Chris Wallace claimed that President Obama used a recess appointment to install Center for Medicare & Medicaid Services head Donald Berwick to avoid defending Berwick's “controversial statements” regarding health care rationing and Britain's National Health Service. Wallace's comments, echoing right-wing media attacks on Berwick, omitted his criticisms of NHS and accurate statement that health care rationing is already happening.
Wallace mimics right-wing attacks on Berwick
Wallace: airs “controversial statements” from Berwick. While interviewing White House senior adviser David Axelrod, Wallace suggested that “the real reason” Berwick was recess-appointed was because the Obama administration “didn't want to defend some of his controversial statements.” Wallace then aired Berwick's “controversial statements” on NHS and health care rationing, claiming they show “he favors government controls on health care.”
From the July 11 edition of Fox Broadcasting Co.'s Fox News Sunday:
WALLACE: Isn't the real reason that Berwick got a recess appointment because you didn't want to defend some of his controversial statements?
AXELROD: Absolutely not.
WALLACE: Let me just put them up on the screen, then you can respond. Here's Berwick on the National Health Service of Britain: “I am romantic about the NHS. I love it.” Here's Berwick on government involvement in health care: “The decision is not whether or not we will ration care, the decision is whether we will ration with ... eyes open.” The fact is Berwick will have a budget bigger than the Pentagon and he favors government controls on health care.
Conservative bloggers made similar attacks. As Media Matters documented, right-wing media figures like Erick Erickson have used these quotes to attack Berwick's appointment, claiming that he “openly wants to destroy the American medical system” and prefers Britain's system “where some people die waiting in line for medical treatment.” The Fox Nation has also attacked Berwick as a “Health Care Rationer Running Medicare.”
Berwick also criticized British NHS
Berwick: “Is the NHS perfect? Far from it.” In the same speech that Wallace cited, Berwick said that NHS was “far from” perfect and that “the NHS has a lot more work ahead.” Berwick then listed 10 suggestions for how the NHS could further improve. From Berwick's 2008 speech:
BERWICK: Is the NHS perfect? Far from it. Far from it. I know that as well as anyone in this room, from front line to Whitehall, I have had the privilege of observing performance and even to help to measure its performance.
BERWICK: There is less progress in some areas, especially with comparison to other European systems, such as in specialty access, in cancer outcomes, in patient centeredness, in life expectancy and infant mortality for socially deprived populations. In other words, in improving its quality, two facts are true: The NHS in en route, and the NHS has a lot more work ahead.
Axelrod to Wallace: "[Y]ou pulled quotes out of longer pieces." Axelrod pushed back against Wallace's misleading characterization of Berwick's statements, noting that Berwick was “quite critical” of NHS:
AXELROD: The fact is that you pulled quotes out of longer pieces. He was also quite critical of elements of the British system, and when he was talking about rationing --
WALLACE: “I am romantic about the NHS. I love it” ?
AXELROD: -- when he was talking about -- he had -- was quite critical of aspects of the British system. He is not coming to implement the British system.
In full comment, Berwick explained that current system rations care
With “eyes open” comment, Berwick was saying U.S. system already rations. In the June 2009 interview with Biotechnology Healthcare Wallace cited, Berwick pointed out that the current U.S. health care system rations care, and that the question for the future is how best to ration. Wallace omitted this context on air. From Biotechnology Healthcare, June 2009:
BIOTECHNOLOGY HEALTHCARE: Critics of CER have said that it will lead to the rationing of healthcare.
BERWICK: We can make a sensible social decision and say, “Well, at this point, to have access to a particular additional benefit [new drug or medical intervention] is so expensive that our taxpayers have better use for those funds.” We make those decisions all the time. The decision is not whether or not we will ration care -- the decision is whether we will ration with our eyes open. And right now, we are doing it blindly.
Indeed, insurance companies already ration care. The insurance industry admits to using cost benefit analyses in coverage decisions. In an interview with NPR's Morning Edition, Wellpoint chief medical officer Dr. Sam Nussbaum told co-host Steve Inskeep: “Where the private sector has been far more effective than government programs is in limiting clinical services to those that are best meeting the needs of patients.” Former CIGNA senior executive Wendell Potter testified before the Senate Committee on Commerce, Science, and Transportation that, “To help meet Wall Street's relentless profit expectations, insurers routinely dump policyholders who are less profitable or who get sick.” Potter further testified that insurers “also dump small businesses whose employees' medical claims exceed what insurance underwriters expected.”