Healthcare rationing is topic of senator's speech
November 18, 2010
WASHINGTON, DC – U.S. Senator Pat Roberts today called attention to rationing already underway at the Centers for Medicare and Medicaid Services (CMS) under the leadership of Administrator Dr. Donald Berwick and as a direct result of the new health care law. He concluded his remarks by asking when the American people can obtain waivers for mandates in Obamacare like those 111 waivers granted to unions and other employers.

The following is the text of Senator Roberts’ remarks delivered on the Senate floor:

“One of the major problems with the new health care law is the huge amount of power and authority that it grants to one man- the Administrator of the Centers for Medicare and Medicaid Services, Dr. Donald Berwick.

“And one of the major problems with Dr. Berwick is his long-standing, well-documented support for government rationing as a means of controlling health

care costs.

“Yesterday, the Senate Finance Committee finally had our very first chance to question Dr. Berwick. I say finally because for months my colleagues and I have requested this opportunity, a request which was denied when President Obama recess appointed Berwick.

“Yesterday’s hearing was a hollow one of sorts, since Dr. Berwick has already been installed at CMS for several months, but an important opportunity all the same. Unfortunately, we were only given five minutes each to question the most important man in American health care today.

“Five minutes sandwiched in between lengthy remarks by the Chairman and the witness, and floor votes.

“When Ranking Member Grassley asked Dr. Berwick if he would commit to appearing before the Committee again so that we could continue our oversight, Chairman Baucus interrupted his response and refused to make any further commitments.

“How’s that for transparency?

“Because I was not able to ask Dr. Berwick my questions yesterday, I’d like to ask them here.

“Dr. Berwick knows that my number one concern with President Obama’s health law is the enormous potential for the government to interfere in the treatment decisions of the doctor and patient.

“Dr. Berwick has a long history of statements supporting government control of treatment decisions, what I would call ‘rationing.’

“Dr. Berwick has said that ‘most people who have severe pain do not need advanced methods; they just need the morphine and counseling that have been around for centuries.’

“He has publicly stated an aversion to new medical technology and health care advances saying: ‘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.’ He refers to this as an ‘excess supply’ of health care.

“And of course we have his infamous quote that: ‘the decision is not whether or not we will ration care- the decision is whether we will ration care with our eyes open.’

“It then should come as no surprise that CMS under Dr. Berwick’s leadership has embarked upon a path of increasing government control, centralized decision-making, and top-down mandates that treat doctors as nothing more than cooks practicing ‘cookbook medicine’, and patients as nothing more than numbers, despite their individual needs and desires.

“One example: attempts by CMS to restrict the number of times seniors with diabetes can test their blood sugar by limiting them to one test strip per day, regardless of what their doctor recommends.

“Doctors understand that diabetes care is an exceedingly complex and personalized enterprise.

“Dr. Berwick: why CMS is replacing the judgment of a doctor on how many times their patient should test their blood sugar with a ‘CMS-knows-best’ approach?

“An even more egregious example of the government getting in between patients and doctors is Dr. Berwick’s recent investigation into the Medicare coverage of the life-extending prostate cancer therapy PRO-venge.

“Provenge is a therapeutic vaccine approved by the Food and Drug Administration to treat late-stage prostate cancer through an innovative process that removes immune system cells from patients, exposes them to cancer cells and an immune system stimulator, and then injects them back into the patient.

“Provenge has been shown to increase life expectancy by an average of four months- but sometimes longer with one patient living an additional seven years.

“In addition, Provenge is special because of its lack of side effects as compared to traditional chemotherapy. So not only can patients live longer, but their quality of life will be better.

“Medicare coverage for FDA-approved drugs is usually automatic.

“Dr. Berwick: why did you initiate a coverage investigation so soon after Provenge was approved? Why is CMS seeking to substitute its judgment for not only patients and doctors, but for the FDA- the gold standard for drug approval worldwide? Are you questioning the FDA’s decision?

“I know the answer to that one. Cost- $93,000 for a complete cycle of Provenge- is the driving factor behind this investigation.

“I am very concerned about the precedent that this sets- not only for other cancer regimens like the promising breast cancer drug Avastin- but for all new medical innovations.

“Some may say that an extra four months of life is not enough to justify this high price tag.

“First, the government should not be in the business of placing dollar values on life. Period.

“Secondly, traditional chemo and all of its associated side effects costs Medicare upwards of $110,000 per patient per year. Provenge is actually a cost saver when viewed in that context!

“Third, this is exactly the type of innovative approach that we need to win the fight against cancer. Medical advances don’t always come in giant leaps- they more often occur at the margins. We should not deny patients and doctors treatment options simply because they don’t offer a complete cure. That is short-sighted, not to mention cruel.

“Finally, if we want companies and investors to continue to pour their dollars and efforts into developing a cure for cancer, this is the wrong approach. The investment into researching and developing Provenge approached $1 billion over 15 years and 15 clinical trials. Refusing to allow a return on this huge investment will send a chilling effect across the health research industry, resulting in less investment and less innovation.

“But maybe less innovation is actually the goal of this Administration and of Dr. Berwick who has targeted the ‘entrance of new technologies, drugs, and devices’ as ‘one of the drivers of low value in health care today.’

Value is a subjective concept.

“Dr. Berwick, I’d prefer that the value of health care be determined by the patient and the doctor, not the government. Would you agree?

“Finally, I have been shocked by the number of Obamacare waivers that have been coming out of the Department of Health and Human Services. According to the New York Times, 111 waivers have been granted to employers to allow them to avoid the new health insurance mandates.

“The only thing more shocking than the number of waivers is who is getting them. Would you believe that they are some of the most ardent supporters of health care reform?

“Unions like the Service Employees International Union (SEIU), the United Federation of Teachers, and the Transport Workers Union have all applied for and been granted waivers from the rules.

“The fact is, Obamacare is bad for business, bad for workers, bad for seniors, and bad for taxpayers.

“Dr. Berwick, Health and Human Services Secretary Kathleen Sebelius, When will the American people get a waiver from Obamacare?

“Repeal this bill.”

Senator Roberts (R-KS) is a member of the Senate Finance Committee and a member of the Senate Committee on Health, Education, Labor and Pensions. He voted against


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Did he put his mouth where the money is?ma-earth213402010-11-18 11:30:06