On the Recess Appointment of Donald Berwick

Published July 7, 2010

By Benjamin Domenech

The White House’s announcement that President Barack Obama will bypass the nomination process of the United States Senate to recess appoint Donald Berwick as head of the Centers for Medicare & Medicaid Services (CMS) is an act of unconscionable hubris.

The White House claims this move is in response to “Washington game-playing,” accusing Republicans of planning to “stall the nomination” as long as possible. That is nothing more than a boldfaced lie. Republicans cannot stall this nomination and never could—it is impossible for them to do so under Senate rules—as not one hearing has been called or scheduled.

It is the White House that is playing games with the health policy of the nation and the welfare of the American people. In bypassing the traditional process through which the Senate advises and consents to nominees, the president is preventing senators and the people they represent from obtaining any answers from Mr. Berwick, who has repeatedly made statements that raise numerous questions about his suitability for this critical position.

The public needs to know whether he still endorses his remarks attacking private-sector solutions to health care problems, in support of “rationing with our eyes open” [link: http://www.healthpolicy-news.org/article/27717/], and expressing his affection for the United Kingdom’s notoriously slow and rationing-plagued National Health Service as “romantic.” [link: http://www.healthpolicy-news.org/article/27705/]

The public would want to hear Berwick’s comments on the video footage discovered and highlighted by The Heartland Institute in May [http://www.healthpolicy-news.org/article/27630/], in which he made the statement, “Any health care funding plan that is just, equitable, civilized, and humane must, must redistribute wealth from the richer among us to the poorer and the less fortunate. Excellent health care is by definition redistributional.”

Senators have expressed concerns about statements such as these, as well as Berwick’s background. He is a nominee with little management experience poised to head the second largest insurer on the planet, an agency with more funding to disburse than all but the top 15 economies in the world. The White House’s decision to make this recess appointment is as much a demonstration of the president’s unwillingness to engage in public debate about Berwick’s views as it is of his concern that some in his own party have privately questioned whether the nominee is outside the mainstream.

Such questions are of course appropriate. The White House’s decision, however, means they will not be answered. Understand: Berwick’s position as head of CMS will give him unprecedented power to apply his extremely unpopular views on health care policy under the president’s new health care regime. And thanks to the White House’s game-playing, he will not answer one question, not one, before he is ensconced in a position where his radical views will affect the life and health care of every American.

As we saw in the process by which Obamacare was rammed through Congress despite immense public opposition, there is nothing—not precedent, not tradition, not even the most basic notions of fairness or responsible governance—that will stop Obama and his allies in their quest to remake American social policy in their image.

Benjamin Domenech ([email protected]) is managing editor of Health Care News.