By Lynn Woolley
July 17, 2010

President Obama’s vision of “change” in America brings with it a core belief that something is not right, and that vast inequities between the classes must be dealt with.  In Dr. Donald Berwick, the President has found his champion of Social Justice for healthcare.

The media controversy is over Mr. Obama’s “recess appointment” of Dr. Berwick to head the Centers for Medicare and Medicaid Services (CMS).  But that’s not really so important.  Recess appointments are fully constitutional, and must then be approved by the Senate by the end of the next session of Congress.  What’s much more important is Dr. Berwick’s vision, shared by the Left, but very different from what we have now.

Few people would argue that we have a wonderful system of healthcare in America.  People with HIV/AIDS and cancer live longer, fuller lives.  Cystic fibrosis patients are living well out of their teens.  We have all but eliminated polio and smallpox in this country.  The disagreement is about our delivery system.  

Conservatives, who like things basically the way they are, will argue that a person should be able to purchase the best health care available – and that the poor are adequately served through charity.  It is true that American hospitals routinely donate millions of dollars worth of care to the poor, often through expensive emergency rooms. 

But healthcare has become almost prohibitively expensive and, in the recession, lots of people are dropping their coverage.  Let’s stipulate that change is necessary.   Congressional Republicans want to work with the private system we have now, retaining what works and tweaking what doesn’t.  Progressives believe our system is unfair and should be scrapped.

That’s precisely what Dr. Berwick believes.   Simply put, Dr. Berwick sees healthcare as a right.  Video footage has emerged showing Berwick summing up his philosophy:  “Any healthcare funding plan that is just, equitable, civilized, and humane must redistribute wealth from the richer among us to the poorer and the less fortunate.  Excellent healthcare is by definition redistributional.”

That someone this radical in his thinking could even be considered for such an appointment is the result of two converging situations:  the historic election of Barack Obama and the skyrocketing cost of medicine.  Neither of these events could have done it alone. 

So now, with Berwick about to take office, we look to the British system for guidance.  What we find there is a numbers game based on what government assesses your worth to be and/or your chances of recovery.  The numbers may not work if you’re too old or too sick – or if the treatment is too expensive.  The British system, the National Institute for Health and Clinical Excellence (NICE), is redistributional, remember.  So part of the care you need may be rationed to someone else.

In 1954, the science fiction magazine Astounding published a seminal story by Tom Godwin called “The Cold Equations.”  In it, an 18-year-old girl stows away on a cargo ship so that she can see her brother in the colonies.  But the ship has only enough fuel for the pilot and a cargo of serum for sick colonists.  The captain can’t doom the colonists to save one person.  The best he can do is buy her an hour before she must be ejected into space.  You read this story waiting for a happy ending, but there is none.  The numbers don’t lie and they don’t have any compassion.

If there is something sinister about the recess appointment, it is that the people are being deprived of a debate.  Dr. Berwick is a Harvard academic who, like Obama, believes American health care should be doled out on the basis of fairness, decided by bureaucrats he refers to as “leaders with plans.”  The cold equations.  

In Dr. Berwick’s America, the needs of the individual would be subordinate to the needs of the collective.   This is more than “change.”  This is a radical transformation that for some people will remove all hope.

Lynn Woolley is a Texas based radio talk show host streaming from www.BeLogical.com.