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All Da King's Men

Dr. Donald Berwick, A Real Life Wesley Mouch

By Da King Published: July 16, 2010

In Ayn Rand's classic novel, Atlas Shrugged, the character of Wesley Mouch is a Washington lobbyist who eventually becomes the country's economic dictator, controlling all commerce and industry. Mouch intentionally destroys free enterprise, thus destroying the opportunities of the common man along with it.

After reading a Wall Street Journal piece by Daniel Henninger, in which Henninger highlights many of the ideas of Dr. Donald Berwick, Obama's recess appointment to head the Centers for Medicare and Medicaid Services (CMS), I believe we have found a real life Wesley Mouch. I find Mouch's, er, I mean, Berwick's ideas to be absolutely chilling. Let me know if you feel the same way. Following are some selected quotes from Dr. Berwick:

Big Brother Knows Best: "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."

If The Patient Dies, So Be It: "You cap your health care budget, and you make the political and economic choices you need to make to keep affordability within reach."

Leaders With Plans: "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."

I can think of many "leaders with plans" who distrusted the free market - Mao, Stalin, Lenin, Hitler, Che, Castro, Hugo Chavez, Mugabe, Obam...well, you get the picture. If frequently turns out to be a nightmare.

Death Panels, Part I - Denying Care: "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."

Death Panels, Part II - Limiting Supply: "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."

Death Panels Part III - Limiting Supply Drastically: "About 8% of GDP is plenty for 'best known' care."

The U.S. currently spends about 16% of GDP on health care. ObamaCare is supposed to add 31 million more people to the insured rolls, and at the same time, Berwick thinks we can cut spending in half. I guess we can, if we deny care to, say......SICK PEOPLE.

Yes, We Get It. You're Going To Limit Supply: "A progressive policy regime will control and rationalize financing—control supply."

You Ignorant Hicks Can't Make Your Own Health Care Choices: "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."

It Doesn't Sound Very Good So Far: "Health care is a common good—single payer, speaking and buying for the common good."

Screw The Patient: "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."

Kill Free Enterprise, Says Mouch: "For-profit, entrepreneurial providers of medical imaging, renal dialysis, and outpatient surgery, for example, may find their business opportunities constrained."

We'll Wait Until You Have Late Stage Terminal Cancer. It's Cheaper: "One over-demanded service is prevention: annual physicals, screening tests, and other measures that supposedly help catch diseases early."

Doctor Doesn't Know Best: "I would place a commitment to excellence—standardization to the best-known method—above clinician autonomy as a rule for care."

Doctor Doesn't Know Best, Part II: "Young doctors and nurses should emerge from training understanding the values of standardization and the risks of too great an emphasis on individual autonomy."

Communism Is Better: "Political leaders in the [British] 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."
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For once, I'm almost speechless. Our anti-hero, Dr. Wesley Mouch, wants to insert the government directly between the doctor and the patient, standardizing life-and-death decisions from the top, rationing care, putting money above the patient's well-being, and acting like a communist dictator in general. I wonder if we'll have any doctors left after Dr. Mouch's plans are implemented. No wonder Obama didn't run this little Hitler past a Senate confirmation hearing, where his views would have been made public. It probably would have started a riot.

Henninger makes a summarizing point:

Vilifying Dr. Berwick alone for his views is in a way beside the point. Within Mr. Obama's circle they all think like this. Defeat Dr. Berwick, and they will send up 50 more who would pursue the same goals [ great...like I'm not depressed enough already]

If the American people want the world Dr. Berwick wishes to give them, that's their choice. But they must be given that choice with full, televised confirmation hearings.

Barack Obama, Donald Berwick and the rest may fancy themselves philosopher kings who know what we need without the need to inform or persuade us first. That's not how it works here.

Well, that's not how it's SUPPOSED to work here, but that's exactly how it IS working, and that's the problem.

The only other thing I can say is...Don't Tread On Me.

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