If a Republican president nominated a managed care executive to run CMS and rammed him through in a recess appointment, allegations about conflicts of interests would abound. Berwick made millions working with for-profit firms that will make money off Obamacare. But because he believes in central planning he gets a recess appointment. That's why elections, including the upcoming mid-term elections, matter.
These concerns might have been settled in a Senate hearing. But Obama cheated us out of that. Sure, recess appointments are common, but this wasn't just any recess appointment. Berwick represented issues of special importance to policy makers and the American people. Those issues needed exposure in the light of public debate.
H/T to Retired Doc.