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 (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 consevatives 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 need Berwick, in Washington, guiding CMS.
A Postscript– As Joanne Kenen points out over at the New America Foundation's New Health Dialogue,:There is a down side to Berwick's recess appointment: "a recess appointment only lasts until the end of 2011 when the current Congress expires." http://health.newamerica.net/blogposts/2010/health_reform_republicans_alas_ones_without_votes_praising_berwick-30404