July 8 2010

IWF in the News: NICE to meet you, Mr. Berwick

Nicole Kurokawa Neily

President Obama officially announced the recess appointment of Harvard professor Dr. Don Berwick as head of the Center for Medicare and Medicaid Services (CMS).

Procedurally, the recess appointment is unusual because the Senate is only on recess for two weeks; in general, recess appointments take place when the Senate is out for longer periods.

Politically, however, it makes sense, because Berwick was an extremely controversial nominee who was unlikely to be confirmed through normal channels. (Of course, we'll never know, because no hearing was ever called.)

Last year, Berwick professed his admiration for the British single-payer system and its National Institute for Clinical Excellence (also known as NICE, ironically enough) - the system that the U.S.' new Federal Coordinating Council for Comparative Effectiveness Research was modeled upon. This agency, which will make recommendations on patients' treatments using "evidence-based medicine" (an Orwellian phrase if there ever was one), will take into account factors like cost effectiveness, and not pay for treatments that are deemed to cost more than the value they provide.

Of course, government-issued guidelines would only apply at first to those on government-provided health care plans - but since many employers are expected to drop their health care coverage in favor of government coverage, the number of people subject to these recommendations is sure to increase over time. Since government recommendations often affect how the private sector does business, this also means that some treatments may eventually be off the table for the population at large. (Well, unless you're rich enough to pay for treatments out of pocket, that is - meaning restrictive guidelines will overwhelmingly affect the poor and disenfranchised.)  

Obviously, no health care system can provide all the health care that people desire because of cost constraints. However, those decisions are best left in the hands of consumers - whose preferences vary widely on the costs and benefits of treatments - and not a one-size-fits-all bureaucratic formula.

The British NHS is no system to emulate; denials of treatment are regular, and long waits are common. Accordingly, survival rates are far below that of the U.S. for diseases like breast cancer, where early detection and treatment can mean the difference between life and death.

Unfortunately, little can be done about Berwick now that the deed is done. But until his term expires at the end of 2011, it's up to the loyal opposition to remind the American people why a British-style health care system is unacceptable.



Read more at the Washington Examiner: http://www.washingtonexaminer.com/opinion/blogs/Examiner-Opinion-Zone/Nice-to-meet-you-Mr-Don-Berwick-CMS-recess-appointment-98035604.html#ixzz0tTY3pJrW

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