Obama Recess Appoints Berwick, Sidestepping GOP Efforts To Delay Health Implementation

Refusing to allow Republicans to delay implementation of reform any longer, the White House announced last night that President Obama would recess appointment Harvard Professor Don Berwick as head of the Center for Medicare and Medicaid Services (CMS), a position vacant since 2006. Republicans had characterized Berwick as a proponent of “health care rationing” and the British health care system just days after Obama announced his nomination in April, precluding any possibility of an open and honest confirmation process that could contextualize Berwick’s statements or debate the need in using quality measures to control health care spending.

Now, the GOP is outraged by his recess appointment:

- SEN. MITCH MCCONNELL (R-KY): “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.”

- SEN. JOHN BARRASSO (R-WY): “This recess appointment is an insult to the American people. Dr. Berwick is a self professed supporter of rationing health care and he won’t even have to explain his views to the American people in a Congressional hearing. Once again, President Obama has made a mockery of his pledge to be accountable and transparent.”

- SARAH PALIN: SarahPalinUSA: Press Corps-pls do your job as Obama sneaks in Berwick appt;pls cover his mission:socialized healthcare&rationing based on”quality of life.”

The GOP’s rhetoric justifies Obama’s recess appointment. Had Berwick’s nomination gone through the committee process, it would have undoubtedly been subject to anonymous GOP holds and delays. The party would have used the hearings as an opportunity to revive the old “death panel” and health rationing smears, putting Democrats on the defensive just as the first benefits of reform are beginning to take effect. The shenanigans would have jeopardized the implementation of the health care law, which relies on CMS to “expand coverage to millions of new Medicaid recipients” and “re-engineer Medicare itself, so that it pays for services in ways that foster better, more efficient care.” As Mark McClellan, who served as CMS administrator from 2004-2006, put it, “What happens at CMS in the next few years will determine whether the new legislation actually improves quality and lowers costs.” “Don [Berwick] has a unique background in both improving care on the ground and thinking about how our nation’s health care policies need to be reformed to help make that happen,” he said.

Berwick is a respected Harvard professor and pediatrician who has built a reputation for improving quality and reducing health care costs. The American Hospital Association, the Federation of American Hospitals and a host of other provider groups praised Berwick, predicting that he “will bring a wealth of knowledge and practical experience to CMS from his perspective as a physician, teacher and passionate advocate for high-quality care.” Berwick’s “experiences from his lifelong quest to find better and safer ways to deliver care will greatly inform and enhance the implementation [of] healthcare reform,” the groups wrote in letter to the Senate Finance Committee.

Thomas Scully, who led the CMS from 2001 to 2003 put it best: “He’s universally regarded and a thoughtful guy who is not partisan,” he said. “I think it’s more about … the health care bill. You could nominate Gandhi to be head of CMS and that would be controversial right now.” 

Berwick’s appointment will expire at the end of the next session of Congress, in late 2011.