Mediaite has a video of Press Secretary Robert Gibbs dodging questions yesterday from CNS News reporter Fred Lucas about Donald Berwick, Obama’s controversial recess-appointment to head up HHS’s Medicare and Medicaid agency. The Washington Examiner provides the transcript:
Lucas: “Among the controversial comments that [Berwick] made in the past that would have come out in the Senate confirmation hearing are “excellent health care by definition is redistribution,” some of the others were mentioned, does the president actually agree with that?”
Gibbs: “Look this is somebody who is uniquely and supremely qualified to run an agency that is important to our government, it’s important to seniors, it’s important to the implementation of the new health care law. This is somebody supported not just by Democrats but by Tom Scully and Mark McClellan, both of whom ran this agency for George Bush.”
Lucas: “But does the president agree with–”
Gibbs: “This is the exact type of political game that the American people have come to understand dominates Washington and doesn’t actually make their health care more affordable.”
Lucas: “You said you were confident there would have been a confirmation had there been a hearing. But do you think that it would have been politically troublesome in an election year to have all of these comments aired out about rationing and redistribution that Dr. Berwick had talked about in the past?”
Gibbs: “You just read comments. Is there, like, a secret comment book that somehow you got and that nobody else got?” <Laughter> “And you just read them to me and somehow they wouldn’t have come out? Did he say things like ‘rationing happens today, it’s just a question of who will do it?”
Lucas: “Well, that was one comment.”
Gibbs: “Actually that was Paul Ryan. He’s a Republican in Congress.”
Lucas: “Well you have your own comments.”
Gibbs: “No, that’s Paul Ryan’s comment.”
Despite Gibbs’s self-satisfaction at tripping up a reporter (who happens to be a good reporter), the implication that Paul Ryan supports rationing just like Donald Berwick is dead wrong. Berwick is a fan of the rationing done by Britain’s National Health Service. Berwick wants the government to decide how to allocate scarce resources. Ryan wants individuals to have the right to make those decisions for themselves. Ryan discussed the differences between his free market plan and ObamaCare in an interview with me earlier this year:
Ryan’s plan reduces the growth of federal Medicare spending by moving toward a free-market system in which those 55 and younger would get a voucher (on average $11,000 per household) to purchase their own health insurance when they qualify for Medicare. Obamacare wouldn’t make Medicare solvent, but it attempts to restrain Medicare spending, Ryan says, through a “comparative effectiveness bureaucracy” and its “IMAB [Independent Medicare Advisory Board] on steroids–new Medicare bureaucracy that will put in all these formula changes bypassing Congress.” Ryan calls this a “rationing system.”
“The current path is not going to happen, it’s not sustainable,” Ryan says. “You literally cannot tax your way out of this. … Medicare itself overcomes the entire size of government.”
“So you either put the government more firmly in control the system and make it a government monopoly program–kill Medicare Advantage, kill HSAs,” and “deeply and systematically ration health care,” or you can “break up the government monopoly, and bring in the power of the free markets.”
“I would simply argue that the history of free market systems shows you more goods and services at lower prices, than closed centrally planned systems, which show you scarcity, rationing, and less innovation,” says Ryan.
So, as a 40 year-old, Ryan says, “I am looking at a choice of two futures: Do I have a future of more control of my health care in a market system that’s competing for my business, for my needs, where I can customize my care, and I get support from the government on purchasing that health care, and a safety net so that poor and sick people get total support? Or do I go to a system where the government literally determines what kind of care I get, when I get it, if I get it?”
“Those are the choices we’ve got right now before us, and that’s the dirty little secret behind Obamacare.”
Of course, Obama and Gibbs want to keep this dirty little secret a secret. The argument against Obamacare rationing put forward by Ryan is exactly what Obama was trying to ignore by bypassing the Senate and giving Berwick a recess appointment.
Update (Ed): Tommy Christopher dropped me a note to explain: “The headline implies that we were laughing at Fred, which isn’t true. It was a laughter of recognition at the trick Gibbs had pulled. Fred is well-liked and well regarded by his colleagues.”
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