Wednesday, November 17, 2010

What To Watch For at This Morning’s Berwick Hearing

CMS Administrator Dr. Donald Berwick finally comes to Capitol Hill this morning, to testify before the Senate Finance Committee.  A couple of key points and themes that may emerge from the proceedings:

It’s About Time:  While many Republicans will argue that a hearing with Dr. Berwick is long overdue, given both his agency’s broad jurisdiction and the multiple previous requests made for his appearance, it’s possible this morning’s hearing may be cut short.  There are a series of votes scheduled for 11:00 – votes that were publicly announced six weeks ago, and known to the majority at the time the hearing was scheduled last week.  So it’s worth asking whether this hearing will be an opportunity for rigorous and thorough scrutiny of Dr. Berwick’s record, and his implementation of the 2,700 page health care law, or merely a “tick-the-box” exercise designed to say Dr. Berwick has testified before Congress whilst avoiding the tough questions on the key issues.

Transparency Much?  A widely leaked copy of his written testimony notes Dr. Berwick’s “pledge…to be as open and transparent as possible” in his dealings.  If that’s the case, why did Dr. Berwick renege on a commitment to release information about the funding sources of the Institute for Healthcare Improvement (IHI) that he headed prior to his appointment?  Dr. Berwick pledged to Sen. Grassley in June that he would disclose IHI’s funding sources – at a time when he remained the organization’s CEO.  However, he chose to ignore his commitment until after his recess appointment, at which point he claimed to Sen. Grassley that he could not honor his earlier pledge because he no longer was affiliated with IHI.  If Dr. Berwick is interested in being “open and transparent,” why didn’t he release his non-profit organization’s financial records when it was in his power to do so?

A “Point-by-Point Rebuttal?”  Astute readers may note that a late July article in the New York Times claimed that Dr. Berwick’s “friends and allies said he was preparing a point-by-point rebuttal [to his critics], most likely to be delivered when he first testifies before Congress.”  A review of his written testimony reveals no such rebuttal to his many controversial statements over the years; in fact, the testimony does not acknowledge his earlier comments at all.  If Dr. Berwick wants “to be as open and transparent as possible,” where is this rebuttal document publicly discussed in the New York Times four months ago?