Previewing the partisan healthcare battle to come next year, the Obama administration's new head of Medicare and Medicaid went to the Capitol on Wednesday to defend the new healthcare law against irritated Republican lawmakers for the first time.
Dr. Donald Berwick, whom Obama appointed in July without Senate confirmation to help lead implementation of the new healthcare law, told lawmakers that repealing the law would be a major a mistake.
"I can't think of a worse plan," Berwick, a pediatrician and leading advocate for improving healthcare quality, told the Senate Finance Committee.
"It would mean that seniors would not be getting the 50% discount on prescription drugs," he said. "Would we tell them … that they will not be able to afford life-saving medicine? Would we tell them they would not be getting life-saving access to preventive services?
"That we won't work on safer care? That we're not going to be more transparent? That we're not going to work hard on fraud and abuse?
But Republican lawmakers repeatedly returned to the circumstances of Berwick's appointment. Obama made the appointment during a congressional recess, allowing Berwick to avoid testifying before Congress.
"This a doggone important committee. We overview 60% of the spending in this country," said Utah Sen. Orrin G. Hatch, who is in line to become the senior Republican on the committee next year.
"I want to know what's going on. I want answers to my questions. This is pathetic."
Hatch complained that Senate Finance Committee chairman Max Baucus (D-Mont.) allowed an hour and a half for the hearing.
The White House made the controversial decision to avoid a congressional confirmation fight over the summer when GOP lawmakers launched a media blitz to portray Berwick as an advocate for rationing care, an accusation that was refuted by leading Republican healthcare experts who defended Berwick.
As head of the Centers for Medicare and Medicaid Services, Berwick oversees an agency that provides healthcare to more than 90 million Americans and has a budget larger than the Pentagon's.
In Wednesday's short hearing, no one repeated the charges against Berwick. But Sen. Jim Bunning (R-Ky.) warned Berwick he would face tougher questions in the new Congress when Republicans take control of the House of Representatives.
"I can assure you that you will not get special treatment next year," Bunning said.
Baucus said he would hold hearings in the Senate as well. But he would not commit to holding another hearing with Berwick before the end of the year.