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The man who heads the agency that runs Medicare and Medicaid got a curiously quiet reception today in his first appearance before Congress. Back during the debate on overhauling health care, Donald Berwick came to embody everything Republicans hated about the law. President Obama ended up giving Berwick a recess appointment to avoid the grief Republicans threatened to give him during nomination hearings.
But, as NPR's Julie Rovner reports, today, Republicans mostly held their fire.
JULIE ROVNER: To listen to Republicans complaining about his nomination earlier this year, you'd have thought Donald Berwick was a fire-breathing socialist who wanted to ration health care to every American man, woman and child. But the Berwick who appeared before the Senate Finance Committee today was more familiar to those who followed his career as an expert in improving health quality and preventing medical errors. Berwick told the senators he was actually recognized by a Senate security guard on his way to the hearing.
Dr. DONALD BERWICK (Administrator, Centers for Medicare and Medicaid Services): He said, you're Don Berwick, aren't you? And I was startled. I said, yeah, why do you want to know? He said, well, my name is John McCormick, he said, and my daughter was Taylor McCormick. And she died when she was 17 months old because of a medical error. I am devoting myself to making sure that doesn't happen to other children, he said. And I want to do anything I can possibly do to help you in your new job.
ROVNER: Berwick's primary goal at the hearing, however, was to defend the new health law. His agency oversees major aspects of the new measure, including major changes to both the Medicare and Medicaid programs.
Dr. BERWICK: The Affordable Care Act has laid an unprecedented foundation for better patient care.
ROVNER: And while Republicans didn't deliver on many of the threatened personal attacks on Berwick, they did use the relatively brief hearing to go after some of the more unpopular elements of the law, particularly its $500 billion worth of reduced Medicare spending over the next decade. Ranking Republican Charles Grassley noted that independent analysts within Medicare have predicted the cuts to health care providers could ultimately hurt patients.
Senator CHARLES GRASSLEY (Republican, Iowa): Dr. Berwick, would you agree with those comments about the health care bill potentially jeopardizing health care for beneficiaries?
ROVNER: Berwick, however, said he's convinced Medicare patients won't suffer and will, in fact, benefit from the changes that the law makes. Things like better coverage of preventive care and closing the so-called donut hole in Medicare's prescription drug benefit.
Dr. BERWICK: I think they'll find themselves in better shape after implementation of this act.
ROVNER: Utah Republican Orrin Hatch, however, came right back. He accused the administration of double counting the Medicare cuts, saying on the one hand they'll improve the program's fiscal picture, at the same time, the money is being spent to finance other portions of the law.
Senator ORRIN HATCH (Republican, Utah): Now, this is like claiming that the American families can use the same magical dollars to pay their mortgage and their grocery bills at the same time. And it's really nonsensical.
ROVNER: Berwick insisted that's not the case and pointed to the Congressional Budget Office's official estimate. But outgoing Kentucky Republican Jim Bunning did point out a major Medicare issue that the law does not address.
Senator JIM BUNNING (Republican, Kentucky): On December 1st, doctors start getting a 23 percent cut when they see Medicare patients. The cost of fixing this formula is probably somewhere around $300 billion, which will require more cuts to Medicare or adding to the deficit for future generations.
ROVNER: Berwick replied that the administration strongly supports a fix to the physician payment problem. Senate Finance Committee Chairman Max Baucus chimed in as well, saying he's working to avert the December 1st cut. But so far, no one is saying where the money should come from.
Julie Rovner, NPR News, Washington.
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