Courtesy of Donald Berwick
Some Republicans are imagining what a confirmation hearing for Donald Berwick would have been like.
Folks around here are still chuckling at the latest satire to flow from the quills of Republican congressional staffers.
In case you missed it, a clever, imaginary transcript of Medicare chief Dr. Donald Berwick's confirmation hearing — a congressional showdown that never happened — was circulated by Republicans on the Joint Economic Committee, earlier this week.
"Our imaginary hearing may be in a satirical vein, but the Administration’s decision to avoid a real one was a serious and disturbing violation of constitutional norms," the Republicans wrote.
President Obama used a recess appointment during the July 4th break to install Berwick as the administrator of the Centers for Medicare and Medicaid Services, dodging a hearing that was sure to be contentious.
Republicans previewed the questions they would have liked to ask the physician and Harvard professor in the transcript, scouring his past remarks and writing to supply answers in Berwick's own words. The Dadaist tactic focused particularly on remarks that Republicans say show a proclivity for medical rationing and British-style health care.
The sources of Berwick's remarks are carefully cited in the piece, but the Republican authors do make some use of poetic license.
For instance, an imaginary Republican senator asks whether Berwick believes bureaucrats should choose which treatments his own wife could get if she became ill. The authors draw his answer from a 1986 paper on neonatal intensive care that appeared in the journal Respiratory Care.
"The need to balance effectiveness against cost has shifted the burden of proof onto the shoulders of those who use or propose to use expensive technologies," he wrote then. That reference might sting because Berwick's wife became seriously ill in 1999.
Sen. Sam Brownback, of Kansas, and Rep. Kevin Brady, of Texas, are the senior Republicans on the Joint Economic Committee. The Senate Finance Committee, however, has jurisdiction over appointments to the Medicare agency.
Another choice exchange: So-called 'Senator B' asks Berwick how the British system provides health coverage to more people for less money. He replies — in a quote drawn from a 2008 address commemorating the 60th birthday of England's National Health Service — that they "place the politicians between the public served and the people serving them." That could have come from a GOP talking-points memo.