Appointment Of Dr. Donald Berwick

Floor Speech

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Mr. BARRASSO. Madam President, I rise to discuss a recess appointment made last week when many of us were traveling to visit with constituents to talk about the issues of the day.

During that time, I was in Wyoming, and one of the main issues brought up at senior centers was the appointment by the President of Dr. Donald Berwick to be the head of Medicare and Medicaid. I heard the concerns of these folks because of statements Dr. Berwick had made about the British health care system and his love of the National Health Service in England. They are concerned as to how this gentleman, who has taken positions and made a number of statements, would run Medicare and Medicaid. Specifically, they had concerns because they had heard his statement:

The decision is not whether or not we will ration. The decision is whether we will ration with our eyes open.

Seniors around the State were concerned about what this means. Then to hear that the President made a decision to do a recess appointment of this very individual, without hearings in the Congress, without an opportunity for the American people to hear specifically his response to questions we might have--is this what the American people want? Absolutely not. We have a President who campaigned on a pledge of accountability and transparency. To me, this makes a mockery of that pledge because this nominee will not have to answer questions about statements he has made.

I see my colleague from Arizona, a State where people on Medicare are concerned, where we have many seniors, a State with a Medicaid population that will be impacted. Yet we now have a director of Medicaid and Medicare, finally named by the President after a full year of debate on a health care law that cut $500 billion from seniors on Medicare and crammed 16 million more Americans onto Medicaid, a program that is currently very broken. I say to my colleague from Arizona, my goodness, the impact on the folks in Arizona is astonishing.

There was an article today in one of the papers that talks about a Medicaid stalemate.

They talk about his home State of Arizona. They say Arizona has had to cut about a dozen benefits from its Medicaid Program, including hearing aids, podiatrist services, capped physical therapy visits. Yet there was nobody in charge of Medicaid when the President and the Democrats in this body said: Hey, don't worry. We are going the cram another 16 million more Americans onto Medicaid--a system we know is broken.

So I turn to my colleague from Arizona and ask him his thoughts on this recess appointment at a time when seniors and folks around the country are concerned about the debt, the deficit, the economy, and now we are seeing the President making a mockery of his previous comments about accountability and transparency.

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Mr. BARRASSO. Madam President, I believe the President of the United States, I say to my colleague and friend, now has what he wants: his health care rationing czar--not someone approved by the Senate but someone he has appointed and put into place without an open hearing.

It is so interesting, as my colleagues from Arizona and South Dakota talk about, that the failings of the British health care system--a system that Dr. Berwick says, ``I am romantic about; I love it; it is a national treasure, a global treasure,'' but then the headline today is: ``U.K. Will Revamp Its Health Service.'' It says: Health care experts called the plan one of the biggest shakeups in the national health service's 62-year history. Its new coalition government in Britain, grappling with weak public finances and rising health care costs, announced an overhaul of the state-funded health system that it said would put more power in the hands of the doctors and involves cutting huge swaths of bureaucracy.

This is at a time when we have just in this country passed not what we voted for but what the Democrats and the President voted for: a bill that increases the bureaucracy, including $10 billion for Internal Revenue Service agents and higher and higher numbers of government workers and bureaucrats taking power away from the doctors, away from the patients. Now it is government-centered health care at a time when Britain is moving away from it, and the person the President of the United States has put in as his health care rationing czar is someone who calls that approach a national treasure; cutting $500 billion from our seniors depending on that for Medicare, not to save Medicare but to start a whole new government program.

Britain is trying to revamp because they know that someone with cancer in the United States has a much better chance of survival than somebody in Britain. It is not because our doctors are better in the United States--and I have practiced medicine in Wyoming for 25 years--it is because people get care in the United States that is delayed and therefore denied in Britain. But Dr. Berwick is romantic. He has fallen in love with that national health service, a service that is not good for patients, and it is not good for providers.

I see my friend from South Dakota, another rural community and State. I am sure he is seeing and hearing the same things from his seniors there, their concerns about what is going to happen to the cost of their care, the quality of their care, and the availability of the care, especially with Dr. Berwick now in charge.

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Mr. BARRASSO. Madam President, if I could just ask my colleague, talking about the Constitution and how we as Americans see ourselves, Senator McCain just quoted a comment made by Dr. Berwick about the darkness of private enterprise. Dr. Berwick coauthored a book called ``New Rules.'' In it, he argues that one of the primary functions of health regulation is to constrain decentralized, individual decisionmaking--constrain individual decisionmaking--and to weigh public welfare against the choices of private consumers. I mean, could anything fly further in the face of what Americans believe? The decisions, the choices of private consumers--that is how we make decisions in America. That is what I recommend for patients: Make your individual choice. What is best for you? How to help keep down the cost of your care; prevention, coordinating care; working and making smart choices for you as an individual. Who knows better? Who knows better how to spend your money? You do. Who knows better how to make choices for your life? You do.

That is not what Dr. Berwick is saying in this book, ``New Rules.'' It is to weigh public welfare against the choices of private consumers.

So I inquire of my colleague from South Dakota, what would people from South Dakota think about that? This is somebody who is saying: Government knows better than you do. People of Wyoming have never felt that way, and I would imagine the people from South Dakota have never felt that way either.

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Mr. BARRASSO. It was interesting, on this floor someone on the other side of the aisle stood and said: If you are against Dr. Berwick, then whose side are you on? As I see my colleague from South Dakota, I can answer that question, and he can answer that question. If you are against Dr. Berwick, then whose side are you on? I am on the side of the American people--the American people who are concerned about $500 billion in cuts to their Medicare, not to help Medicare, not to strengthen Medicare, but to start a whole new government program.

I am on the side of the people who believe we should not redistribute wealth in this country. I am on the side of my patients and friends in Wyoming who do not want the rationing of care. I am on the side of my friends and patients in Wyoming who do not want government-run health care. But that is what we have now.

We have a President-appointed czar, essentially--a czar--to ration health care. That is not what the American people want. It may be what the Democrats in Congress want. It may be what the President of the United States wants. I view this as an arrogant use of Presidential power at a time when I think the American people were intentionally misled all during the fall because the President refused to appoint somebody, would not name anybody to be in charge of Medicare and Medicaid when the whole debate was going on. Only after the bill was signed into law--only then--would he announce to the country his choice was somebody way outside the mainstream of how we in America deliver health care, want our health care, how we care as patients, how we care as physicians--way out of that mainstream, someone whose approach is a very different one, who loves a system where we know people with diseases are denied care, where care is delayed, and where today the whole country is saying: I think we got it wrong. We need to relook at this. They see what is happening, and I think the American people will know what will happen to us as a nation if we go down the path of a nationalized health system where we redistribute wealth, ration care, and government runs the health care system of our Nation.

It is the wrong decision by the President. It is the wrong direction to go. The American people know it, and they do not like it.

Once again, the American people are not going to have their voices heard because the American people are going to be denied an opportunity to voice their opposition to this nominee to their elected representatives because the President decided he knew better than this Congress and made a decision to appoint someone at a time when the American people wanted their voices heard.

Madam President, I yield the floor, and I suggest the absence of a quorum.

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