What kind of benevolent dictator would declare his love for Britain’s stingy, depressing, complicated, cold and arbitrary National Health Service by describing [2] it as “generous, hopeful, confident, joyous and just”?
That would be Harvard-based pediatrician Donald Berwick, who recently received a recess appointment as Administrator of the Centers for Medicare and Medicaid Services by the benevolent dictator who describes his pessimistic and stale vision for America as “hope and change.”
Recess appointments are an executive procedure used, for better or for worse, when the Senate gives a presidential appointee a difficult time during confirmation hearings—for example, when they filibuster a nominee. Obama’s appointment of Berwick bears the distinction of having been given without a confirmation hearing having even been scheduled.
It’s as though Obama decided that the very requirement that his nominee appear before a Democratic-controlled Senate constituted an unreasonably difficult hurdle. This isn’t a recess appointment—it’s a vacation to Bermuda appointment.
As the Wall Street Journal noted [3], “Circumventing Senate confirmation to appoint the new Medicare chief is part of the same political willfulness that inflicted ObamaCare on the country despite the objections of most voters.” CBS News observed [4], “The debate over Berwick’s recess appointment makes clear what the White House knew all too well—Berwick may not have survived the Senate confirmation process, which would have turned into a proxy debate over health care reform.”
Berwick, who will be put in charge of the health care of 100 million Americans without so much as a public query about his plans in office, has been quoted saying [2], “I am romantic about the N.H.S.; I love it.” He has called himself “an American fan” of the system, “distant and starry-eyed.”
In his London speech commemorating the N.H.S.’s 60th birthday, Berwick delivered [2] such pro-American pronouncements to his audience as “Do not trust market forces to give you the system you need… I cannot believe that the individual health care consumer can enforce through choice the proper configurations of a system as massive and complex as health care. That is for leaders to do.”
When it comes to Berwick’s affection for health care systems centered around use of death panels, apparently absence makes the heart grow fonder. After returning home and mooning over the UK’s National Institute for Health and Clinical Excellence, the operational arm of the N.H.S., Berwick realized [2] that “All I need to do to rediscover the romance is to look at health care in my own country.”
That country would be the United States, which has the greatest health care system in the world, and would be a profound source of inspiration for anyone who truly loved medicine. Berwick’s own place of employment is Harvard Medical School, where you would think there would have been a few medical advances in recent years to set his heart aflutter.
But no—Berwick’s passion is for euthanasia counseling and quality-adjusted life years [5].
Berwick of course has never had to live under the jurisdiction of the N.H.S. You might call his affair with the British health care system a long-distance relationship.
Describing the supposed British backlash against American conservatives’ depiction of the N.H.S. during the health care reform debate last summer, the New York Times gushed [6], “A Twitter campaign, We Love The N.H.S., is still going strong, with supporters sending messages about their own good experiences.”
In fact, said campaign [7] didn’t even last 30 days from its first Tweet to its last, and has attracted a piddly 520 followers internationally. This is despite such helpful but unheeded administrative prompts as “What do you love about the nhs?” and “Please Retweet: 10,000 supporters visualised.”
Admittedly, the riotously popular N.H.S. does have a Facebook fan page [8] with 3,500 members. Then again, an ill-worded N.H.S. sign implying that contraception would be facilitated by anal rather than vaginal intercourse has a Facebook fan page [9] with 124,475 members. So perhaps fan counts are not such a flattering measure of the N.H.S.’s popularity.
Even the New York Times had to admit [6] that Brits “complain endlessly about the National Health Service… They deplore the system’s waiting lists, its regional disparities in treatment, its infection-breeding hospitals and its top-heavy bureaucracy.” I guess the grass is greener on the other side of the pond!
If Donald Berwick wants to swoon over endless waiting lists, fatally protracted wait times, diminished access to specialized care, craven efforts to shield [10] patients from learning [11] about or acquiring [12] costly life-saving drugs [13], pathetic heart attack and cancer survival rates, depersonalized patient treatment, and centralized bureaucratic decision-making [14] about individual health care options, that’s his choice. But forgive the rest of the U.S. if we aren’t quite as smitten as he is.
