Archive for August, 2010

Recess is Ending Soon – Shouldn’t that end Berwick’s “Recess Appointment”? lol

August 16, 2010

I’ve been taking a long recess myself prior to election season.  But I guess that season is now upon us, so… once again it’s time to write about ObamaCare!  There are a number of  issues I need to get to, but let’s start with the low-hanging emotional fruit that jacks me up and troubles my “little man” (ala Barton Keyes in “Double Indemnity”- you can check Keyes out here – ‘Film Noir’ always paints a more stark and honest picture than the media do).

During his campaign, Mr. Obama promised that, under his Administration, all important aspects of the health care debate would be aired on CSPAN for all to see. This was supposed to be a token of how unique and open the Obama Administration’s approach to controversial issues would be.  Of course, everyone knows, and Mr. Obama is on record admitting,  that his promise has long since been broken.

But now a new level of promise-breaking and hypocrisy has been reached.  By choosing to appoint  Dr. Donald Berwick as the head of the Centers for Medicare and Medicaid Services (CMS) via the mechanism of a “recess appointment,”  President Obama has gone out of his way to actually PREVENT the normal CSPAN coverage that would be expected under ANY administration appointing someone to this critical post!

Now the Nation will be denied  the customary and usual process of Senate confirmation hearings regarding this important appointment – an appointment which can influence much of the future access to health care for the at-risk populations subject to Medicare and Medicaid –  Seniors and the Poor.  This action is extraordinary, not because “recess appointments” have never been made before, but because of the extraordinary breech this constitutes of even the basic “Notion” (to quote Mr. Obama)  put forth by this Administration that it would be an honest and transparent  broker for the Public  in deliberations related to health care reform.   Simply incredible!   And no one even seems to notice!!!  Perhaps we are so accustomed to the hypocrisy and unfulfilled promises of this Administration that this one flies under the radar.


“It is one thing for an occasional insurance company to treat policy-holders this way – it is a far, far different thing when a Government rations health care to all of its citizens this way – determining who we can afford to treat,  and who shall die.”


So, what ever happened to this Administration? – the one that was supposed to be the most transparent in history?  Why are we treated to the spectacle of Press Secretary Gibbs having petty arguments with a reporter about what statements Dr. Berwick has or has not made?  If the Administration wanted clarity on Dr. Berwick’s philosophy and statements, why didn’t they want to go through the Senate hearing process instead of having the barely competent Gibbs make denials that no one really believes?

The short answer is that the Obama Administration has basically given up on using honest public debate to rally public opinion to their side on the health care issue.   A knock-down, drag-out hearing regarding Dr. Berwick’s beliefs, while not affecting the outcome of confirmation, would only heighten the Public’s perception that something of incredible value is being taken away from them – forever.  And they would be correct.

Dr. Donald Berwick has a long history as a true believer in a system that  grants health care access to those meeting certain specified  criteria while freeing up resources from others who do not meet  the Administration’s vision of “worthy” recipients.  Specifically, Dr Berwick has stated that “Any health care funding plan that is just, equitable, civilized, and humane must redistribute wealth from the richer among us to the poorer and the less fortunate. Excellent health care is by definition redistributional.”  But, in the world that I grew up in, we always counted the elderly and chronically ill as belonging to the “less fortunate”  class .  After all, these folks were afflicted with diseases and outright pain that the rest of us, fortunately, did not have to bear.    Also, the last time I checked, many elderly Americans on fixed incomes are among the poorest Americans.

Dr. Berwick, however, extols the virtues of the British System which scraps sentimentality in favor of cost-effectiveness,  and denies access to care to many who are elderly and sick.   Dr. Berwick’s enthusiasm for the British National Health System has led him to gush “It’s such a seductress.”  This despite the many scandals that have beset the system, including last year’s repeated reports of tens of thousands of unnecessary deaths occurring in hospital.  These scandals have recently caused Britain to move away from its commitment to a centralized system, in favor of a more regionally based NHS that would re-empower health care professionals in their local institutions.  No matter, “seduction” has no rational explanation – while Britain is falling “out of love” with the NHS, Dr. Berwick seems to be smitten by the order and authoritarianism inherent in this system which allows for Government control of resources and the meting out of ‘just outcomes’  to the “tax paying units,” aka patients, lol.  Undoubtedly this sort of Government control and centralized power resonates with his personal worldview, which abhors the chaos of  “private enterprise.”

This is clear in a recent statement made when Dr. Berwick contrasted the British vs. the American system by telling a British audience ” You could have let an unaccountable system play out in the darkness of the private enterprise (system) instead of accepting that a politically accountable system must act in the harsh and admittedly sometimes very unfair daylight of the press, public debate, and political campaigning.”

What “unfair daylight??”  Where is the “unfair daylight” exposing the Obama Administration’s health care system??  In a Senate hearing? NO!! Instead, we have an unnecessary recess appointment aimed absolutely at hiding and obscuring the seminal issues from Public View “in the darkness of…” NOT private enterprise, but, instead, in the darkness of absolute Government control!!  And who is holding the Administration  “politically accountable??”   The “Press??” You must be joking!! They are playing along with the Administration- characterizing this key recess appointment as “business as usual” while our control over our very lives ebbs away!

The whole thing has me wanting to take a shower just to get clean. Wow! Whatever happened to my Country?  The one that cared about all its citizens, not just those with political special interest “juice?”  The Country that cared about its fellow citizens’  mothers and fathers, and about those younger citizens with extraordinary (sometimes expensive) health care challenges?

That version of America1.0 has evidently been dumped by the Obama bean counters onto the ash heap of history.  The dirty little secret is that Administration hardliners like Dr. Ezekiel Emanuel and Dr. Donald Berwick actually believe that Private Insurers spend way too much on patients, and they can’t wait to rein in that spending using Federal mandates and subsidies on the Exchanges as levers to effect compliance.   Their interim goal is to regulate all coverage decisions by private insurers to conform to a pre-determined probability curve that satisfies budget requirements and patient “value.”  Their ultimate goal, of course, is to eliminate the private insurer “middle man” from the transaction, leaving the patient directly supplicant to his Government for his very life.  Of course, because there will be no “middle man” or higher authority, there will be no chance of changing coverage or appealing the decision.

It is one thing for an occasional insurance company to treat policy-holders this way – it is a far, far different thing when a Government rations health care to all of its citizens this way – determining who we can afford to treat,  and who shall die.  Letting a Government that is intent on cost-reduction (actually expenditure reduction) have the final say as to who receives treatment, is the ultimate  “Conflict of Interest.”

While the bean counters make false promises of saving resources and money, make no mistake, our Nation is becoming morally poorer every day that this Government-mandated rationing system takes shape, supposedly for our benefit, we are told by our so-called Representatives – “for the Good of the American People.”   This is just fiction – a contemptible  attempt  to  implicate an American Public that has heroically opposed this plan at landslide levels from the very beginning, as  the reason why our kindly Government has implemented this system.    Until we find a way to undo this travesty, being perpetrated in our name, unfairly,  it will be our Nation, and we as a people that pay the moral price for Dr. Berwick’s and President Obama’s “seduction” by the real motivation behind this system – the promise of life-and-death power over every citizen –  in the hands of the State …

I like to think Keyes from “Double Indemnity” would snortingly reject out of hand this sort of  “We smart folks can best choose who should survive”  mentality- not because he was a cynical insurance investigator who could see all the flaws in this system,  but because of the force of his intuitive compass, his “little man,”  which made him immune to the kind of  “seduction,”  as well as to the blind belief in planning and control, which ultimately destroyed his best friend, Walter Neff.


The Skeptic


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