Berwick recess appointment is a savvy move

Please excuse the brevity and lack of links. I’m on vacation writing from my phone.

Obama’s decision to use a recess appointment to install Dr. Donald Berwick as head of CMS is extremely wise. Why? Because it’s critical for the Administration to establish momentum and create ‘facts on the ground’ for the implementation of health reform. Earlier health care programs such as Medicare faced battles over rule-writing and the specifics of implementation but there was nothing equivalent to the current efforts to repeal the law.

The recess appointment (a way for
the president to bypass Congressional hearings and a vote to confirm the nominee) puts Berwick in place right away and keeps him there till the end of the next Congressional session in late 2011. That’s a long time for Berwick to make progress on health reform implementation. By the time he does face Congressional scrutiny to make his appointment permanent it can be on the basis of his work to that point on Medicare and Medicaid, not some sensationalistic distortion of his views on the UK’s National Health Service and rationing.

A FierceHealthcare story (Obama’s recess appointment of Berwick as CMS head draws criticism from Republicans) indicates the move may “backfire” by focusing voters on how Obama circumvented the typical confirmation process.

I really don’t think all this focus on process resonates with the average voter. How many people can explain the procedural measures used to pass health reform just a few months ago? Who can argue with a straight face that President Bush’s approach to resource appointments was more restrained and appropriate?

It’s a very small set of wonks that care about this stuff anyway. And believe me, those people already made up their minds.

July 7, 2010

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