President Barack Obama’s recess appointment of Dr. Donald Berwick to head the Centers for Medicare and Medicaid has created a furor among conservative bloggers, including one who refers to Berwick as “rationer-in-chief.” But his supporters say Medicare needs his leadership now.
Dan Pfieffer, the administration’s communications director, wrote on WhiteHouse.gov that Obama made the appointment because “[m]any 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.”
The Apothecary’s Avik Roy calls Pfieffer’s explanation “laughable” and says because of Berwick’s views on the British National Health Service, Democrats did not want to hold public hearings. Roy continues, “Berwick would only generate more controversy if he aired his views in Congress. And we’re not talking ‘controversy’ in the mountain-out-of-a-molehill sense: we’re talking about the basic philosophy of whether or not we should have a free or centrally-planned health care system. The American public, and more importantly, the American idea, are not on Berwick’s side.”
Hot Air’s Ed Morrissey also disagrees with the White House explanation: “No one ’stalled’ Berwick. The truth is that Obama was afraid to have Berwick questioned by Congress, which should have everyone questioning his suitability for the position, even without considering his prior statements on wealth redistribution and slobbering fanboyism of the British state-run health service.”
April Fulton and Julie Rovner observe on NPR’s Shots blog that “Senate Republicans vowed to block Berwick, even though many admit he’s highly qualified, because they want to revive their battle over the health care law, which is getting decidedly mixed reviews on an array of fronts. Recent polls have shown support for the new health overhaul up slightly. But still only about half the public has a positive view of the law. One strategy of health care overhaul opponents has been to try to get measures that would effectively nullify the measure on a state-by-state basis onto November ballots.”
Heritage’s Conn Carroll calls Berwick “rationer-in-chief” and continues, “The fact that the White House chose to empower Dr. Berwick by recess appointment is particularly audacious. The recess appointment power was intended to be used for occasions when the Senate is out for months at a time. The Senate is currently out of session for just 11 days. Worse, the Senate majority has never even scheduled a hearing so that Dr. Berwick’s rationing views could be given an ‘open’ forum. In fact, Dr. Berwick has not even returned Senators’ written questionnaires.”
Philip Klein of the American Spectator notes several controversial statements from Berwick and says, “Had [Obama] appointed Berwick during the health care debate, it would have exposed how much Obama’s ultimate vision for U.S. health care borrows from the British model.”
The New Republic’s Jonathan Cohn has a cautiously optimistic take: ”CMS director is always an important job. But it’s even more important now, as the Obama administration starts to implement health care reform. Not only must CMS prepare to deliver coverage to millions of new Medicaid recipients. It must also re-engineer Medicare itself, so that it pays for services in ways that foster better, more efficient care. Figuring out how to provide better care for less money is Berwick’s specialty, making him, at least on paper, a perfect choice for the job. … For the record, a serious conversation about Berwick’s qualifications and plans would have been worthwhile. I’ve heard even people sympathetic to Berwick question whether his administrative experience is adequte. But, again, it’s hard to have a serious conversation when one of the two political parties refuses to be serious.”
Wonk Room’s Igor Volsky agrees with the administration’s reasoning behind a recess appointment: “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.”
Health Beat’s Maggie Mahar seems pleased, writing: “We needed Berwick, in Washington, guiding CMS. Yesterday — or eight years ago.”
Time’s Kate Pickert tries to figure out what the recess appointment could mean for Berwick’s success in his new role: “So the White House is trying to stay a step ahead of Republicans – playing defense even before they could run their offensive play against Berwick, labeling the pediatrician, highly regarded researcher and expert on health care policy simply an ‘expert on rationing.’ How this will affect Berwick, who is a brilliant policy wonk but whose provocative public statements exposed his political naivete? Well, Berwick is getting a lesson in politics now and it’s one that Republicans will eagerly remind him of every time he comes into contact with them in the next 18 months or so.
And the website for the documentary Money-Driven Medicine has posted several video excerpts of interviews with Berwick from the film.