Special Report

Bowdlerizing Berwick

The media campaign to sanitize Donald Berwick's record.

By 7.12.10

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Thomas Bowdler was an English physician whose desire to publish an edition of Shakespeare amenable to 19th-century sensibilities led him to sanitize many of the Bard's juiciest passages. The result was predictably risible. One of his most hilarious revisions was to change Lady Macbeth's cri de coeur, "Out, damned spot," to "Out, crimson spot!" As absurd as it was, this project did preserve the good doctor's name for posterity in the verb "bowdlerize." And it would be difficult to come up with a better term to describe what the establishment media have attempted to do with the record of Donald Berwick, the Harvard pediatrician whom our President just appointed Administrator of the Centers for Medicare & Medicaid Services (CMS).

Although most Americans had probably never heard of Berwick before last Wednesday's recess appointment, he is well-known in the health care industry. And there, as the Swan of Avon would put it, is the rub. He has written and spoken extensively, and his views concerning wealth redistribution, rationing, and the free market are very much at odds with those of mainstream health policy experts as well as the electorate. Moreover, he has not been reticent about revealing his positions in writing and public statements. This is one of the reasons Obama chose to bypass the Senate confirmation process and it is why Democrat-friendly journalists and bloggers have worked diligently, since his nomination last April, to bowdlerize Berwick's record.

One of the most disingenuous attempts to sanitize Berwick's radical views was produced by the New Republic's Jonathan Cohn: "He'll redistribute wealth That's what Republicans said about President Barack Obama Now they're saying it about Donald Berwick." In other words, the GOP has fired up its mythical "noise machine." A quick perusal of Berwick's positions, however, makes it obvious that the Republicans haven't distorted his record at all. Here's one of his most widely publicized assertions on health reform: "Any healthcare funding plan that is just, equitable, civilized and humane, must redistribute wealth" Such statements make it difficult to honestly argue that Berwick is not for redistribution.

Faced with this inconvenience, some of Berwick's bowdlerizers have shrunk from Cohn's brand of brazen dishonesty. They have instead argued that Berwick's comments are unremarkable. At Media Matters, for example, Matthew Gertz writes that all government health care programs are redistributive: "Medicare and Medicaid redistribute wealth from those who can afford private insurance to those who cannot." This argument is not merely inaccurate -- millions of middle-class and wealthy seniors are on Medicare -- it is logically incoherent. Dr. Berwick's fondness for spreading the wealth around is not rendered reasonable by the regrettable fact that Washington bureaucrats already rob Peter to pay for Paul's health care.

Another member of the "What's all the fuss about?" school is Washington Post blogger Ezra Klein, who attempts to decontaminate Berwick's toxic assertion that "the decision is not whether or not we will ration care; the decision is whether we will ration with our eyes open." Claiming that Republican Paul Ryan told him much the same thing in an interview, Klein insinuates that even conservatives accept the need for state-imposed rationing. But Klein is being less than candid about the congressman's words. In reality, Ryan repudiated Berwick's statist philosophy: "[R]ather than having government ration care to manage decline, let's take those market signals that work in every sector of the economy to reduce cost and improve competition."

Berwick's view of rationing is, in fact, the opposite of Ryan's. The latter believes it should be driven by the informed decisions of consumers in a free market, while our new CMS head has summed up his contempt for the intelligence of patients as follows: "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." And yet the media consistently portray Berwick as an advocate of patient-centered care. The New York Times ran a piece last month titled "Letting the Patient Call the Shots," which credits Berwick with advocating a health system that would "transfer control from doctors to the patients themselves."

Ironically, the deceptive journalism of Cohn, Klein, et al. is largely gratuitous. There are more subtle ways to bowdlerize Berwick's record. One method Bowdler himself used to sanitize Shakespeare was to simply eliminate all references to certain "offensive" characters. And, in fact, some media outlets have followed his example by editing Berwick out of the news. Geoffrey Dickens reports, "[T]here was no mention of the President's decision to make the recess appointment on Tuesday night's NBC Nightly News, CBS Evening News or ABC's World News. In fact the embargo on the information continued through Wednesday morning as there were zero mentions on ABC's Good Morning America and CBS's The Early Show."

Donald Berwick's views on wealth redistribution, rationing. and the free market are far to the left of mainstream public opinion, and a wide variety of conservative and libertarian health care experts have correctly identified him as a clear and present danger to our medical delivery system. Thus, having abetted the Democrat health care agenda by deliberately hiding the ugliest features of Obamacare, the establishment "news" media are now attempting to sanitize the record of Obama's radical new CMS administrator. This incredibly dishonest campaign provides yet more evidence that the Fourth Estate itself is a clear and present danger -- to the republic.

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About the Author

David Catron is a health care revenue cycle expert who has spent more than twenty years working for and consulting with hospitals and medical practices. He has an MBA from the University of Georgia and blogs at Health Care BS.