Republicans responded to today’s swearing in of Dr. Don Berwick to head the Center for Medicare and Medicaid Services (CMS) by condemning President Obama for recess appointing the nominee. One by one, the GOP took to the Senate floor to argue that they would have welcomed a debate on Berwick’s qualifications in a fair and open hearing. “For anybody to suggest that Republicans are to blame for the fact that Dr. Berwick’s nomination didn’t come to a vote or wasn’t brought to the senate floor is sheer fantasy,” Sen. Jon Kyl (R-AZ) insisted. “We have not held up the nomination. We have not protested a vote.” “We’ve been critical of Dr. Berwick. Since when has that been a crime?”

Kyl began with the standard Republican talking points. He claimed that Berwick will ration health care for American seniors, deny payment for services that were not cost effective and import British health care to America. But then, in an apparent effort to criticize Berwick’s view of prevention, Kyl took a turn for the unexpected and suddenly took credit for the preventive service provisions in the health law:

KYL: Another couple things about Dr. Berwick. He’s expressed disapproval for costly cutting-edge medical technologies and said prevention services like annual physicals, screening tests and other measures were over demanded. Well, one of the things we did in the health care legislation was to provide a lot of different incentives for preventive care, for screening to try to help people avoid illnesses on the theory that it would be a lot cheaper if we didn’t do a lot of treatment that was unnecessary. If you could identify in advance that an individual had a need for some treatment, maybe you could catch the disease, say the cancer, for example, early and not have to have the expensive treatment, the end-of-life kind of care that frequently is very, very expensive.

Watch it:

Kyl’s use of the pronoun “we” is surprising, since every single Senate Republican voted against the preventive provisions in the health care bill when they voted against the measure, and many in the GOP now want to repeal the entire law — including the very preventive screenings that could “catch the disease.” Kyl is co-sponsoring a measure to repeal the entire law.

Still, he isn’t the only Republican to take credit for some of the health care law’s more popular provisions. In April, House Minority Leader John Boehner (R-OH) took credit for provisions that would outlaw rescission of coverage and allow children to stay on their parents’ health plans for longer. Sen. Chuck Grassley (R-IA) similarly issued two press released praising the law’s “standards for the tax exemption of charitable hospitals” and its improvements of “Medicare payments to doctors in rural states like Iowa.”

My CAP colleagues Ellen-Marie Whelan and Leslie Russell are out with a new report arguing that the federal government needs to establish a better public
health response plan to address the long term health consequences of the BP oil spill and future health emergencies. When it comes to the oil spill, Whelan and Russell are concerned about three things: 1) how the actual oil will effect the workers in charge of cleaning it up, 2) what effect burning off the oil will have on workers and the surrounding communities, and 3) what effect the dispersant used to help the oil evaporate easier will have on workers and the surrounding communities.

Since there is no master plan to synchronize the government’s response to the health care consequences from the spill, Whelan and Russell “propose the creation and implementation of a Public Health Response Plan,” an initiative under the direction of the Assistant Secretary for Health [ASH] that would ensure that all of the relevant federal agencies coordinate their response. ASH would oversee the effort and decide which agencies would address the initial health ramifications from the spill and which would be charged with monitoring the long-term health effects.

Watch their explanation here:

The plan would streamline the work of federal agencies rather than creating a new bureaucracy. In this case, the CDC “would be at the center of this plan to respond to workers in potentially dangerous situations and begin the process of monitoring the exposed population and tracking data,” the report notes. “As other agencies such as the FDA, NDMS, and SAMHSA enter the scene, instead of functioning in isolation they would be added as new team members with the ASH responsible for making sure they are all working seamlessly, with different agencies assuming different roles over time.” Whelan and Russell see this as “as a series of concentric circles with each of the circles representing a different agency or office”:

The innermost circle represents the first agency or office that responds to the potential crisis and each additional circle signifies another agency as it is determined their expertise is required to address the developing crisis. Each agency continues to have a defined, specific response, but collectively they represent a far more coordinated effort.

But all of this will require more funding than the $20 billion “Claims and Escrow” fund BP has already set aside. Whelan and Russell describe the fund as “a down payment” and argue that “sufficient funds should also be placed into an escrow account to provide for the long-term monitoring and future health services needs” — a number that is certainly undefined.

The Secretary of HHS has discretion to delegate ASH as the supervising authority to oversee the response and so it seems that the government can adopt this plan within existing law. What’s clear is that the federal government seems to be the only entity with the ability to monitor the long term health consequences of the spill. BP should not be trusted to handle this task.