July 15, 2010

Berwick and Kagan DQ Themselves

I haven’t commented in the Supreme Court nomination of Elena Kagan or the recess appointment of Donald Berwick to the Centers for Medicare and Medicaid Services, largely because the reasons they are disqualified to serve are so evident, and partly because others have done a good job of enumerating them.

In each case, the nominees have disqualified themselves with their own words.

Kagan demonstrates her clear ineligibility to serve in this exchange with Senator Tom Coburn, of Oklahoma:

Coburn: Do you believe it is a fundamental, pre-existing right to have an arm to defend yourself?

Kagan: Senator Coburn, I very much appreciate how deeply important the right to bear arms is to millions and millions of Americans. And I accept Heller, which made clear that the Second Amendment conferred that right upon individuals, and not simply collectively.

Coburn: I’m asking you, Elena Kagan, do you personally believe there is a fundamental right in this area? Do you agree with Blackstone [in] the natural right of resistance and self-preservation, the right of having and using arms for self-preservation and defense? He didn’t say that was a constitutional right. He said that’s a natural right. And what I’m asking you is, do you agree with that?

Kagan: Senator Coburn, to be honest with you, I don’t have a view of what are natural rights, independent of the Constitution. And my job as a justice will be to enforce and defend the Constitution and the laws of the United States.

Coburn: So you wouldn’t embrace what the Declaration of Independence says, that we have certain God-given, inalienable rights that aren’t given in the Constitution that are ours, ours alone, and that a government doesn’t give those to us?

Kagan: Senator Coburn, I believe that the Constitution is an extraordinary document, and I’m not saying I do not believe that there are rights pre-existing the Constitution and the laws. But my job as a justice is to enforce the Constitution and the laws.

Coburn: Well, I understand that. I’m not talking about as a justice. I’m talking about Elena Kagan. What do you believe? Are there inalienable rights for us? Do you believe that?

Kagan: Senator Coburn, I think that the question of what I believe as to what people’s rights are outside the Constitution and the laws, that you should not want me to act in any way on the basis of such a belief.

Coburn: I would want you to always act on the basis of the belief of what our Declaration of Independence says.

Kagan: I think you should want me to act on the basis of law. And that is what I have upheld to do, if I’m fortunate enough to be confirmed, is to act on the basis of law, which is the Constitution and the statutes of the United States.

As Joe Farah at WorldNetDaily noted: “This woman apparently thinks our rights descend from our Constitution, which is crazy,” said Farah. “The Constitution is there to protect our unalienable, God-given human rights – not to define our rights or to invent them.” Bingo. Ring the gong.

Meanwhile, in today’s Wall Street Journal, Daniel Henninger also lets Dr. Berwick nuke himself:

Dr. Berwick’s ideas on the design and purpose of the U.S. system of medicine aren’t merely about “change.” They would be revolutionary.

One may agree with these views or not, but for the president to tell the American people they have to simply accept this through anything so flaccid as a recess appointment is beyond outrageous. It isn’t acceptable.

“I cannot believe that the individual health care consumer can enforce through choice the proper configurations of a system as massive and complex as health care. That is for leaders to do.”

“You cap your health care budget, and you make the political and economic choices you need to make to keep affordability within reach.”

“Please don’t put your faith in market forces. It’s a popular idea: that Adam Smith’s invisible hand would do a better job of designing care than leaders with plans can.”

“Indeed, the Holy Grail of universal coverage in the United States may remain out of reach unless, through rational collective action overriding some individual self-interest, we can reduce per capita costs.”

“It may therefore be necessary to set a legislative target for the growth of spending at 1.5 percentage points below currently projected increases and to grant the federal government the authority to reduce updates in Medicare fees if the target is exceeded.”

“About 8% of GDP is plenty for ‘best known’ care.” (currently it’s about 16% — Ed.)

“A progressive policy regime will control and rationalize financing—control supply.”

“The unaided human mind, and the acts of the individual, cannot assure excellence. Health care is a system, and its performance is a systemic property.”

“Health care is a common good—single payer, speaking and buying for the common good.”

“And it’s important also to make health a human right because the main health determinants are not health care but sanitation, nutrition, housing, social justice, employment, and the like.”

“Hence, those working in health care delivery may be faced with situations in which it seems that the best course is to manipulate the flawed system for the benefit of a specific patient or segment of the population, rather than to work to improve the delivery of care for all. Such manipulation produces more flaws, and the downward spiral continues.”

“For-profit, entrepreneurial providers of medical imaging, renal dialysis, and outpatient surgery, for example, may find their business opportunities constrained.”

“One over-demanded service is prevention: annual physicals, screening tests, and other measures that supposedly help catch diseases early.”

“I would place a commitment to excellence—standardization to the best-known method—above clinician autonomy as a rule for care.”

“Health care has taken a century to learn how badly we need the best of Frederick Taylor [the father of scientific management]. If we can’t standardize appropriate parts of our processes to absolute reliability, we cannot approach perfection.”

“Young doctors and nurses should emerge from training understanding the values of standardization and the risks of too great an emphasis on individual autonomy.”

“Political leaders in the Labour Government have become more enamored of the use of market forces and choice as an engine for change, rather than planned, centrally coordinated technical support.”

“The U.K has people in charge of its health care—people with the clear duty and much of the authority to take on the challenge of changing the system as a whole. The U.S. does not.”

In each instance, read the whole thing.

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3 Comments

  1. When are people like Berwick going to stop lying and pretending the public sector and the government don’t gain financially (profit!) from socialization? More government control equals higher salaries for the public sector and pandering to the public by dispensing ‘free’ goods and services politicians hope to get re-elected and continue grabbing those nice salaries for doing pretty much nothing.

    And it’s funny he mentions the British NHS, which even many socialism advocates admit is horrendous. I guess a more “noble” system does not necessarily mean a better one.

    Comment by zf — July 15, 2010 @ 11:07 am

  2. Berwin’s approach will make health care more affordable, yes indeed, for those that die prematurely while waiting for care. Cash Windfall for Human Clunkers” just in time for re-appearance of the federal estate tax.

    Comment by Michael — July 15, 2010 @ 3:22 pm

  3. [...] Henninger, after providing numerous examples of Berwick’s “revolutionary” ideas in the WSJ says: There is no need to rehearse [...]

    Pingback by Saturday Political Matinee « Nice Deb — July 17, 2010 @ 11:48 am

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