Just because you have a medical degree . . .

. . . doesn't necessarily mean you know your anus from the lateral epicondyle of your humerus. I got an e-mail from a flack for a physician named Hal Scherz who is the president of an organization (about which I have so far found no independent information) called Docs4PatientCare. He writes:

Just as the Administration rolled over the American people with the health care bill, this recess appointment shows a similar contempt for the democratic process and a ruthless determination to impose government-run health care. To place Dr. Berwick, someone with an admitted love for socialized medicine, to assume such an important position without proper vetting is dangerous for the health of our entire nation. People don’t want politicians coming in between them and their doctor.

and

The recess appointment of Dr. Donald Berwick to head the Center for Medicare and Medicaid Services, put to rest any doubts about what President Obama’s true motives are in pushing for so called health care reform. Don’t be fooled by flowery words or big pipe dreams. By virtually every measure, socialized medicine fails and people die. Obamacare will turn off the engine of innovation and medical advancement. It will usher in a new medical dark age that will have a ripple effect worldwide."

This is obviously characteristic right wing rhetoric, but let's step back for a second and deconstruct it as argumentation.

The administration rolled over the American people with the health care bill.

The bill was passed by both houses of the duly elected Congress of the United States and signed into law by the duly elected President of the United States, in accordance with the United States Constitution and the mechanism by which laws have been promulgated in the United States since 1787.

This recess appointment shows a similar contempt for the democratic process.

George W. Bush made 47 recess appointments, many of them to higher offices than Director of CMS.

and a ruthless determination to impose government-run health care.

Pure speculation, does not logically follow. Berwick is appointed to an administrative position in which he does not make policy and can only implement the requirements of the law.

To place Dr. Berwick, someone with an admitted love for socialized medicine . . .

Berwick has expressed admiration for certain aspects of the British health care system. He has never asserted that the United States should adopt a government run health care program. The insinuation is unsupported. (Whether or not you think that would be a good thing anyway is beside the point.)

People don’t want politicians coming in between them and their doctor.

I suspect that most people would agree with that statement, but it is irrelevant. Berwick has never proposed such a thing, nor is that a defensible conclusion about the consequences of anything he does propose. He advocates that physicians be given a better base of scientific knowledge on which to discuss treatment options with their patients. He is in fact known as a radical advocate of so-called patient-centered medicine in which patients are the ultimate authorities on their own health care. He has in fact been criticized for insisting that physicians should give their patients what they want, even if it is against the physician's best judgment about what is in their interest. Here is an actual quote from Donald Berwick:

I freely admit to extremism in my opinion of what patient-centered care ought to mean. I find the extremism in a specific location: my own heart. I fear to become a patient. Partly, that fear comes from what I know about technical hazards and lack of reliability in care. But errors and unreliability are not the main reasons that I fear that inevitable day on which I will become a patient. For, in fighting them, I am aligned with the good hearts and fine skills of my technical caregivers, and I can use my own wit to stand guard against them.

What chills my bones is indignity. It is the loss of influence on what happens to me. It is the image of myself in a hospital gown, homogenized, anonymous, powerless, no longer myself. It is the sound of a young nurse calling me, "Donald," which is a name I never use—it’s "Don," or, for him or her, "Dr. Berwick." It is the voice of the doctor saying, "We think...," instead of, "I think...," and thereby placing that small verbal wedge between himself as a person and myself as a person. It is the clerk who tells my wife to leave my room, or me to leave hers, without asking if we want to be apart. Last month, a close friend called a clinic for her mammogram report and was told, "You have to come here; we don’t give that information out on the telephone." She said, "It’s OK, you can tell me." They said, "No, we can’t do that." Of course, they "can" do that. They choose not to, and their choice trumps hers: period. That’s what scares me: to be made helpless before my time, to be made ignorant when I want to know, to be made to sit when I wish to stand, to be alone when I need to hold my wife’s hand, to eat what I do not wish to eat, to be named what I do not wish to be named, to be told when I wish to be asked, to be awoken when I wish to sleep.

Call it patient-centeredness, but, I suggest, this is the core: it is that property of care that welcomes me to assert my humanity and my individuality. If we be healers, then I suggest that that is not a route to the point; it is the point.

By virtually every measure, socialized medicine fails and people die.

This is manifestly inconsistent with easily observable reality. As I have noted here repeatedly, and as anyone can easily discover with minimal effort, those countries that have what Scherz would call socialized medicine have better health outcomes than we do. Their people are healthier, they live longer, they are happier with their health care, and they save 50% of what we waste on useless or harmful medical interventions.

Obamacare will turn off the engine of innovation and medical advancement.

On the contrary, the Patient Protection and Affordable Care Act, and related legislation and executive initiatives, include increased investment in scientific research to discover more effective treatments.

In short, everything this man says is false, absurd, and generally the exact opposite of the truth. Let me tell you what really bothers him: he is a pediatric urologist, a narrow medical specialist. That means that under the current system of medical financing, he makes much more money than primary care doctors. Berwick, and as far as I can tell Barack Obama, want to reorder health care financing so that more resources go to primary care and specialty care is somewhat less lucrative. Scherz is afraid that some day, he'll only pull down a quarter million dollars a year or so, and that's not enough for the upkeep on his mansion.