CMS
Administrator Donald Berwick, MD, and
CMS Chief Actuary Richard Foster
testified before the House Ways and Means Committee last week at a hearing
titled, “The Impact of the Affordable Care Act on the Medicare Program and
Medicare Beneficiaries.” We were there.
In the fall,
Dr. Berwick testified before the Senate Finance Committee but this was his
first time in front of a House committee. After discussing his background in
medicine and what he views to be the many the benefits of the Affordable Care
Act (ACA), Dr. Berwick held his own during tough questioning. This was also a ‘sniff him over’ process,
given he has been promoted for confirmation again.
In his
opening statement, Chairman Dave Camp (R-MI) noted the contrast between Dr.
Berwick’s optimism on the ACA and Mr. Foster’s bleak outlook for Medicare due
to the ACA. Foster has disagreed with others and the Congressional Budget Office on ACA savings, which Foster
thinks are unlikely to be achieved. Democrats used the hearing to try to “shatter the
myths about reform,” as stated by Ranking Member Sander Levin (D-MI) during his
opening statement. Democrats repeatedly pointed to what they view as the most
popular provisions of the law and what would happen if the law was repealed. In other words, this was a
genuine partisan circus event.
There were
plenty of controversial questions and answers. On tort reform, Dr.
Berwick said he supports “exploring a national solution” on medical liability
but would not comment on non-economic caps. Rep.
Vern Buchanan (R-FL) told Dr.
Berwick about a letter he wrote to CMS regarding concerns of Florida
cardiologists with Medicare payment cuts for cardiology services (this "2010 Rule" issue preceded Berwick’s
coming to CMS, but he’s sure hearing about it). When Rep. Sam
Johnson (R-TX) described physicians no longer participating in Medicare and
having to reduce staff, benefits and charity care, Dr. Berwick stated that
enrollment in Medicare is the highest ever for physicians. Poor Dr. Berwick -- he wants to talk about improving quality and patient
safety and lowering costs in those ways, but there was no chance of that. Too bad he couldn’t just speak his mind, though.
He had a lot of constructive non-partisan things he could have shared there,
but that wasn’t what this hearing was about.
What did we
and the nation learn from this hearing that we don’t already know? Nothing.