Republicans complained at Medicare Administrator Donald Berwick’s first appearance before Congress that they have been unable to review his work implementing President Barack Obama’s health-care overhaul.
Obama appointed Berwick in July without Senate approval, denying Republicans a chance to question him in a confirmation hearing. He defended the law today before the Finance Committee, which supervises Medicare, the health insurance program for the elderly and disabled, and the Medicaid program for the poor. The session was held to just over an hour.
The hearing previewed exchanges to come next year as Republicans take control of the House. Republicans on the panel didn’t question Berwick about remarks he’s made about rationing care or new boards and offices within his agency the law creates to slow health spending. Senator Orrin Hatch, Republican of Utah, said the hearing was too short.
“It’s like asking us to drain the Pacific Ocean with a thimble,” he said, calling the hearing “pathetic.”
Berwick called the health law “the best opportunity in a generation to make progress” on improving health care. Prompted by Senator Debbie Stabenow, Democrat of Michigan, he later warned that if Republicans succeeded in repealing the law, as they have promised, the outcome would be “terrible.”
A repeal may mean Medicare beneficiaries returning 1.8 million checks for $250 each that they received under the law for drug costs and a loss of improved benefits, such as better coverage for preventive health services, he said. Efforts at Berwick’s agency to reduce hospital-acquired infections and increase anti-fraud efforts might stop, he said.
“I can’t think of a worse plan than repealing this law,” he said.
Senator Max Baucus, the Montana Democrat who leads the Finance Committee, said repealing the law signed in March would deepen the budget deficit.
The overhaul would reduce the growth of spending in Medicare and Medicaid by about $455 billion during a decade, according to the Congressional Budget Office, the accounting arm of Congress.
Republicans such as Kansas Senator Sam Brownback have said those cuts should be repealed. Texas Senator John Cornyn has introduced legislation to repeal a new board empowered to propose further spending reductions in Medicare, beginning in 2015. Twelve Republicans have signed on as co-sponsors to Cornyn’s bill, including Hatch.
While no Republicans used the word “rationing” today in their questions to Berwick, he alluded to the topic himself.
“My principle is that patients should get all of the care they want and need, when and how they want and need it,” he said in response to a question from Senator Ron Wyden, Democrat of Oregon. Wyden told Berwick he wanted an approach to end-of-life care that is “the opposite of rationing.”
Republicans have criticized Berwick for remarks he made to the journal Biotechnology Healthcare in June 2009. It had asked him whether research into the comparative benefits of different medical treatments might lead to rationing.
“The decision is not whether or not we will ration care -- the decision is whether we will ration with our eyes open,” he responded in the interview. “And right now, we are doing it blindly.”
In a prepared statement distributed before the finance hearing, Berwick said that the health law won’t cut guaranteed Medicare benefits “nor will it ration care.” He didn’t say the line during his testimony.