Republicans are prepared to paint President Barack Obama's choice to lead the CMS as a proponent of rationed healthcare who favors a government-run system comparable to the one in Britain, according to a memo released by the Republican Policy Committee and interviews with key GOP senators.
On Monday, the White House officially nominated longtime patients' advocate Donald Berwick to run the nation's Medicare and Medicaid programs. By far the largest payer of healthcare in the United States, the CMS has become a critical point of discussion in the wake of the new health reform law.
The GOP memo, released yesterday, highlights a number of comments Berwick has made in print and in interviews that appear complimentary of Britain's National Institute for Health and Clinical Excellence.
The brief also highlights a Berwick quote from a trade journal where he said, “The decision is not whether or not we will ration care—the decision is whether we will ration with our eyes open.”
Early in the reform debate, Republicans said that stepped-up government involvement in healthcare, whether through a comparative effectiveness panel or under a public health insurance option, would lead to denials or restrictions on certain types of care.
“Obviously, there are going to be some real problems with that nomination,” said Sen. Jon Kyl of Arizona, the second-highest ranking Republican and a member of the Senate Finance Committee, which approves the administration's health nominees. “He appears to be a big fan of the whole idea of rationing.”
The budding stance by Republicans hints that the nomination fight for Berwick could become a proxy battle over the bitter health reform fight on Capitol Hill—the wounds from which have barely begun to heal, even as implementation has started.
Republicans on the Senate Finance Committee said they are at the earliest part of the vetting process, and many added that they want to reserve judgment until they learn more about the 63-year old pediatrician and founder of the Institute for Healthcare Improvement in Boston.
“We're going to be very interested in his ideology, on whether he thinks government or the private sector is better in determining things,” said Sen. Chuck Grassley of Iowa, the ranking Republican on the Senate Finance Committee. He added that there are questions over his “views towards choice for doctors and what his attitude is on end-of-life.”
Sen. Tom Coburn, (R-Okla.), a physician, said he expects Berwick to answer a full range of questions.
“Well, he just has a different philosophy than many of us in medicine,” Coburn said.