bureaucratic intervention in intimate decisions between patients and their doctors, he has an embarrassingly unsophisticated perspective concerning it. Recall his statement, “If there’s a blue pill and a red pill and the blue pill is half the price of the red pill and works just as well, why not pay half-price for the thing that’s going to make you well?” 56 Or how about this gem from Dr. Barack: “We’re going to start encouraging paying doctors not based on how many tests they take, but based on the quality of the outcome—does somebody end up healthy.... If you go to the doctor you get one test. Then (you are) referred to a specialist, you get another test. Then maybe you go to a third person, the surgeon, you get a third test—it’s all the same test but you’re paying three times. So . . . we’ll pay you for the first test and then e-mail the test to everybody. Right? Or have all three doctors in the room when the test is being taken.” 57
Obama appointed Donald Berwick, CEO of the Institute for Healthcare Improvement, to be the administrator for the Centers for Medicare and Medicaid Services (CMS). According to Robert M. Goldberg of the Center for Medicine in the Public Interest, the role of the CMS will be expanded under ObamaCare to define “the quality of health care for every insurance plan, set reimbursement rates for physicians in Medicare and Medicaid, and decide what treatments are more ‘valuable’ than others.” Goldberg surmises, “Berwick will get control of the practice of medicine.”
The CMS will have the sweeping power “to unilaterally write new rules on when medical devices and drugs can be used, and how they should be priced” as part of ObamaCare’s strategy of “retaining costs through controls on specialist physicians. Based on the government’s premise that they often make wasteful treatment decisions,” ObamaCare “will subject doctors to a mix of financial penalties and regulations to constrain their use of the most costly clinical options.” 58
It would be disturbing enough for any person to have such broad authority, but Obama’s choice—Donald Berwick—is not just any person. Like Obama, he believes in radical wealth redistribution and that socialized medicine is an ideal vehicle to achieve it. Don’t take my word for it, take Berwick’s: “Any health care funding plan that is just, equitable, civilized and humane must ... redistribute wealth from the richer among us to the poorer and the less fortunate,” he said, adding, “Excellent health care is, by definition, redistributional.” Berwick also idealizes the ineffectual, scandal-plagued British healthcare system, condemning America’s system for running in the “darkness of private enterprise.” 59
Writing of Britain’s National Health Service rationing, Berwick said, “You plan the supply; you aim a bit low; historically, you prefer slightly too little of a technology or service to much too much; and then you search for care bottlenecks, and try to relieve them.” Goldberg notes that in 2008 Berwick’s pet British system “denied cutting edge cancer drugs to 4,000 people, forcing thousands to remortgage their homes to pay for treatment. Love is blind. With regard to Dr. Berwick’s devotion to the NHS, it’s deaf and dumb as well.” 60
ObamaCare’s architects ultimately intended to ration care because that was the only way these command-control types knew to reduce costs. They are philosophically on board with Obama’s idea that a bureaucracy’s payment determination can’t be influenced by a person’s spirit and “that at least we can let doctors know and your mom know that... this isn’t going to help. Maybe you’re better off not having the surgery, but taking the painkiller.” 61 They believe in substituting their value judgments for the freedom of choice of American healthcare patients as to whether they need care. Under a free system, a patient can spend as much or as
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