June 1, 2010

By Dave Andrusko

Good evening. Part Two catches you up on all things pro-life in Oklahoma. Part Three, by contrast, tells you about a disturbing decision in Great Britain. Part Four Alerts you to the last few discounted hotel rooms at NRLC 2010. And be sure also to read "National Right to Life News Today" (www.nationalrighttolifenews.org) and send all and all of your comments to daveandrusko@gmail.com. If you like join all those who are now following me on Twitter at http://twitter.com/daveha.

Over the years I have come to appreciate the sage wisdom and insight captured by the phrase, "You can't make this stuff up." What's meant is that what somebody is saying is so outlandish--and/or is so at odds from what they pretend they are saying--that a neutral party can only shake their head in total disbelief.

Dr. Donald Berwick

I give you Donald Berwick, MD, a pediatrician and a professor at Harvard Medical School, who is President Obama's choice to run HHS's Centers for Medicare & Medicaid Services, a colossal bureaucracy with 43,500 employees and an annual budget of $780 billion (billion with a "b"). His nomination is running into opposition in the Senate--and for good reason.

"You can't make this stuff up" applies in several senses.

Many, many accounts dismiss Republican opposition as mere election year "politics." Obama Administration officials, such as spokesman Reid Cherlin, tell publications, such as Politico, that "Republicans are using the nomination as an 'excuse to re-fight health care.'"

But if Berwick's nomination confirms the worst fears of opponents of ObamaCare (fears adamantly denied at the time), how in the world is this "refighting" the battle to point this out? It is merely offering evidence that what they warned about is coming to pass.

And the ever-quotable Berwick has offered lots of evidence that Team Obama really does look to the British nationalized health care system as a model for guiding its conversion of the American medical care system. (Bear in mind that unlike many who wish to drastically overhaul the American health care system, Berwick does not shy away from the word "rationing.")

So what has Berwick said about Britain's National Health Service (NHS)? Well, one piece of evidence that it must be pretty flattering is that "his decade long efforts to improve the NHS were so well-regarded that Queen Elizabeth granted him an honorary knighthood in 2005," according to Politico. That, by the way, is the highest honor available to someone who is not a British citizen.

The backbone (or the muscle, depending on how you look at it) behind the NHS is its rationing board--the National Institute for Clinical Health Excellence (NICE). And no, I am not making this up.

In an essay ("Personal Paper") that he wrote for the British Medical Journal in July 2008, Berwick confessed, "I am romantic about the NHS. I love it. All I need to do to rediscover the romance is to look at healthcare in my own country."

Market forces--competition--"is a major reason for duplicate, supply-driven, fragmented care system," he charged. In case anyone misses the point, Berwick says the American health care system runs in "the darkness of private enterprise."

Berwick is very, very protective of NICE. NICE uses something called "quality adjusted life years," the result of which is you darn well better not be old and diagnosed to be in seriously poor health. (For a thoughtful explanation and critique, see http://powellcenterformedicalethics.blogspot.com/search?q=quality+adjusted+life+years)

Last year he was interviewed by Biotechnology HealthCare, and was tossed this softball:

(Interviewer)" NICE is a bogeyman here in the United States."

(Berwick) "I know that, and it's a misunderstanding of the deepest sort. NICE is extremely effective and a conscientious, valuable, and--importantly--knowledge-building system. The fact that it's a bogeyman in this country is a political fact, not a technical one."

We've run stories in TN&V and, of course, in National Right to Life News, about the abysmal care in the NHS. Bioethicist Wesley Smith wrote about the all too frequent "horror stories" last week on his blog:

"Behind [Berwick's] platitudes, those stated goals and love for the NHS are mutually inconsistent. In NHS health care, there are long waits, women giving birth in elevators, injured people have been kept in ambulances for hours rather than brought into the ER to skew care statistics, cancer patients refused life-extending chemotherapy imposed by rationing boards, and skyrocketing hospital acquired infection, with ants and other vermin in some ORs. You have computer meltdowns resulting in 6 month waits for care, doubled spending for bureaucracy, a paucity of pain control specialists, too few emergency doctors. His idealistic vision of the NHS is way off the reality. And by the way, in the UK, elites like Berwick can opt out of the NHS via private insurance and health care–because it is better."

While a lot of attention was paid last year to abortion and ObamaCare, precious little was given to the rationing components, except by NRLC. The Berwick nomination could provide a platform for a further discussion.

Berwick's own views, especially about what is the best way to wring out cost savings, are pretty much impossible to miss. "The chronically ill and those toward the end of their lives are accounting for potentially 80% of the total health care bill out there," he has said. "There is going to have to be a very difficult democratic conversation that takes place. The decision is not whether or not we will ration care. The decision is whether we will ration with our eyes open.""

Dr. Hal Scherz had this to say in response, writing at realclearpolitics.com:

"This sort of 'eyes-open' endorsement of rationing by government panels, especially for the chronically ill and those (Sarah Palin call your office) who are 'towards the end of their lives,' has about it chilling echoes of an earlier controversy over similar views held by Dr. Ezekiel Emanuel, the brother of White House chief of Staff."

As noted above, some Senate Republicans are beginning to gear up, among them Senate Minority Leader Mitch McConnell (Ky.), Pat Roberts (Ks.), and John Barrasso (Wyoming), a physician.

"Dr. Berwick is the perfect nominee for a president whose aim has always been to save money by rationing health care," Roberts said last week, adding Berwick "was the wrong man, at the wrong time, for the wrong job."

Please send your thoughts to daveandrusko@gmail.com.

Part Two
Part Three
Part Four