By Robin Strongin. Republicans on Capitol Hill are still steaming over President Obama’s decision to install Dr. Donald Berwick as administrator of the Centers for Medicare and Medicaid Services via a recess appointment (http://www.politico.com/news/stories/0710/39759.html), bypassing the normal confirmation process which would have included a hearing before the Senate Finance Committee.

Now, GOP members of the Finance Committee are insisting, in a letter to committee chairman Max Baucus (D-MT), that a hearing should take place anyway.  In their letter, they argue that the lack of such a forum “casts a shadow over (Berwick’s) legitimacy and authority to serve as administrator during a critical time for CMS.”

That rhetoric may be overhyped.  After all, Berwick is hardly the first nominee, Democratic or Republican, to take office by virtue of a recess appointment.

Nonetheless, there is a legitimate point here that a hearing needs to take place.  But, while Senate Republicans want to grill Berwick on his now-infamous speech that some interpret as extolling the virtues of Britain’s National Health Service, I believe there is a far more compelling reason for him to face congressional inquisitors.

By 2014, approximately 30 million now-uninsured Americans are going to be joining the ranks of those with health coverage and, in so doing, significantly increasing the utilization of health services.  As many analysts have pointed out, if this utilization escalation happens within our current health care system, it’s reasonable to expect health costs to shoot skyward without a commensurate increase in quality and cost-effectiveness.

The new health reform law establishes a framework for developing health care delivery and payment reforms, but it’s just that – a framework.  CMS, the Centers for Medicare and Medicaid Services, is charged with evaluating and selecting demonstration projects that have the potential for nationwide implementation – a process that former CMS administrator Dr. Mark McClellan has said could take a decade.

I want to see Dr. Berwick before the Senate Finance Committee so we can learn more about how he, a strong advocate of delivery reform, plans to accelerate this process.  Our health care system can ill afford to have coverage expansions and essential system improvements be years out of synch.

I mean, let’s be honest here.  Congress isn’t going to allow Don Berwick to transform the U.S. health care system into the British NHS, assuming he really wants to do so.  But the executive and legislative branches do need to work together on making health system improvements a reality sooner rather than later.  That needs to be the subject of the confirmation hearings Dr. Berwick never had.

This entry was posted on Monday, July 19th, 2010 at 1:46 pm and is filed under Advocacy, Health Reform, Medicaid, Medicare, Policy, Politics. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.