DONALD BERWICK: BEHIND SLAMMED DOORS

Closed door politics was the norm throughout the health care reform debate, and it seems that the Administration continued that practice with its latest move-the recess appointment of Dr. Donald Berwick to serve as the Administrator of the Centers for Medicare and Medicaid Services (CMS).  CMS is a vast federal agency that administers care to 100 million seniors, children, and low-income families, with an annual budget of over $800 billion a year-a budget larger than the Pentagon's. With the newly enacted health care bill, the CMS Administrator must oversee the implementation of this 2,409-page bill, including a massive Medicaid expansion and more than $500 billion in cuts to the Medicare program, which will impact more than 44 million seniors enrolled in Medicare. 

To say that this position is important is an understatement.  A recent Wall Street Journal article asserted that this appointment is more important to the direction of the country than Elena Kagan's nomination to the Supreme Court.  However, despite repeated promises of transparency in governing, President Obama quietly appointed Berwick to this position during the Independence Day recess.  When public outrage arose over that action, he formally re-submitted the nomination to the Senate, although the recess appointment stands and it is unlikely that Berwick will ever face any confirmation hearings or a confirmation vote.

While President Obama is not the first president to use the recess appointment, it is a mechanism that should be used only as a last step in the case of unreasonable delay, not a first.  Berwick was nominated on April 19, less than three months ago.  The recess appointment of Berwick was an effort to bypass the scrutiny of the Senate and the American people for one simple reason-if they knew who Berwick is and what he stands for, they would never support the nomination. 

Earlier this month, I joined with my Republican colleagues on the Finance Committee to ask Chairman Baucus for a hearing to question Berwick on his views.  This is particularly important given the troubling nature of many quotes from Berwick regarding his views on health care. Some of the most disturbing include: 

·          On rationing: "The decision is not whether or not we will ration care-the decision is whether we will ration with our eyes open."

·          On single-payer health care: "I admit to my own devotion to a single-payer mechanism as the only sensible approach to health care finance I can think of."

·          On the British National Health Care system: "I think the NHS is one of the great human health care endeavors on earth.  It can be an example for the whole world, an example, I must say, that the United States needs now more than most other countries do."

The worrisome list of Berwick's statements is growing and troubling. 

Many Idahoans, along with many other Americans, were strongly opposed to the health care bill, yet it was forced through Congress with backroom deals and false claims.  Similar to the same gimmicks and procedural abuses used to force through the health care bill, this recess appointment was done to bypass public scrutiny and Senate procedure to keep the public in the dark until the appointment was final.  The public reaction has taught the Administration an important lesson in transparency.  Unfortunately the President's resubmission of the appointment appears to be nothing more than political cover. What should happen is Berwick should come before the Senate Finance Committee for a full vetting of his record and positions and his nomination should be put before the Senate for a vote. We will see. 

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