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Obama Names Berwick as CMS Head, Using “Recess Appointment” Authority

July 7, 2010 News 11 Comments


President Obama today named Donald Berwick to head the Centers for Medicare and Medicaid Services while Congress is recessed, allowing Berwick to bypass nomination hearings and Congressional voting. The move also avoids public debate of the administration’s healthcare reform law before the midterm congressional elections.

Berwick, a Harvard Medical School professor and president of the Institute for Health Care Improvement, would have faced questions about previous comments in which he praised Britain’s government-run National Health Service and stated that healthcare rationing is inevitable.

Sen. John Kerry (D-MA) said, “Republican lockstep stalling of Don’s nomination was a case study in cynicism and one awful example of how not to govern. When these federal programs were in trouble, they denied the administration the capable guy the president had chosen to oversee them. The president did the right thing making this a recess appointment”

A statement from Sen. Mitch McConnell (R-KY) said, “As if shoving a trillion dollar government takeover of health care down the throat of a disapproving American public wasn’t enough, apparently the Obama Administration intends to arrogantly circumvent the American people yet again by recess appointing one of the most prominent advocates of rationed health care to implement their national plan. Democrats haven’t scheduled so much as a committee hearing for Donald Berwick but the mere possibility of allowing the American people the opportunity to hear what he intends to do with their health care is evidently reason enough for this Administration to sneak him through without public scrutiny."

Sen. Max Baucus (D-MT) who chairs the Finance Committee that would have overseen Berwick’s nomination hearings, was was quoted as saying, “Senate confirmation of presidential appointees is an essential process prescribed by the Constitution that serves as a check on executive power and protects Montanans and all Americans by ensuring that crucial questions are asked of the nominee – and answered. Despite the recess appointment, I look forward to working with CMS as they implement health reform to deliver the better health care outcomes and lower costs for patients we fought to pass in the landmark health reform law.”

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Currently there are "11 comments" on this Article:

  1. this announcement seems to trouble me than maybe it should; for example why has this been necessary – doesn’t it just cause more political friction and heartburn for those of us who live in healthcare? When 1st nominated for this role, many of your readers saw this as a positive appointment and since then many who have worked with Dr. Berwick have come forward with very favorable experiences to relate. And so, I think I should be feeling good that our President sidesteped polictical roiling and placed this person in the job so that the People’s business can move forward.

    Yet I am troubled – with a nagging question as to why this exingency was needed, since as stated “the position has been vacant since 2006” – in the business world a position vacant w/o a collaspe for 4 years means that the position could be scraped – now I don’t necessarliy agrred with that sentiment, it does make me ask why the apparant urgency? was it merely to avoid political squabbling? or maybe it is the other item that bothers me – the width and breath of the political writings and presentations by Dr. Berwick that promote rationing of healthcare – my own father and an aunt and an uncle are all at risk here and myself and my wife may soon to subjected to nonesense (IMHO) rationing – and I have several experiences with this in the last 10 months that are simply scary.

    So yes, this does bother me and I think correctly so.

  2. Agree totally, joe a. Nicely stated. Too much power in the executive branch, and infers something is being hidden. I laud Berwick for his past accomplishments, am a big fan of process, quality and metrics, but do not support government run health care. The government practically runs it now with around 60% of health care expenditures coming from government programs, if I’m not mistaken. They must control costs and as a consequence will move to rationing. It’s a natural step for governments.

    The “rationing” may come in many ways – cost of waiting for services if you are not sick enough (think transplant list for everything), outright denials, or rationing specialist versus primary care. Imagine the black market opportunities, the push to medical tourism – where patients can choose more freely if they are cash payers. The whole thing scares me to death. (no pun intended)

  3. Bush had 171 recess appointments, Clinton 139, Reagan 243. Both parties have a long journey to return to establishing productive executive and legislative branchs.

    But in the end, I would to live no where else. God Bless the USA!

  4. I can only assume joe a made his submission from a device either without spellcheck or with a screen so small or illegible he was unable to view his mistakes.

  5. Thank you Dutch Uncle Albert for putting this into perspective.

    Krockholt, I doubt there will be any revolt from the masses this November. Most Americans are grateful for the help the Dems are giving them.

  6. my, what a strange (to me) set of responses to my posting – isn’t it possible these days to take a subject like this on w/o creating nasty political psoturing? I tried to avoid my own when writing, but apparantly several of my fellow readers cannot – too bad.

    and yes, I am using a tool for submittal that does not provide a spellcheck, sorry ..

  7. The column around Donald Berwicks ‘recess’ appointment were middle of the road, quoting both sides of the aisle in defense and opposition.

    The post column diiscussions and views also demonstrate partisan views reflecting party-line bickering… surprise!

    At the end of the day, “Dutch Uncle Albert’s” numbers reflect both sides of the aisle have contributed to recess appointments, but “two-wrong’s don’t make it right”.

    The problem for “us” is that the promise of “Transparency” is absent and all of us will pay in one way or another… whether were the patient, the caregiver, or the taxpayer.

    So whether you were “for” the mystery 2,000 page HCR, or against it, the bottom line is there is something fundamentally wrong when the majority of America is “opposed” to any legislative bill and the majority party’s leadership informs others to “pass the bill and read it later…” and as Alcee Hastings (Chmn of House and Means Committee) so eloquently put it, “we change(d) the rules as we go along…”

    Final question… how many of us out there would sign a vendor’s multi-million HIE contract before reading it?

  8. Some folks find it hard to separate “politics” from “government”, so I’ve removed comments that didn’t really add value to the topic of Don Berwick’s appointment. I kept my original post as close to neutral as I could, including one “pro” comment, one “anti”, and one neutral, but political beliefs create strong tunnel-vision goggles for some readers. The bottom line is that I (and most readers, I suspect) think Berwick is a great choice for the CMS job even though we might not have seen the urgency to fill a position that’s been vacant for four years using a process that is legal, but not exactly transparent (and rarely used for positions at this level). And intentional or not, that move keeps healthcare reform out of the public eye until after the next round of elections.

  9. Dear Mr. Histalk. I don’t see eye to eye with you on many topics. Some others do, some others don’t.

    But please don’t fall in to the media trap of balance. You are an anonymous blogger for a reason. It allows you some semblance of honesty (not posting links in comments to companies who are in direct competition with your favored sponsors excluded ;)).

    Posting one view in favor and one against isn’t balance.

    In my view be yourself. Allow your bias to come out. We all have bias. It’s dishonest to try to fake balance. It’s why the old media is almost dead. Blogs and new media (including yourself) are thriving because they don’t try to fake balance.

    I feel you are falling in to the same trap. I liked it when you were open about being a small government libertarian, at least then people could either agree or disagree with you. It feeds debate IMHO.

    Success often breeds a desire to be safe, which in turn leads to mediocrity. Weird how that works.

    Just my 2 cents.

    [From Mr. HIStalk] Thanks! I only do “balanced” when I’m posting a specific news item that I’m blasting out individually, which doesn’t happen too often (Eclipsys acquisition, CPSI CFO suspended, etc.). I stick to the facts on those, and I disagree that posting one comment for and against isn’t balanced (since I chose those comments specifically as the best representing the two arguments). Otherwise, it’s whatever is on my mind, including the “regular” postings about the same news item. And I do often remove the links in comments, not because they compete with sponsors, but because I don’t want to encourage people to post comments just so they can pitch their own company, blog, etc. to my audience.

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