President Barack Obama used his recess appointment power to install his choice to lead the Centers for Medicare and Medicaid Services, Dr. Donald Berwick, thwarting Republican opposition to the pick.
It’s a blow to Republicans in the U.S. Senate, which is on its summer break. Senate Republicans had vowed to stall Berwick’s appointment ostensibly for his support of "rationing" healthcare. Berwick will now avoid a contentious nomination hearing and serve as chief of CMS, which has lacked a leader since 2006, until the end of 2011.
Reports that Obama would tap Berwick, a Harvard medical school professor, pediatrician, and president and CEO of the Cambridge, Mass.-based Institute for Healthcare Improvement, began circulating in March. Obama made the pick official in April, and Republicans determined to re-hash the debate over healthcare reform wasted no time in voicing their antagonism to the choice.
The GOP’s opposition to Berwick centers around a 2008 paper he co-wrote, according to The Boston Globe, detailing the “Triple Aim’’ of healthcare.
“With some risk, we note that the simplest way to establish many of these environmental conditions is a single-payer system, hiring integrators with prospective, global budgets to take care of the health needs of a defined population, without permission to exclude any member of the population,’’ Berwick wrote with his co-authors.
Republicans also seized on comments Berwick made in 2008, during an address to a group of British physicians, about Great Britain’s National Health Service. Despite his avowed admiration for the system, Berwick spent the majority of the speech criticizing the British healthcare system. His praise was aimed at the system’s cost-to-quality ratio.
The United Kingdom has a longer life expectancy than the U.S., according to the CIA world factbook, and the country’s healthcare system’s per capita cost is half that of the American system.
Republicans were quick to castigate the recess appointment, with Senate Minority Leader Mitch McConnell (R-Ky.) calling it “truly outrageous,” according to the Los Angeles Times.
“As if shoving a trillion-dollar government takeover of healthcare 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 healthcare to implement their national plan,” McConnell said in prepared remarks.
“This recess appointment is an insult to the American people,’’ added Sen. John Barrasso (R-Wyo.), according to the Globe. “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 hearing. Once again, President Obama has made a mockery of his pledge to be accountable and transparent.’’
Sen. Pat Roberts (R-Kan.) also piled on: “Once again, the Obama administration is going behind closed doors out of fear the American people will learn that Dr. Berwick plans to use rationing as a cost-cutting tool to achieve the billions of dollars in cuts to Medicare called for in the health care reform bill.’’
Despite the vociferous opposition inside the Beltway, Berwick has won support even from within the Grand Old Party. Mark McClellan, who headed the agency under President George W. Bush, said Berwick is exactly what the agency needs. CMS has lacked a permanent leader for the past four years.
"Don is a person who’s spent his entire career committed not just to talking about ways to make health care better, but actually helping organizations around the country change health care for the better," McClellan told National Public Radio when Berwick’s appointment became official in April.