Republicans Have A Brief Opportunity To Grill CMS Administrator

The Los Angeles Times: Donald Berwick, head of the Centers for Medicaid and Medicare Services, testified before the Senate Finance Committee today in its first hearing on health reform. Berwick, who President Obama "appointed in July without Senate confirmation to help lead implementation of the new healthcare law," defended the healthcare overhaul in the face of questioning by "irritated Republican lawmakers." Before today's hearing, they had "repeatedly returned to the circumstances of Berwick's appointment. The White House made the controversial decision to avoid a congressional confirmation fight over the summer when GOP lawmakers launched a media blitz to portray Berwick as an advocate for rationing care, an accusation that was refuted by leading Republican healthcare experts who defended Berwick" (Levey, 11/17).

Reuters: "Senate Republicans decried the cost of Medicare and Medicaid and accused the Obama administration of blocking their oversight of the federally supported insurance programs for the elderly and the poor" at Wednesday's hearing. " Berwick and committee Democrats said provisions in the health law that strengthen funding for preventive services and allow CMS to experiment with ways to provide more efficient and coordinated care will help reduce costs. ... Medicare drew attention last week when the co-chairs of a panel looking at ways to reduce the federal deficit called for sweeping changes to cut the program's costs." CMS will look into "'bundling' payments for multiple procedures and 'health home' models in which patients with at least two chronic conditions can designate a provider to coordinate treatments." At the hearing, "Republicans on the finance committee focused during the hearing on what they perceive as a lack of transparency surrounding Medicare and Medicaid" (Stephenson, 11/17).

PBS: "A pediatrician and long-time advocate for health system reform, Berwick will head the Center for Medicare and Medicaid Services through several years of major changes." CMS currently oversees health coverage 100 million Americans under the Medicare, Medicaid, and Children's Health Insurance Programs, and will oversee coverage for 16 million additional beneficiaries when Medicaid expands eligibility in 2014 under the new health care law. Berwick has "advocated for changing the way doctors and other health care providers are paid to reward quality rather than quantity of care, for using evidence-based medicine to find the most effective treatments, and for using electronic health records to improve efficiency and coordination of medical care" (Winerman, 11/17).

The Hill: The hearing, which lasted an hour and a half, opened with lengthy speeches and left only a few minutes for Republicans to interrogate Berwick. "Sen. Orrin Hatch (R-Utah) called the hearing 'pathetic' and said the time constraints made any real questioning difficult." Berwick said he "'can't think of a worse plan' for seniors than to repeal the bill," noting that the new health care law gives seniors a 50 percent discount for prescription drugs in the Medicare "doughnut hole" and improves their access to preventive services. He said the health reform law will help Americans get care "how they want and need it," by "allowing hospitalized patients to continue to get curative treatments even if they opt for palliative care" (Pecquet, 11/17).

ABC News: "'Obviously asking us to cover all our concerns in this hour-long hearing with only five minutes per side, per person, is like asking us to drain the Pacific Ocean with a thimble,'" Sen. Hatch complained of the hearing. Sen. Jim Bunning (R-Ky.) told Berwick "'Your recess appointment was an end-run around Congress,'" and "'I can assure you you won't receive special treatment next year.'" Bunning promised Berwick he'd have a harder time in the House of Representatives, where Republicans will take control in January, than in the Senate. "At a minimum, they promise to run Berwick and other Obama administration officials through a series of tough hearings" (Hartman, 11/17).

Bloomberg: "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" (Wayne, 11/17).

Kaiser Health News posted an advance copy of his prepared statement, and also has a resource guide, which includes Berwick's own words about the British health care system.