap rhinoplasty or Ottawa for lasik, that’s your decision. Where do people go for the serious, life-threatening stuff? You know the answer.
Freedom is not being compelled to purchase a product, any product, under threat of imprisonment or fine. And if the new plan is so terrific, why are doc’s dropping/refusing to take new medicare patients all over the country?
Had a look at the Massachusetts fiasco lately? Price controls and soon-to-be-bankrupt insurers. Sounds fantastic!
- Laurent Colvin Says:
July 13th, 2010 at 12:22 amHi Chris,
Actually, I agree with you about being forced to buy insurance from a For-Profit-Health-Insurance company. If they can force you to buy one product they can force you to buy any product.
The government services should be paid for through taxes, with no profit involved. Hence why I support HR 676 or Californias SB 810.
As for whether YOU want to call Single Payer socialist or not, well, it has to do with the definition. Since a Single Payer System preserves competition between doctors and hospitals I say it is still Capitalism. You may see it another way, but I still prefer Single Payer.
- Laurent Colvin Says:
July 13th, 2010 at 12:11 pmBankrupt insurers sounds like a good idea! Perhaps if they go out of business it will be because; they don’t deliver on their promise, they change the contract on you after they’ve sold you a bill of goods, they’ve harmed people, they’ve stolen from people…
I don’t see the down side.
But as to another matter, this assertion that the Federal government can’t do anything right (touted mostly by those who call themselves Republican) they back op their claim with odd examples. For instance, the length of the line at the DMV. Might I point out that every driver, in every state has a drivers license, with a picture, that can be used to identify said driver quite well. You only have to renew that license once every 6 years in California and they besides taking pictures they also administer practical and written tests in a multitude of languages. But you receive a first come-first serve number and you can watch the numbers progress on a large screen.
Let’s look at another business for a comparison, the average HMO emergence room. Long lines, and you’re not even given a number! You wait a very long time in some cases only to be told, “You don’t have an emergency, so we can’t see you now. Come back when you are worse.”. The doctors are often stressed due to workload, large numbers of mistakes are made, proceedures are done wrong, wrong medications are given, wrong limb is removed, but they have to take off the otherone anyway, so both are lost, infection rates in hospitals are high AND your insurance carrier will fight you on paying for this crappy service.
The DMV looks good by comparison.
the
- Tony Ondrusek Says:
July 13th, 2010 at 12:37 pmLaurent:
Having an industry go bankrupt is not the thing to do if you feel that some parties might not be behaving properly. The entire mortgage industry collapsed two years ago, home sales tanked, and we are in the worst recession in history. Is that really what you want to happen?
Or would you prefer reform to keep the insurers in line and solvent?
Comparing the DMV to the emergency room is disingenuous.
People who go to the DMV go their for a legitimate purpose; to get a license, title, etc.
But many people go to the emergency room when instead — as you correctly stated — they should be visiting their family doctor instead. The emergency room is for what it is called: EMERGENCIES.
Another comparison would be to note that when you go to the DMV, you have to PAY for their services.
Instead, at the emergency room, everyone else has to pay when someone abuses the system instead of taking care of their problem with their family doctor.
Keep your hopes high, though. With Obamacare, hospitals and emergency rooms will operate much like the DMV, and if you want better quality care than what the government provides…well, you will be SOL. - Chris Says:
July 13th, 2010 at 1:49 pm“Hence why I support HR 676 or Californias SB 810.”
I assume you are talking about the universal health care passed by the loons in Sacramento. It will only cost $200 billion/yr to implement. Of course CA is in a deep hole now, and Sacramento takes in a little less than $100 billion annually. So why not spend $200 billion /year on utopia? Can I get a pony thrown in?
“…wrong limb is removed, but they have to take off the otherone anyway, so both are lost…”
The president told me the unscrupulous medical profession was removing feet and tonsils for profit. Now you are telling me that they’re doing it by accident, in emergency rooms. This really is a rotten country. Fortunately the feds don’t make mistakes or waste $$. Can you say VA?
[] More than a year after the Veterans Administration (VA) announced that more than 10,000 patients were accidently exposed to HIV and other conditions resulting from failure to maintain operational standards: not much has changed. New reports say that inadequate sanitary practices at a Missouri VA hospital are to blame for exposing about 1,800 patients to HIV as well as 3,400 patients at a VA facility in San Diego.[]
http://www.helium.com/items/1879185-a-look-at-whats-behind-the-va-hiv-infection-scare
And guess what, no recourse for anyone affected.
Tony,
Good column and good arguments against the “progressive” mindset. You ask a great question, “Is this really what you want to happen?”. Unfortunately, I believe the answer is yes, they do want to see the system collapse on itself. The goal is not to make the system function and respond better. It is to destroy the system and punish capitalism. But I think you probably already suspected as much. - Laurent Colvin Says:
July 13th, 2010 at 2:54 pmDear Tony,
Thank you for your wonderful question. Do I want the destruction of the Health Insurance Industry to damage our fragile economy even further? No, I don’t, and the destruction of the For-Profit-Health-Insurance-Industry doesn’t have to. If you read HR 676 (and I have read every page) you find that John Conyers and Dennis Kucinich have spelled out how, over about a ten year period; insurers can convert to non-profits, people who have invested in insurance companies can divest that portfolio to reinvest in something less horrific (let’s say, landmines) as the Single Payer System is instituted.
