WASHINGTON, DC – U.S. Senator Pat Roberts today sent a letter to Kathleen Sebelius, Secretary of Health and Human Services, and former Governor of Kansas, urging her to reconsider support for the nomination of Dr. Donald Berwick to be the Administrator for Centers for Medicare and Medicaid Services.

 The following is the text of the letter:

Dear Secretary Sebelius: 
 
 I write to express my deep reservations regarding President Obama’s nominee for the Administrator of the Centers for Medicare and Medicaid Services, Dr. Donald Berwick. Despite your public support for Dr. Berwick and your comments that his controversial statements have been “taken out of context”, I urge you to take a closer look at his positions on government control and rationing of health care.

 As you know, the Administrator of CMS is one of the most powerful and important positions in the executive branch of government. As the agency responsible for running Medicare and Medicaid, programs upon which well over 100 million Americans rely, CMS is the largest purchaser of health care in the U.S.. It has an annual budget of over $1 trillion, employs over 4,000 workers, and most important, drives payment, pricing and coverage policy for the rest of the health care market.

 I hope you will recall, I have long taken a special interest in nominees for this position- no matter which party nominates them. With the federal government taking over an increased share of the health care market under the new health reform law, the CMS Administrator will become an even more important figure for patients and doctors across the country. Accordingly, my concern that we get the right person for the job has taken on a heightened significance.

 Based on my extensive research into Dr. Berwick's speeches, articles and statements, I am very concerned by his positions on the issues of government control and government rationing of health care. In your defense of the Berwick nomination you said: "it's unfortunate that a lot of what is being said currently has very little to do with Dr. Berwick or his outstanding qualifications, I think there have been some statements of his taken out of context."

 Kathleen, please explain which of the following statements and positions have been "taken out of context":

 1. Dr. Berwick is an avowed supporter of and contributor to the British National Health Service (NHS). This is important because the NHS relies on rationing to control costs and routinely denies or delays access to life-saving treatments that are commonly available in the U.S.. In addition to having been bestowed with an honorary knighthood for his contributions to the NHS, Dr. Berwick has called the NHS "not just a national treasure" but "a global treasure.".

 2. Dr. Berwick has praised the NHS rationing body, the National Institute for Health and Clinical Excellence (NICE), and recommended that the U.S. follow its lead, saying that NICE has "developed very good and very disciplined, scientifically grounded, policy-connected models for the evaluation of medical treatments from which we ought to learn." NICE has recommended the denial of access to many treatments that are widely available in the United States, such as those treating various types of cancer including lung cancer, recurrent cervical cancer, and colorectal cancer. 

 3. Dr. Berwick has also routinely made statements in support of government rationing in this country, saying for example: "the decision is not whether or not we will ration care- the decision is whether we will ration care with our eyes open."

 4. When it comes to health care Dr. Berwick is staunchly anti-free market, and pro-government control. He has said: "I cannot believe that the individual healthcare consumer can enforce through choice the proper configurations of a system as massive and complex as health care. That is for leaders to do." He is also a proponent of single-payer healthcare, saying that "if I could wave a wand...health care [would be] a common good- single-payer, speaking for and buying for the common good."

 5. Dr. Berwick is also very suspicious of new innovation in the health care marketplace, often lamenting the role of new drugs and technologies and saying for example: "one of the drivers of low value in health care today is the continuous entrance of new technologies, devices, and drugs that add no value to care." And he has famously said that "most people who have serious pain do not need advanced methods; they just need the morphine and counseling that has been around for centuries."

 6. Along these lines, Dr. Berwick has advocated for global spending caps on health care, saying: "it may be necessary to set a legislative target for the growth of spending at 1.5 percentage points below currently projected increases and to grant the federal government the authority to reduce updates in Medicare fees if the target is exceeded."

 7. Finally, Dr. Berwick views single-payer, government-controlled health care as a means of redistributing wealth. He has said: "any health care funding plan that is just, equitable, civilized, and humane must- must- redistribute wealth from the richer among us to the poorer and less fortunate."

 Kathleen, as a member of the Senate Finance Committee, it is my responsibility to thoroughly vet this nominee. I will continue to examine Dr. Berwick's positions and background, and it is my sincere hope that you and I can cooperate throughout this process to insure that Kansans and all patients, especially our seniors, are protected from government rationing.

      Sincerely,

      U.S. Senator Pat Roberts

 Senator Roberts is a member of the Senate Committee on Finance and the Senate Health, Education, Labor and Pensions Committee.

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