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In a Surprise Move, Administration Appoints Berwick to Head CMS

Tuesday night the White House Blog explained: “In April, President Obama nominated Dr. Donald Berwick to serve as Administrator of the Centers for Medicare and Medicaid Services (CMS). Many Republicans in Congress have made it clear in recent weeks that they were going to stall the nomination as long as they could, solely to score political points.

“But with the agency facing new responsibilities to protect seniors’ care under the Affordable Care Act, there’s no time to waste with Washington game-playing. That’s why tomorrow the President will use a recess appointment to put Dr. Berwick at the agency’s helm and provide strong leadership for the Medicare program without delay.”

A “recess appointment” means that the president is putting Berwick in place while Congress is on recess (i.e. is taking a vacation). As a result, Berwick won’t have to go through a Senate confirmation hearing. Senate conservatives had made it clear that they hoped to defer this hearing for as long as possible.

The White House Blog notes that “CMS has been without a permanent administrator since 2006, and even many Republicans have called on the Administration to move to quickly to name a permanent head.”

Predictably, conservatives do not share this point of view.

But the truth is that, in the end, Berwick was bound to be confirmed. As I wrote in “Media Myths about Dr. Donald Berwick,” Dr. Berwick enjoys support that ranges from the AARP to three former directors of the Centers for Medicare and Medicaid Services (CMS) who served under Republican presidents. “This is not really about Don Berwick,” John Rother, executive vice president for policy and strategy at the AARP told McClatchy Newspapers. “In ordinary times, the nomination of somebody with Don’s record and standing in the field would not be controversial.” Thomas Scully, who led the CMS under President George W. Bush agreed: “He’s universally regarded and a thoughtful guy who is not partisan. 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 also enjoys warm endorsements from the American Association of Family Physicians, the American Medical Association, and the American Hospital Association.

When I wrote that post, arguing that Berwick would be confirmed, I realized that the real danger was that conservatives would manage to postpone Berwick’s appointment for months, using that time to continue their campaign to demonize him, while leaving Medicare without a leader– thus crippling Medicare’s ability to set an example for health care reform. (As I have written for the past three years, I believe that Medicare reform will pave the way for healthcare reform.)

Mark McClellan, who served as Administrator under President George W. Bush from 2004-2006, made this point two months ago, when President Obama tapped Berwick: “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.”

Not long ago, while responding to a comment on another blog (www.thehealthcareblog.com), I said that I doubted that Obama would appoint Berwick during the Congressional recess. Fortunately, I added: “I could be wrong. If the administration realizes that conservatives can defer Berwick’s confirmation for too long, it will have to act.”

I’m so very glad that my initial prediction was wrong. We needed Berwick, in Washington, guiding CMS. Yesterday– or eight years ago.

Maggie Mahar is an award winning journalist and author. A frequent contributor to THCB, her work has appeared in the New York Times, Barron’s and Institutional Investor. She is the author of  “Money-Driven Medicine: The Real Reason Why Healthcare Costs So Much,” an examination of the economic forces driving the health care system. A fellow at the Century Foundation, Maggie is also the author the increasingly influential HealthBeat blog, one of our favorite health care reads, where this piece first appeared.

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maggiemahar
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James,
Sorry, obviously, I meant Ted K., not Robert.

maggiemahar
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James- Democrats as well as Republicans were critical of Robert Kennedy’s “intemperate” speech. They thought it was over-the top. On the other hand, everyone recognized that the core of what he said about Bork was true. My husand took law school classes with Bork; he thought Bork was very bright and basically liked him, but was shocked by the extremity of his views and how passionately he argued for them. For example: Bork was anti-abortion. He thought that illegally seized evidence should be admitted in court. He personally was opposed to evolution theory (though I don’t think he would have… Read more »

james
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james

“The confirmation hearing would not have been a substantive example of Advise and Consent.” So the standard now for whether or not to follow the U.S. Constitution’s clear check and balance on the power of the Executive Branch is whether one thinks such a review of a nominee would be “substantive.” Who decides whether the review would be “substantive”? Why, the Executive Branch and the party in power, of course! So, here is an example of the level of “substantive” discourse exhibited towards a prior nominee for a judicial position: “Robert Bork’s America is a land in which women would… Read more »

bev M.D.
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bev M.D.

Um, Matthew; I find myself in the surreal position of commenting to defend Nate! Actually you are very late to the party; he USED to malign people personally but has vastly improved lately. And I myself have had previous disagreements with Maggie’s facts. Perhaps it is the way she puts her own interpretation on things and then presents them as fact. (No, Maggie; I still have not forgotten the “watch all prostate cancer regardless of grade” thing – but spare me arguing it over again, please.) And, as a woman, even I would say that her misogynist comment was over… Read more »

Nate
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Nate

Carvil has healthcare reform -16
http://www.democracycorps.com/wp-content/files/dcor062210fq6.web_.pdf
Interesting stats from NRO
This June in Arizona’s Maricopa County, 227 voters switched from no affiliation or some other party to the Democratic party. This includes 44 former registered Republicans.
Another 211 voters switched to “independent”; this total included 55 Democrats and 69 Republicans.
Another 217 left the Democratic party to become “Party Not Designated.”
And 530 joined the Republican party, including 190 former registered Democrats and 252 who were “Party Not Designated.”

Nate
Guest
Nate

Poolster.com has it 38.5 D to 33.6 R. Double the spread and throw in a big margin of error and Bush was the fav prez eva!

Nate
Guest
Nate

what is the rule on personal attacks so I know? It appears attacking anyone with beliefs that track right is ok and encouraged but saying the exact same thing to someone who shares the left slant is not allowed? I understand why you wouldn’t want readers calling each other misogynist or publiclly questioning the size of their genitalia but it seems that is acceptable if it comes from the left. Question someone’s accuracy and honesty though is going to far? Even when that person CONSTANTLY questions the honesty and accuracy of others? Still trying to find the meat of the… Read more »

Matthew Holt
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Nate, if that’s the best you can do perhaps you’d better go find other windmills to tilt out and leave THCB to the serious people. Maggie’s right that overall the feeling towards repeal is waning. And the Rassmussen poll that you quote has, at the least, severe methodological problems, and is based on a useless “should the bill be repealed” question. You want back up, go here http://crooksandliars.com/karoli/rasmussen-polls-lies-damn-lies-and-statisti And when it comes to the real aspects of the bill that would be repealed (you know, reality, Nate, rather than the Thomas Moore Utopian anarchistic society with no government where your… Read more »

Tim
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Tim

Maggie, You honestly think that response put you on a different level than Tapper? Now that you’ve called Tapper names (feel better?), put your “journalist” hat back on: was there a hold on the nomination by a GOP Senator, or not? If so, which one? Was there any GOP control on the scheduling of a confirmation hearing, or not? The substantive distinction you are working very hard to avoid is between the delay of a hearing — which would justify a recess action — and the exercise of the minority party’s right to “fight” during a constitutionally sanctioned hearing. So… Read more »

J.S.
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J.S.

WaPo LIBERALS LAUGH @ BERWICK APPOINTMENT http://bit.ly/9S3e5J As a matter of politics, the president’s choice of Berwick was, well, the polite word would be bold. The less polite word: boneheaded. Administration officials argue that Republicans would have seized on any nominee as an opportunity to re-litigate the health-care debate. But Berwick offered opponents a loaded gun with his talk about rationing, his discussion of health reform as a matter of redistributing wealth, and his effusive praise for the British system. If the president wanted to buy a fight like this, he ought to have been better prepared to wage it.… Read more »