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Reactions to Berwick's CMS Appointment

 |  By jsimmons@healthleadersmedia.com  
   July 08, 2010

Yesterday, President Obama used a recess appointment to install Institute for Healthcare Improvement President and CEO Donald Berwick, MD, as head of the Centers for Medicare and Medicaid Services. While recess appointments by presidents are not uncommon, they can be controversial—especially after healthcare reform has been debated publicly for the past year.

Berwick received hundreds of endorsements from medical, trade, labor, and consumer organizations. But he also has come under the scrutiny of numerous senators who had anticipated engaging him in discussion of over the finer details of healthcare reform.

In introducing him yesterday, Obama said it was “unfortunate that at a time when our nation is facing enormous challenges,” many in Congress have decided to delay critical nominations for political purposes. The recess appointment will allow Berwick to “get to work on behalf of the American people right away,” Obama added.

“Given the importance of health reform to millions of Americans, tapping a respected leader for CMS is of the utmost importance,” said American Hospital Association President and CEO Rich Umbdenstock said in a statement. “Don has dedicated his career to engaging hospitals, doctors, nurses and other healthcare providers to improve patient care. ... His knowledge of the healthcare system makes him the right choice.”

“Dr. Berwick will provide leadership and inspire the talented and dedicated people at CMS as it embarks on the implementation of the recently enacted healthcare law,” said Chip Kahn, president and CEO of the Federation of American Hospitals. “Dr. Berwick is a proven leader in improving the quality and safety of healthcare in this country. The FAH looks forward to working with Dr. Berwick to fulfill the promise of healthcare reform.”

J. Fred Ralston, Jr., MD, president of the American College of Physicians, said in his statement that his group joined more than 700 stakeholders on the front lines of healthcare delivery—including business, consumers, insurers, and clinicians—to support Berwick’s nomination. “He is well respected in the healthcare community and [is] known for his desire to bring constructive change to healthcare delivery.”

“As a research professional, a clinician, and a policy analyst, he brings an extensive background that’s crucial to ensuring that healthcare policy improves patient care and the practice of medicine,” said AAFP President Lori Heim, MD, of Vass, NC, in a statement. “His leadership has helped ensure that best practices in medical care and groundbreaking medical research are brought to the physicians' offices, and his support for strengthening primary care in the Medicare and Medicaid systems will help set the path for building up the foundation of all high quality healthcare.”

In the Senate, where confirmation hearings would have been held, Sen. Max Baucus (D MT), chair of the Senate Finance Committee, criticized the White House for not going through the standard nomination process. “Senate confirmation of presidential appointees is an essential process prescribed by the constitution that serves as a check on executive power and protects ... all Americans by ensuring that crucial questions are asked of the nominee—and answered,” Baucus said.

However, Baucus added, “I look forward to working with CMS as they implement health reform to deliver the better healthcare outcomes and lower costs for patients we fought to pass in the landmark health reform law.”

Sen. Chuck Grassley (R-IA), the Senate Finance Committee’s ranking minority member, said the Obama administration “has taken advantage of the fact that there’s no check on its power, with one party control of Congress and the White House,” he said. “The nomination hasn’t been held up by Republicans in Congress and to say otherwise is misleading. As ranking member of the committee of jurisdiction, I requested that a hearing take place two weeks ago, before this recess.”

“The American people deserve better than this type of arrogance of power,” said Sen. Orrin Hatch (R-UT). Without so much as even a hearing, President Obama chose to circumvent the Senate and the American people by recess appointing his controversial nominee, Donald Berwick....No Senator—Democrat or Republican—was given the chance to ask Dr. Berwick about his strong support of Britain’s single payer National Health Service or his belief that government delivers higher quality care than the private sector.”

Sen. Tom Harkin (D IA), chairman of the Health, Education, Labor and Pensions (HELP) Committee, said, “In light of Republican arguments for strengthening Medicare and reducing waste, fraud, and abuse in the system, their opposition to Dr. Berwick’s nomination is unfathomable.”

Sen. John Kerry (D-MA), from Berwick’s home state, said: “Republican lockstep stalling of Don’s nomination was a case study in cynicism and one awful example of how not to govern. Republicans screamed that these federal programs were in trouble, then tried to deny the Administration the capable guy the President had chosen to oversee them. The President did the right thing making this a recess appointment.”

Janice Simmons is a senior editor and Washington, DC, correspondent for HealthLeaders Media Online. She can be reached at jsimmons@healthleadersmedia.com.

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