[Congressional Record Volume 156, Number 102 (Monday, July 12, 2010)]
[Senate]
[Pages S5728-S5729]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
A SECOND OPINION
Mr. BARRASSO. Mr. President, I come to the floor today, having just
returned from spending a wonderful week over the Fourth of July in
Wyoming, visiting with people across the Cowboy State at senior
centers, Kiwanis clubs, Rotary clubs, and repeatedly the issue came up
of this appointment of Dr. Berwick to head Medicare and Medicaid.
My colleague who just left the floor talked about the playbook of
delay and obstruction. I will tell you that this recess appointment and
the overall appointment of Donald Berwick is absolutely a page out of
the playbook of the U.S. President of delay and obstruction.
Last year I came to this floor and said we should have somebody in
charge of Medicare and Medicaid. When this body is talking about
cutting $500 billion from our seniors on Medicare, not to save Medicare
but to start a whole new government program, there ought to be somebody
in charge of Medicare in this country who can answer the questions
about what are the impacts going to be. But the President of the United
States refused to name anyone.
At a time when this body was debating how to handle 16 million more
Americans jammed and crammed into Medicaid, a program where half the
doctors in the country will not see those patients, it is like giving
somebody a bus ticket when a bus isn't coming. Those people may have
coverage but they are not able to get care. There should have been
somebody in charge of Medicaid. I came to this floor and said: Mr.
President, it is time to make someone take over the responsibilities,
to be in charge of Medicare and Medicaid so they can come and explain
to this Senate and this country what the impacts are going to be of the
cuts in Medicare and the cramming of more and more people into
Medicaid. But the President of the United States refused.
The playbook of delay and obstruction belongs to this administration.
The playbook of delay and obstruction is what led us here today, to a
situation where no one was even named to be in charge of Medicare and
Medicaid for the United States until after an extremely unpopular and
unwise health care bill was signed by the President of the United
States. Then and only then did the President of the United States
decide who he would want to put in charge of Medicare and Medicaid. To
me, this is an insult to the American people, an insult that the
American people would never ever have an opportunity of having open
congressional hearings to have explained to them the positions of this
man nominated to head Medicare and Medicaid for this country.
I think the President of the United States has made a mockery of his
pledge to be accountable as an administration, to be transparent as an
administration. That is what I heard at senior centers in Rock Springs,
WY, and in Riverton, WY, at a Kiwanis club, people there as well as at
a meeting in Powell, WY, at the Rotary club. People all across Wyoming
and all across the country are very concerned, saying how is this going
to affect me personally. Seniors know if you take $500 billion away
from their Medicare, not to help seniors, not to help Medicare, but to
start a whole new government program--they are very interested how that
is going to work because that affects each and every one of them
personally.
I heard my colleague from Rhode Island talk about coordinated care. I
am with him. We need to coordinate care. That is why I was surprised to
see Members of the Democratic side of this Senate vote to kill the
program of Medicare Advantage for 10 million Americans. These are
individuals who signed up for Medicare Advantage because there is an
advantage. It actually helps with preventive medicine and it helps with
coordinated care. That is going away. Yet the President of the United
States did not have anybody in charge of Medicare or Medicaid to
explain what would be the impact of getting rid of Medicare Advantage
on those 10 million people who need coordinated care and needed
preventive medicine.
When I hear my colleague from Rhode Island say if you are against Dr.
Berwick, then whose side are you on, I would say I am on the side of
the people of Wyoming, the seniors of this country, the people who are
seeing $500 billion of Medicare cut from them to start a whole new
government program. They realize it is not going to help them. That is
why at town meetings and visits around the State of Wyoming people
believe ultimately they are going to end up paying more for their care
and are going to have less care available to them because of this very
unpopular health care law. That is why, week after week, I come to the
Senate floor to talk as a practicing physician, someone who has taken
care of patients for 25 years around the State of Wyoming, to give a
doctor's second opinion, to talk about what I see, as a physician, with
this health care law that ultimately I believe is going to be bad for
patients, bad for payers--the people across this country who are going
to pay the bill for this--and bad for providers, the nurses and doctors
who take care of the patients.
Here we now have appointed, without a hearing, without a debate,
without this Senate having had a chance to vote, a Director of Medicare
and Medicaid who has expressed many opinions that do fly in the face of
and are way out of line with the opinions of the American people. So it
is not a surprise you see headlines in places such as the New York
Times that say ``Tough Confirmation Battle Looming For Medicare
Nominee.'' That is in the New York Times.
The Boston Globe, the hometown paper where the nominee has been known
to practice, ``Dangerous To Your Health,'' of Dr. Berwick.
What is this administration trying to hide? Why is this
administration unwilling to have hearings? Why is the administration
not allowing Dr. Berwick to come to Congress to explain to
[[Page S5729]]
the American people his opinions and his views? All we know is what we
have read, what we have seen from his speeches, the things he has
written. Likely, it is because if those things were heard by the
American people this man may absolutely be unconfirmable.
If that is what the President wants, that is what the President got.
Because right now I will tell you the President of the United States
has his own health care rationing czar.
You say how can you imagine that sort of thing? Let's look at some of
these quotes from Dr. Berwick.
The decision is not whether or not we will ration care--the
decision is whether we will ration with our eyes open.
This is not some long-ago quote. This is last year:
The decision is not whether or not we will ration care--the
decision is whether we will ration with our eyes open.
This is what he says about the British health care system. He says:
I fell in love with the [national health system] . . . to
an American observer, the [National Health Service] is such a
seductress.
