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White House Defends Medicare Nominee

By John Reichard and Emily Ethridge, CQ Staff

May 13, 2010 -- In an exchange that presages a bruising confirmation battle, the White House hit back hard Wednesday night against Republican attempts to cast Donald M. Berwick, the president's nominee to lead the Centers for Medicare and Medicaid Services, as someone who would deny patients necessary care.

Berwick, a professor of pediatrics at Harvard Medical School and the head of the nonprofit Institute for Healthcare Improvement, traveled to the Capitol on Wednesday to meet with Kansas Republican Sen. Pat Roberts, one of his fiercest critics, in advance of his confirmation hearing before the Senate Finance Committee.

But the visit apparently did little to change Roberts' views.

"Most of us will agree that he is the wrong man, wrong time, wrong job," Roberts said on the Senate floor afterward.

Roberts has assailed Berwick's work on comparative effectiveness research to determine which treatments and medicines are most effective. Republicans contend that it might be used to deny payment for treatments determined to be less effective in studies of a broad population. GOP members also raised that argument to criticize the health care overhaul (PL 111-148, PL 111-152).

Roberts also portrayed Berwick as supporting rationing patient care at the end of life, quoting the pediatrician as saying that "most people who have serious pain do not need advanced methods; they just need the morphine and counseling that have been around for centuries."

Sounding one of the themes that drove opposition to the president's health care overhaul, Roberts said, "This is very similar to the president's remarks about the elderly approaching the end of their life."

The White House denounced the remarks as a distortion of Berwick's record and an effort to rehash unsuccessful arguments about the health care overhaul.

Spokesman Reid Cherlin said Republicans were trying to use the confirmation process to "trot out the same arguments and scare tactics they hoped would block health insurance reform."

"The fact is," Cherlin said, "rationing is rampant in the system today as insurers make arbitrary decisions about who can get the care they need. Don Berwick wants to see a system in which those decisions are transparent — and that the people who make them are held accountable."

Berwick is also slated to meet soon with Minority Leader Mitch McConnell, R-Ky., Majority Leader Harry Reid, D-Nev., and Finance Committee Chairman Max Baucus, D-Mont., according to aides. A date for his hearing before the Senate Finance Committee has not been set.

Cherlin said the president looked forward to Berwick's confirmation.

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