berwick, is that correct? >> the office of -- >> cms. >> yes.yes, sir. >> so that's a recent development. i don't know that gives me pause or what, but at any rate -- >> senator, we did that to maximize, i think, efficiencies. it was going to be an independent office and once we looked at overhead costs of duplicating everything from front office help to legal, staff, it was seen as an expedited way to maximize and leverage our assets. >> maximizing dr. berwick does give me pause but let's go on to another subject. as former governor of kansas, i know you're very well aware that we have 83 critical access hospitals out in our state, most of any state, fully two-thirds of our hospitals and you also know that the critical access hospitals are not, not part of the five-year exemption from the ipap review, the independent -- >> payment advisory board. >> yes. very independent to say the least. i'm not happy with that. i think we are obligated our responsibility as individual members to set the medicare reimbursement rates as best we know them. that

berwick, is that correct? >> the office of -- >> cms. >> yes. yes, sir. >> so that's a recent development. i don't know that gives me pause or what, but at any rate -- >> senator, we did that to maximize, i think, efficiencies. it was going to be an independent office and once we looked at overhead costs of duplicating everything from front office help to legal, staff, it was seen as an expedited way to maximize and leverage our assets. >> maximizing dr. berwick does give me pause but let's go on to another subject. as former governor of kansas, i know you're very well aware that we have 83 critical access hospitals out in our state, most of any state, fully two-thirds of our hospitals and you also know that the critical access hospitals are not, not part of the five-year exemption from the ipap review, the independent -- >> payment advisory board. >> yes. very independent to say the least. i'm not happy with that. i think we are obligated our reonsibility as dividual members to set the medicare reimbursement rates as best we know them. that is

berwick, is that correct? >> the office of -- >> cms. >> yes. yes, sir. >> so that's a recent development. i don't know that gives me pause or what, but at any rate -- >> senator, we did that to maximize, i think, efficiencies. it was going to be an independent office and once we looked at overhead costs of duplicating everything from front office help to legal, staff, it was seen as an expedited way to maximize and leverage our assets. maximizing dr. berwick does give me pause but let's go on to another subject. as former governor of kansas, i know you're very well aware that we have 83 critical aess hospitals out in our state, most of any state, fully two-thirds of our hospitals and you also know that the ctical access hospitals are not, not part of the five-year exemption from the ipap review, the independent -- >> payment advisory board. >> yes. very independento say the least. i'm not happy with that. i think we are obligated our responsibility as individual members to set the medicare reimbursement rates as best we know them. that is a bat

if you like your poll -- by a gentleman by the name of berwick who believe we should ration health care and not spend money on the lives of people who may be at the end of their life. sarah palin called that a death panel. put it down in a twitter to explain it all. i think she did that. and we've seen the manifestation with the employments, with the action, with them taking an initiative to counsel people to accept death when there's medicine there that may save them or extend their lives. i don't think that's a business of the federal government to pay people, to counsel others to die quicker. that's what turns out of that policy, and i'm glad that they rescinded it and i'm hopeful that's not something that creeps back again. if you have a doctor like him it's going to creep back again. that's his philosophy. but obamacare cannot be allowed to stay in this code. it must go. it's got to be repealed and we are about to do that. the first steps and the legislative steps took place on this yesterday with the rules debate upstairs, hours of debate on the rule and how this debate would go o

berwick, who is the head of c.m.s., the head of medicare and medicaid services and we plan to ask a lot of questions about the doctor and the statements he made in the past, obviously that confirmation did not happen and he was a recess appointment. that's something i think we ought to deal with as well. but i had 11 amendments all on rationing. there it was 12:30 in the morning in the finance committee and i had 11 and finally we got to the last two and i said why don't we consider them en bloc. i had about a minute or two to explain each amendment. they were voted down automatically, it was on a party line vote. and by the time we got to 12:30 or 1:00 on my amendments, there were a lot of people that, you know, you simply hand over your vote to somebody else and they will vote you in regards to the fact that you're absence, they had a lot of proxies, so there weren't too many in the room. but i noticed that senator schumer was in the room, so i stuck one of his bills that didn't make it, along with my two -- or my additional bill, and it was defeated on a party line vote. and then i s

berwick, who is the head of c.m.s., the head of medicare and medicaid services and we plan to ask a lot of questions about the doctor and the statements he made in the past, obviously that confirmation did not happen and he was a recess appointment. that's something i think we ought to deal with as well. but i had 11 amendments all on rationing. there it was 12:30 in the morning in the finance committee and i had 11 and finally we got to the last two and i said why don't we consider them en bloc. i had about a minute or two to explain each amendment. they were voted down automatically, it was on a party line vote. and by the time we got to 12:30 or 1:00 on my amendments, there were a lot of people that, you know, you simply hand over your vote to somebody else and they will vote you in regards to the fact that you're absence, they had a lot of proxies, so there weren't too many in the room. but i noticed that senator schumer was in the room, so i stuck one of his bills that didn't make it, along with my two -- or my additional bill, and it was defeated on a party line vote. and then i s