President Obama has selected Dr. Donald Berwick to head the Centers for Medicare and Medicaid Services. Berwick is a Harvard professor, a pediatrician, and the CEO of a nonprofit that, according to its website, has a staff of over 100 people. These seem like dubious qualifications to head a massive organization with a budget greater than that of the Department of Defense.
As Jeffrey Anderson explains, however, Dr. Berwick is a perfect pick for Obama. For like Obama, Berwick believes that our health-care system should be run through Washington, and that the bureaucracy should exercise a strong degree of control over questions of life and death.
Unlike Obama, Berwick is completely up-front about this. His view of the rationing of health care is that “the decision is not whether or not we will ration care — the decision is whether we will ration with our eyes open.”
Berwick has his eyes on the British method of rationing, as implemented through Great Britain’s National Health Services (NHS) and its National Institute for Clinical Health and Excellence (NICE). This is the horrendous bureaucracy whose exploits John Hinderaker chronicles from time to time in his “Annals of Government Medicine” series.
According to the Wall Street Journal, NICE currently holds that, except in unusual cases, Britain cannot afford to spend more than about $22,000 to extend a life by six months.” The question, as the Journal puts it is: “Who would you rather have making decisions about whether a treatment is worth the price — the combination of you, your doctor and a private insurer, or a government board that cuts everyone off at $22,000?” I vote for the first option.
NICE also considers the quality of the lives it is deciding whether to save. Here, it employs the “quality-adjusted life years measurement,” considering such factors as “the level of pain the person is in, their mobility and their general mood.” Old folks should remember to whistle “Always Look on the Bright Side of Life” when presenting themselves to the death panel.
Berwick believes that the British system is “not just a national treasure; it is a global treasure.” By selecting Berwick, Obama has confirmed that he basically agrees. Those of us who, by contrast, think the British system represents a future that does not work should do everything within our power keep America free from what Anderson aptly calls “Obama’s and Berwick’s disruptive (and, one might even say, deadly) designs.”
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