Panel queries Medicare chief

Republicans say hearing too short to be meaningful

Donald Berwick, President Obama’s chief health care adviser, testified before the Senate Finance Committee yesterday. (Joshua Roberts/Bloomberg News)

By Ricardo Alonso-Zaldivar

Associated Press / November 18, 2010

Text size – +

WASHINGTON — As a physician and thinker, Donald Berwick was known as one of the nation’s leading health care innovators. As President Obama’s Medicare chief, he has been a mystery man — until yesterday.

The 64-year-old Boston pediatrician appeared before the Senate Finance Committee four months after his appointment as the only Medicare administrator to assume the post without Senate confirmation. But the tightly orchestrated hearing left Republicans complaining they were given only a nibble at his record.

Berwick told senators that he opposes rationing of health care and that even people who are near death have a right to treatment. As a matter of principle, he said, he believes patients should get “all the care they want and need, when and where they want and need it.’’

Health care savings should be squeezed by avoiding medical mistakes, eliminating waste and duplication, and helping people with chronic illnesses manage better so they can stay out of the hospital, he said.

Finance chairman Max Baucus, Democrat of Montana, introduced Berwick as Obama’s point man on health care overhaul. The law makes Medicare the laboratory for new models of care, such as turning primary care practices into “medical homes’’ that use nurses to keep close tabs on frail patients in the community. Berwick is also responsible for Medicaid and children’s health insurance.

Before his nomination, Berwick taught at Harvard University and headed the Institute for Health Care Improvement, a hands-on think tank that promotes coordination in a fragmented health care system. Republicans had raised questions about his praise for the British health care system, saying it revealed a bias toward big-government approaches that could lead to rationing here.

Democrats say Obama went around Congress to appoint Berwick because the White House did not want a key player sidelined for months by partisan wrangling.

Berwick asserted that he doesn’t think a one-size-fits-all approach works in a country as diverse as the United States.

GOP senators were skeptical of Berwick’s assurances. Orrin Hatch, a Utah Republican who next year will be the committee’s senior Republican, said the 90-minute hearing did not allow enough time to explore complicated questions.