Who talks like that? He said:
The [National Health Service] is not just a national
treasure, it is a global treasure. As unabashed fans, we urge
a dialogue on possible forms of stabilization to better
provide NHS with the time, space, and constancy of purpose to
realize its enormous promise.
I will tell you as a practicing physician that the rates of cancer
survival in the United States are much higher than in Britain. It is
not that our doctors are better, it is that people get care sooner--
early detection, prevention, early treatment. Those are the keys to
cancer survivability. So what we know is that it is not that the
doctors in the United States are better than those in England, it is
that the patients in the United States get care where they do not in
England. But, then again, Dr. Berwick loves the British health care
system. He actually says:
I am romantic about the National Health Service; I love it.
That is what we have. We have a recess appointee who also went on to
have some ideas about wealth in the United States. He said:
Any health care funding plan that is just, equitable,
civilized and humane must redistribute wealth from the richer
among us to the poorer and less fortunate.
Here we have a recess appointee who will make decisions for hundreds
and hundreds of billions of dollars, that impact the lives of the
American people, without ever having a Senate debate, without ever
having a Senate hearing, without us ever having one word of testimony
because the President of the United States believes that he knows
better than the people of this country.
Dr. Berwick coauthored a book. He talked about one of the primary
functions of health regulation is to ``constrain decentralized
individual decisionmaking.'' Let me say that again: ``Constrain
decentralized individual decisionmaking.'' Individuals? Humans? People
around the communities. People in our home States. He says we want to
constrain local people making local decisions. And he says to weigh
public welfare against the choices of private consumers. For a
consumer, what is more important to them than their health?
This is not a one-party-only situation. Even Max Baucus, Senate
Finance chairman, issued a statement critical of this end-around
decisionmaking by the President.
It is interesting how things change. When Barack Obama was a Member
of the U.S. Senate, as he was not that long ago, the President at the
time, George W. Bush, made a recess appointment. This is what
President, then Senator Obama, had to say of John Bolton. He said,
``He's damaged goods.'' He said, ``He'll have less credibility.''
Don Berwick is damaged goods. He will have less credibility. I am not
talking about that with a couple of Senators, I am talking about it
from the standpoint of the American people. The American people know
and understand that the President of the United States is trying to
hide something. That is why there has not been an open hearing. The
Republicans have been asking for an open hearing. The Republicans have
been asking for a number of weeks for an open hearing. I have been
asking that the President name somebody to this position since last
year but, no, in the playbook of delay and obstruction, the
administration has decided not to do that--don't name anybody until
well after the bill is signed into law and then don't allow that person
to come to the Senate for a confirmation hearing.
What are they trying to hide from the American people? That is where
we are today. We are in a situation where the President of the United
States has made an appointment, a recess appointment without hearings,
without the American people knowing or being able to ask the questions.
What exactly are you going to do here, Dr. Berwick, when you cut $500
billion from our seniors on Medicare? What is that impact going to be
on their lives when you cut money from hospice, when you cut money from
nursing homes, when you cut from physical therapy, when you cut from
rehab, when you cut money from hospitals, when you cut money from
physicians? We have more and more people becoming Medicare age every
year. Why is the President of the United States unwilling to have that
individual come to the Senate and explain to the American people how it
is going to work? The people have a right to know.
That is why I am not surprised and was not surprised this past week
in Wyoming--in Riverton, in Rock Springs, in Powell, as I traveled
around the State--to have people coming up to me saying: What is going
to happen to my Medicare, now that the President has made this recess
appointment over the Fourth of July, when the Members of Congress are
not in Washington but are at home, visiting with the folks in their
districts?
What is this going to mean for my health care or, as many others say,
what does this mean for my mom or my dad? Those are questions that are
not going to be answered because the President of the United States has
decided to make a recess appointment at a time the American people have
the right to expect and deserve to know from a President who has
campaigned and promised, promised the American people, transparency and
openness and accountability, and now the American people realize they
have received none of those things.
So, again, as a physician I come to the Senate floor. I spent all day
Friday at a Wyoming Medical Center visiting with people in Casper.
Senators around the country went home and talked to people, in fact,
many back to where they worked. I went back to where I worked at the
hospital, visited with doctors and nurses and patients as well. All are
concerned, concerned about this health care law that they believe is
going to raise the cost of their health care, lower the quality;
concerned about a health care law that they believe is going to be bad
for them as patients, bad for the taxpayer because the costs are going
to go up; bad for the providers, the nurses and doctors who take care
of them; bad for the American people.
That is why so many of them, still today, believe this health care
bill should be repealed and replaced with things that put patients in
charge, not insurance company bureaucracies, not Washington, DC
bureaucrats; that would put patients in charge. That is what we need in
this country. That is the kind of health care the American people need.
That is what they are asking for. And when my colleague says: If you
are against Dr. Berwick, then whose side are you on? I am on the side
of the people I have taken care of all around the State of Wyoming for
the last 25 years.
I yield the floor and I suggest the absence of a quorum.
The ACTING PRESIDENT pro tempore. The clerk will call the roll.
The assistant legislative clerk proceeded to call the roll.
Mr. DURBIN. I ask unanimous consent that the order for the quorum
call be rescinded.
The ACTING PRESIDENT pro tempore. Without objection, it is so
ordered.
Mr. DURBIN. Mr. President, I ask unanimous consent to speak as in
morning business.
The ACTING PRESIDENT pro tempore. Without objection, it is so
ordered.
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