Thomas Jefferson, 10 days before his death, politely declined attending 4th of July celebrations in the District of Columbia in a polite letter containing these words:
The general spread of the light of science has already laid open to every view. the palpable truth, that the mass of mankind has not been born with saddles on their backs, nor a favored few booted and spurred, ready to ride them legitimately, by the grace of god.
Today, Barack Obama showed his complete disdain for those words by using a recess appointment to name a new head of the Centers for Medicare and Medicaid Services. You see, Donald Berwick firmly believes that he has a right to ride:
Fifth, 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 do not agree. I find little evidence anywhere that market forces, bluntly used, that is, consumer choice among an array of products with competitors’ fighting it out, leads to the health care system you want and need. In the US, competition has become toxic; it is a major reason for our duplicative, supply-driven, fragmented care system. Trust transparency; trust the wisdom of the informed public; but, do not trust market forces to give you the system you need. I favor total transparency, strong managerial skills, and accountability for improvement. I favor expanding choices. But, 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. (Emphasis added. Also note the “total transparency” of a sneak appointment without any hearings. If Berwick was actually true to his written word, he would have refused the back door method of sneaking him in.)
Berwick advocates cutting off expensive treatments for “end of life” patients. Presumably he and the other booted and spurred riders – er – “leaders” get to decide what constitutes “end of life”.
And in fact, Berwick, from now until his appointment ends at the <edit> END of the first session of the next Congress> seating of the next Congress, will be writing the riding manual for Americans newly saddled with ObamaCare. (UPDATE: Fixed the incorrect statement of when the appointment ends. Sorry.)
Boots and saddles, Americans. Time to rise up, throw the saddle from your back and remove Berwick’s boot from your neck. Toss Obama’s enablers out in November.