Berwick: More Dr. Death mongering

The Globe’s Susan Milligan reports today on the attempt by Republicans to tag Harvard professor Donald Berwick as a death merchant.  Berwick runs a research program that looks at ways to cut waste and improve health care services.  He is up for the job as head of The Center for Medicare and Medicaid Services, an agency that has the power to make major changes in the way health care is funded and delivered.   

GOP’s senators are making it clear they plan to turn Berwick’s confirmation hearings into a forum for continuing debate over the newly-minted health care overhaul law. Republicans believe hammering at the law will help them win seats in the fall’s midterm elections.

Senate Republican leader Mitch McConnell of Kentucky said on the Senate floor last night that Berwick is an “expert on rationing.’’

By lauding the United Kingdom’s National Health System, McConnell said, Berwick “is applauding a system where care is delayed, denied, or rationed.’’

 At one time, only insurance companies and hosptials  balked at changes in the way we pay for care. The social conservatives stuck to abortion. Now, all that has changed. For more on that see the November 30 issue of The New Yorker  for a story on the Karen Ann Quinlan case — “The Politics of Death.”  Jill Lepore talks about how a hospital ethics panel had to decide whether the comatose women could ever recover. As she put it “These ethics committees are now better known as death panels.”

 The New Yorker has a pay wall so if you don’t have a subscriptions, it’s off to the library. You can read the abstract first.

 The Quinlan case marked a fundamental shift in American political history: in the decades since Quinlan, all manner of domestic-policy issues have been recast as matters of life and death—urgent, uncompromising, and absolute. Mentions Pope Paul VI’s “Of Human Life” and the Roe v. Wade decision in 1973. Two years later, the Quinlan case brought the end of life into the halls of government. In the wake of Roe and Quinlan, a very small but by no means inconsequential number of people have come to believe that Congress, the President, the courts, and assorted unnamed bureaucrats are plotting to deny medical care to the very sick and the very old, to babies born with deformities, to the elderly and infirm, to the ailing and the poor, to the disabled and insane. Most recently this conspiracy theory hijacked health-care reform.




Priorities for Comparative Effectiveness + Senate and health reform

The Institute of Medicine, a Congressional research arm, released a list of  “100 health topics  (.pdf) that should get priority attention and funding from a new national research effort to identify which health care services work best.”

Among the high priority issues: atrial fibrillation, hearing loss, fall prevention for the elderly, MRSA prevention, localized prostate cancer,  lower back pain, Alzheimer’s disease, a form of breast cancer called Ductal Carcinoma In Situ, ADHD, unintended pregnancies and obesity.    

For more on effectiveness research and the conservative objections to it see my earlier post.

If you have a cold, what should you do? Take aspirin? Vitamin C? Flush your sinuses out with a little pot that looks like a lamp a kid would rub to release a genie? (I have one of those.) What about pain from gallstones? Should you let a doctor take out your gall bladder?  (I used to have one of those.)

Among those who sat on the panel: Brigham and Women’s Hospital president Dr. Gary L. Gottlieb, Dr. JoAnn E. Manson, also of the Brigham, and head of the Women’s Health Initiative and and Dr. James N. Weinstein of the Dartmouth Institute for Health Policy and Clinical Practice, which has been leading research into the area for years.



Also, Sens. Kennedy and Dodd yesterday proposed a less expensive version of the health reform plan put forward by Senate Democrats. Kaiser Health News has a good round up of stories — including some that question the senators’ math. This from CQ Politics:

Democrats have struggled with CBO to get the agency’s cost estimates of their legislation down to a less staggering price tag. Dodd alluded to the behind-the-scenes negotiations during the Thursday conference call, at a point when he thought reporters were unable to hear him.”This is great news, staff really did a wonderful job,” he told other senators who had joined him on the call. “I talked to [CBO director] Doug Elmendorf more times over the weekend, trying to get these numbers. It got to be pretty frustrating. The results are great”