Obama's new Medicare/Medicaid chief wants Sarah Palin's "death panels"....
Dr. Donald Berwick, appointed during the summer recess so as to avoid a messy confirmation hearing during which his views on how government should ration health care would be explored, exemplifies what Sarah Palin warned about during the ObamaCare debate.
The WSJ editors stress that by the standards of many in his profession, Berwick's views are conventional, not radical. He professes himself "romantic" about the UK's National Health Service, and says of rationing: "The decision is not whether or not we will ration care—the decision is whether we will ration with our eyes open."
The WSJ editors elaborate on what Berwick will do:
The White House doesn't bother to disagree. According to a "topline message points" document on his nomination that we obtained, "The fact is, rationing is rampant in the system today, as insurers make arbitrary decisions about who can get the care they need. Don Berwick wants to see a system in which those decisions are transparent—and that the people who make them are held accountable."
The people who can write such things with a straight face believe there is no difference between rationing through individual choices and price signals and rationing through politics and bureaucratic omniscience. In an influential 1996 book "New Rules," Dr. Berwick and a co-author argued that one of "the primary functions" of health regulation is "to constrain decentralized, individual decision making" and "to weigh public welfare against the choices of private consumers."
He then recommended "protocols, guidelines, and algorithms for care," with the "common underlying notion that someone knows or can discover the 'best way' to carry out a task to reach a decision, and that improvement can come from standardizing processes and behaviors to conform to this ideal model." And guess who will determine the "best way"?
Such a command-and-control vision is widespread among America's technocratic medical left, but it is also increasingly anachronistic amid today's breakneck medical progress. There isn't a single "ideal model" in a world of treatments tailored to the genetic patterns of specific cancers, or for the artificial pancreas for individual diabetics, or other innovations that are increasingly common.
This is nonetheless where Dr. Berwick, in his bureaucratic wisdom, will look for his "savings." It is also where his personal view of the "public welfare" will have the power to trump the mere "choices of private consumers."
Then there is RomneyCare, which, a WSJ op-ed informs us, is creating a "Massachusetts health care train wreck"--in just four years. In addition to price controls on insurance, already a contentious reality into which the courts have been drawn, rate controls on physicians, specialists and hospitals are in store. And worse is the rank deception associated with implementing RomneyCare:
An entitlement sold as a way to reduce costs was bound to fundamentally change the system. The larger question—for Massachusetts, and now for the nation—is whether that was really the plan all along.
"If you're going to do health-care cost containment, it has to be stealth," said Jon Kingsdale, speaking at a conference sponsored by the New Republic magazine last October. "It has to be unsuspected by any of the key players to actually have an effect." Mr. Kingsdale is the former director of the Massachusetts "connector," the beta version of ObamaCare's insurance "exchanges," and is now widely expected to serve as an ObamaCare regulator.
He went on to explain that universal coverage was "fundamentally a political strategy question"—a way of finding a "significant systematic way of pushing back on the health-care system and saying, 'No, you have to do with less.' And that's the challenge, how to do it. It's like we're waiting for a chain reaction but there's no catalyst, there's nothing to start it."
In other words, health reform was a classic bait and switch: Sell a virtually unrepealable entitlement on utterly unrealistic premises and then the political class will eventually be forced to control spending. The likes of Mr. Kingsdale would say cost control is only a matter of technocratic judgement, but the raw dirigisme of Mr. Patrick's price controls is a better indicator of what happens when health care is in the custody of elected officials rather than a market.
Even worse is yet to come: One Massachusetts State legislator who co-sponsored RomneyCare introduced a bill to require doctors to participate in government health care programs as a condition of getting a license to practice medicine in the State.
Bottom Line. ObamaCare and free choice are simply incompatible. All health care systems ration. The question is how they ration. ObamaCare advocates want a government to do it. Does anyone think that such decisions will not favor their friends--union members, for example? Private choice--central to a free society--will be verboten in ObamaCare Clinic--except for those at the top who, like European politicians, will find the best care wherever it is to be found. Age 76, and want one more year of life via proton beam therapy for your brain tumor? You'd better be Teddy Kennedy. The rest get The Shaft--a/k/a, Death Panels.
Letter from the Capitol, LFTC, Economy, Conservative Politics
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