Research Briefing

Obama Using Recess Appointment To Sneak His Controversial CMS Nominee Past Senate

“President Obama intends to use a recess appointment to install Donald Berwick as the head of the government's Medicare and Medicaid programs.” (“Obama To Use Recess Appointment To Name New Medicare, Medicaid Head,” The Associated Press, 7/7/10)

BERWICK SUPPORTS BRITAIN’S PRACTICE OF RATIONING HEALTH CARE

Berwick Sees Need For "Health Care Rationing," Arguing That Government Will Need To Make "Decisions About Who Will Have Access To Care And The Extent Of Their Coverage." "And he embraces government health care rationing. 'The decision is not whether or not we will ration care,' he said in a 2009 interview, 'the decision is whether we will ration with our eyes open.' This is a view Berwick has held for a long time; more than 10 years ago he wrote that 'limited resources require decisions about who will have access to care and the extent of their coverage.'"  (Jeff Jacoby, Op-Ed, "Dangerous To Our Health," The Boston Globe, 6/16/10)

When Discussing Comparative Effectiveness Research, Berwick Praised Britain’s National Institute For Health And Clinical Excellence (NICE). Q: “Are we on the right track with a federal CER agency?” Berwick: “The National Institute for Health and Clinical Excellence (NICE) in the United Kingdom and also, to some extent, the Institut National de La Sante in France have developed very good and very disciplined, scientifically grounded, policy- connected models for the evaluation of medical treatments from which we ought to learn. ... These organizations have created benchmarks of best practices that we could learn from and adapt in this country.” (Katherine T. Adams, “An Interview With Dr. Donald Berwick: Rethinking Comparative Effectiveness Research,” Biotechnology Healthcare, 6/09)

• Berwick Agrees That NICE Is “A Bogeyman” In The US, But Calls It “Extremely Effective... Conscientious, Valuable.” “I know that, and it’s a misunderstanding of the deepest sort. NICE is extremely effective and a conscientious, valuable, and – importantly – knowledge-building system. The fact that it’s a bogeyman in this country is a political fact, not a technical one.” (Katherine T. Adams, “An Interview With Dr. Donald Berwick: Rethinking Comparative Effectiveness Research,” Biotechnology Healthcare, 6/09)
• Berwick Calls It “Irrational” To Not Consider Costs For Rationing. “You can say, ‘Well, we shouldn’t even look.’ But that would be irrational. The social budget is limited – we have a limited resource pool. It makes terribly good sense to at least know the price of an added benefit, and at some point we might say nationally, regionally, or locally that we wish we could afford it, but we can’t. We have to be realistic about the knowledge base.” (Katherine T. Adams, “An Interview With Dr. Donald Berwick: Rethinking Comparative Effectiveness Research,” Biotechnology Healthcare, 6/09)

AND IT’S NOT JUST RATIONING BERWICK LOVES ABOUT

BRITISH GOVERNMENT-RUN HEALTH CARE SYSTEM

Berwick: “If you’re a cynic, you’ll want to go get a cup of tea about now.  I am going to annoy you, because I am not a cynic. I am romantic about the NHS; I love it.  All I need to do to rediscover the romance is to look at health care in my own country.” (Donald Berwick, “A Transatlantic Review Of The NHS At 60,” NHS Live, 7/01/08)

• Berwick: “The NHS Is One Of The Great Human Health Care Endeavors On Earth.” (Carrie Budoff Brown, "GOP Aims To Revive Health Care Debate," Politico, 6/1/10)
• Berwick: “To An American Observer, The NHS Is Such A Seductress.” (Carrie Budoff Brown, "GOP Aims To Revive Health Care Debate," Politico, 6/1/10)
• Berwick: “It Can Be An Example For The Whole World -- An Example, I Must Say, That The United States Needs Now More Than Most Other Countries Do.” (Carrie Budoff Brown, "GOP Aims To Revive Health Care Debate," Politico, 6/1/10)

Berwick Calls The NHS The "Holy Grail Of Universal Coverage" And Decried The American System And "The Darkness Of Private Enterprise." "He has publicly saluted Britain's socialized National Health Service for rejecting the 'immoral' American system and 'the darkness of private enterprise.' He declares that 'the Holy Grail of universal coverage' cannot be achieved with consumer-centered health care, but only through 'collective action overriding some individual self-interest.'" (Jeff Jacoby, Op-Ed, "Dangerous To Our Health," The Boston Globe, 6/16/10)

BUT THE BRITISH ARE SUFFERING UNDER THE “HOLY GRAIL OF UNIVERSAL COVERAGE”

Under The NHS, Children Face Rationing For “Common Operations.” “Children will be some of the first victims of NHS cuts after one health trust introduced rationing for common operations. Young patients suffering from tonsillitis will only be allowed to have their tonsils out if they have suffered at least five bouts in the last year. They will also have to show that the condition is affecting their lives before qualifying for surgery in Greater Manchester.” (“Prove You’re Sick Enough For Surgery,” The Daily Mail, 5/28/10)

"'In Britain 36 Percent Of Patients Have To Wait More Than Four Months For Non-Emergency Surgery,' Wrote Journalist James Bartholomew In The Spectator. 'In The US, A Mere Five Percent Do.'" (Jeff Jacoby, Op-Ed, "Dangerous To Our Health," The Boston Globe, 6/16/10)

• Critics Have Stated That British Run Health Care "Is So Amazingly, Achingly, Miserably, And Mortally Incompetent." "By one metric after another -- cancer survival rates, performance of diagnostic tests, availability of CT and MRI scanners, consultation with specialists -- US health care is superior. 'British state-run health care,' Bartholomew concluded, 'is so amazingly, achingly, miserably, and mortally incompetent.'" (Jeff Jacoby, Op-Ed,"Dangerous To Our Health," The Boston Globe, 6/16/10)

Under The NHS, “Pregnant Women Were Forced To Travel Up To 99 Miles” To Find A Hospital. “Pregnant women were forced to travel up to 99 miles in order to give birth last year after being turned away by overstretched maternity units. Official figures reveal that one unit was forced to close for 78 hours because it could not cope with demand. Another trust shut its doors 112 times, forcing women only minutes or hours from giving birth to seek care elsewhere.” (Daniel Martin, “Overstretched Maternity Units Mean Mothers Face A 100-mile Journey To Have Baby,” The Daily Mail, 4/22/10)

Under The NHS, “Poor Nursing Care, Filthy Wards And Lack Of Leadership…Led To The Deaths Of Up To 400 Patients A Year.” “Poor nursing care, filthy wards and lack of leadership at Basildon and Thurrock University NHS Hospitals Foundation Trust led to the deaths of up to 400 patients a year. Figures compiled by a health watchdog showed death rates at the Essex trust were a third higher than they should have been.” (Rebecca Smith, “Hundreds Of Patients Died Needlessly At NHS Hospital Due To Appalling Care,” The Telegraph, 11/26/09)

Under The NHS, Patients “Suffered Appalling Care” That “Would Shame A Third World Country.” “Their comments follow a damning report which estimated that one million patients had suffered appalling care, including neglect and cruelty, at the hands of NHS staff, many of them nurses. Hundreds more people have come forward with their tales of appalling treatment since the report, by the Patients Association, was published on Thursday. … But nurses have admitted that in some cases patients are suffering appalling treatment on wards. Maureen Hamilton, who has been a nurse for more than 40 years, said that the standards of care ‘would shame a third world country,’ particularly on wards looking after the elderly.” (Kate Devlin, “Standard Of Care In Some Wards ‘Would Shame A Third World Country,” The Telegraph, 8/29/09)