As for people going to emergency rooms instead of going to their family doctor – what if they can’t afford one, and their only resource IS the emergency room? Or, more likely, they just don’t know what resouces are available to them, so they go to the emergency room out of ignorance.
Because there will always be people who do not have the where with all that other do they will always cost those with money more as their premiums go up. So again I ask, do you want to pay a HIGH premium to an insurer who passes that cost onto a few AND reaps a profit, or would you rather have everyone who works for a living pay a fair share (3% to 4%) so that everyone can be seen, keep costs down, and no one profits from other peoples illness?
- Laurent Colvin Says:
July 13th, 2010 at 3:06 pmCorrection, my previous post should have been directed to Chris.
As for the VA troubles, yeah we all read that. Infection rates are running rampent in all hospitals, as are iatrogenic injuries. But insurers aren’t helping the issue when they take money away from the healthcare system to invest in ciggarettes, http://boingboing.net/2009/06/06/health-insurers-inve.html. If there was ever a conflict of interest this is it!
- John Darlington Says:
July 13th, 2010 at 3:50 pmA message for “Jeff”!
Hey Jeff. Maybe if you stopped reading the biased report from the WHO/UN and read a little more you would discover that the ranking were based on an equality not quality standard. That is why countries with national health services like the UK were ranked high.
Wake up and smell the roses, Jeff. Socialized medicine is coming your way and you are going to pay a good part of the cost.
John
- Chris Says:
July 13th, 2010 at 9:11 pmLC,
Give us a rest. You will not convert anybody on these pages. I’m not crazy enough to attempt to get you to see things my way but obtuse and knuckleheaded thinking deserves refutation? Seriously, you’re speaking to people who derive their incomes from helping fellow citizens obtain insurance coverage of one form or another.You say yourself that the bill is designed to destroy the for-profit-health-insurance-industry. I’ll give you bonus points for honesty. You know as well as we do that this scam was not marketed that way but the end result will certainly be the destruction of not only the insurance system but also of our medical system.
You may consider that a feature and not a bug but people with vision and some real-world experience beg to differ. And we want an honest debate, something that did not occur and is continuing with this bogus recess appointment that Tony wrote about. The admin. can’t have an honest debate because the bill is hated and is growing more and more unpopular as people discover what’s in it.
You’re link to insurers around the world owning 4.5 billion of tobacco stocks is a complete non-sequitur. do you know how many hundreds of billions, if not trillions, insurers are required to keep in reserves? Where do you think that money sits?
Don’t like tobacco? Fine but last I checked it’s not illegal. I’ll bet if you turn over a few more rocks, you might find insurers that invest in, wait for it, for-profit medical ventures. Oh, the humanity! And I’m gonna let you in on a secret. If you have a 401-K, you own some tobacco, along with big, evil oil and weapons manufacturers and who knows what else.
You should troll for converts in an area where the iq’s aren’t above room temp because people who think, even a little bit, for themselves and don’t believe hype and propaganda see through the bs. This is a huge loser for the left and it will probably be repealed or de-funded. Unfortunately there’ll be a lot of damage done in the process.
- Laurent Colvin Says:
July 14th, 2010 at 12:38 amDear Chris,
And I must say that when I say dear I am again being honest. You see we actually agree on a lot. The plan that Obama has put forward is a sure fire way of doing real harm to our economy. I believe that wholeheartedly. Furthermore, I think that we agree that the government should not be in the business of forcing people to buy a product from any private business concern, be it insurance or any other product.
Where we differ is that I believe that healthcare should be provided via taxes to everyone with no for-profit-health-insurers involved.
You think that free market forces will do all the regulating necessary to ensure the quality and provide all the social protection that the American people need in a health insurance corporation. Of course those free market forces didn’t actually work for either the insurance industry or the housing industry, as you pointed out, but you’re willing to let them at it again. You also seem to think that there is no conflict of interest for a health insurance company owning stock in cigarette manufacturers.
But I do disagree with that. I think that if you are going to be in the business of promoting health you should be opposed to those things that cause ill-health or disease. I guess I am funny that way, an idealist perhaps, but it is a more tenable position than yours.
As for turning over rocks… isn’t that what we’re starting to do right now?
I may not be changing the minds of anyone who would willfully be involved with selling insurance, but I know that my opinion is shared by a lot of other doctors, nurses, and lay people. I never did support Obama’s plan, and I don’t support it now. I am still pushing for the passage of HR 676 and or California’s SB 810, and I will so long as my car has better health insurance than I do.
- Chris Says:
July 14th, 2010 at 4:44 pmAgreed to disagree then. No problem.
- Medical Tourism Says:
November 25th, 2010 at 4:51 amI think it is clear that Obama’s plan will benefit the majority of Americans but hurt mainly the health care industry. Calling the american health care system “second to none” is a joke. If it would really be “second to none” you wouldn’t have millions of Americans traveling for medical care to other countries.
I believe any change from the situation we have right now is for the better.
