Under normal circumstances, the Senate Finance Committee would have held a hearing on the nomination, with Dr. Berwick fielding questions from both supporters and critics. Then the committee would have voted on whether to report the nomination to the full Senate for its approval.
President Obama sidestepped that process — which Senate Republicans could have derailed with a filibuster — by taking advantage of a Constitutional provision that allows the president to make appointments while Congress is between legislative sessions or in recess during a session. Congress recessed for the Fourth of July holiday and will not reconvene until Monday, July 12.
So what's the hurry?
The president issued a statement today saying that he was making a recess appointment in the case of Dr. Berwick and 2 other nominees for federal office because "many in Congress have decided to delay critical nominations for political purposes."
Political purposes? Yes, of course. The political process is for the public good. By circumventing it Obama cheated us of an important debate.
Lori Heim, MD, the president of the American Academy of Family Physicians, told Medscape Medical News that the recess appointment "serves CMS, physicians, and the public very well" because the Obama administration could not afford to wait any longer to fill the post...Nonsense.
"With healthcare reform legislation comes a renewed need to have a strong CMS administrator because of all the implementation that will fall to CMS," said Dr. Heim, whose medical association supported Dr. Berwick's nomination.“All the implementation that will fall to CMS” is a big part of the problem with Obamacare. It puts enormous power into the hands of health care czars to implement things that would, in the pre-Obamacare world, have required legislative approval. I guess it's another reason why, as Nancy Pelosi said, we needed to pass this bill in order to find out what was in it.
Dr. McClellan, as well as Thomas Scully, another former CMS administrator appointed by George W. Bush, have both declared their support for Dr. Berwick. Such endorsements, taken together with Republican opposition to Dr. Berwick, demonstrate that "political debate is not about somebody's qualifications," Dr. Heim said. "It is strictly on a partisan basis."
She's right, it's not so much about qualifications. It's about ideas. Berwick's supporters have not critically examined his ideas.
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