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Obama Bypassing Senate To Fill Medicare Post

ERICA WERNER   07/ 6/10 10:46 PM ET   AP

Obama Berwick

WASHINGTON — President Barack Obama intends to use the congressional recess to bypass the Senate and appoint Dr. Donald Berwick, an expert on patient care who's drawn fire from the GOP, to oversee Medicare and Medicaid, the White House announced late Tuesday.

The appointment was to be made Wednesday, with lawmakers out of town for their annual July Fourth break, White House communications director Dan Pfeiffer said in a post on the White House blog.

The decision means Berwick can assume the post of administrator of the Centers for Medicare and Medicaid Services without undergoing confirmation hearings in the Senate. Republicans have indicated they're prepared to oppose him over comments he's made on rationing of medical care and other matters. Democrats want to avoid a nasty confirmation fight that could reopen the health care debate. Berwick was nominated in April but no confirmation hearing had been scheduled.

"Many Republicans in Congress have made it clear in recent weeks that they were going to stall the nomination as long as they could, solely to score political points," Pfeiffer wrote. "But with the agency facing new responsibilities to protect seniors' care under the Affordable Care Act, there's no time to waste with Washington game-playing."

The decision to use a recess appointment to skirt the Senate is sure to draw fire from Republicans although the tool has been used frequently by presidents of both political parties. Obama last made a batch of recess appointments in March, and along with Berwick he was to make two other less prominent appointments Wednesday, one to a pension board and the other to a science post in the White House, the White House said. The recess appointment will allow Berwick to serve through next year without Senate confirmation.

"This recess appointment is an insult to the American people," Sen. John Barrasso, R-Wyo., said in a statement. "Dr. Berwick is a self-professed supporter of rationing health care and he won't even have to explain his views to the American people in a congressional hearing. Once again, President Obama has made a mockery of his pledge to be accountable and transparent."

The Senate Republican leader, Sen. Mitch McConnell of Kentucky, said "the fact that this administration won't allow the man charged with implementing the president's plan to cut $500 billion out of Medicare to testify about his plans for the care of our nation's seniors is truly outrageous."

Berwick, 63, is a pediatrician, Harvard University professor and leader of a health care nonprofit organization who's drawn support from many quarters, including the American Medical Association, since his nomination to oversee the enormous Medicare and Medicaid health insurance plans for the elderly, poor and disabled.

He's been criticized by Republicans for a number of comments, including telling an interviewer last year: "The decision is not whether or not we will ration care – the decision is whether we will ration with our eyes open. And right now, we are doing it blindly."

Republicans have seized on that to cast Berwick as someone who would deny needed care based on cost, while supporters contend rationing already is done by insurance companies and Berwick simply wants transparency and accountability in medical decisions.

It's just those echoes of last year's acrimonious health care debate that Democrats would prefer not to replay on the Senate floor.

Medicare has been without an administrator since 2006, and the White House says the need to fill the post is critical because of its role in implementing the new health care law. Medicare is to be a key testing ground for numerous aspects of the new law, from developing new medical techniques to trying out new payment systems, and the White House says a permanent leader is key with deadlines in the law approaching.

In addition to his professorship at Harvard, Berwick is the president of the Institute for Healthcare Improvement, a nonprofit in Cambridge, Mass., that works to develop and implement concepts for improving patient care.

Also being appointed Wednesday were:

_Philip E. Coyle III as associate director for national security and international affairs at the White House Office of Science and Technology Policy.

_Joshua Gotbaum as director of the Pension Benefit Guaranty Corporation.

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WASHINGTON — President Barack Obama intends to use the congressional recess to bypass the Senate and appoint Dr. Donald Berwick, an expert on patient care who's drawn fire from the GOP, to overs...
WASHINGTON — President Barack Obama intends to use the congressional recess to bypass the Senate and appoint Dr. Donald Berwick, an expert on patient care who's drawn fire from the GOP, to overs...
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COMMUNITY PUNDITS
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cybersense 10:51 AM on 07/07/2010
I may or may not think this guy is right for the job, but because of the all the barriers of this congress members to get anything done, for the sake of games (the kind children play in High School) I think I can't blame this President for just getting something done. This is what it has come to, and although this nomination is one of the not so high profile elements to everything in the grand scheme of  Read More...
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HUFFPOST PUNDIT
ReedYoung
global mean land-ocean temperature 1880 to present
12:23 PM on 07/11/2010
How exactly is that biased, subservient, corporatist media garbage by the Approximated Press a "news" article?

from above: "The decision to use a recess appointment to skirt the Senate is sure to draw fire from Republicans although the tool has been used frequently by presidents of both political parties." (Republican-biased, one sided commentary in an allegedly "news" article is s.o.p. for AP; it is NOT journalism.)

Then AP parrots Repunklican talking points of Barrasso and McConnell -- plays "stenographer" as most trusted name in journalism Jon Stewart correctly puts it -- without even mentioning the **documented fact** that Senate Repunklicans have abused the filibuster (which is intended to allow Senators of the minority party only to stall what they strongly feel is the most morally wrong actions of the majority) by using the filibuster with historically unprecedented frequency. That much historical context (not in those exact words, obviously; this is *my* opinion, not journalistic style) should be a minimum journalistic standard, if they're going to let the opposition partisans inject their opinions to a "news" article.

"Historically unprecedented" btw not only means more than ever before, it's 2 - 3 **times** more than any other previous Senate in the same time period.

http://blogs.alternet.org/skeeterbitesreport/2010/03/01/solid-evidence-emerges-of-gops-unconstitutional-abuse-of-power-in-senate/
http://www.mcclatchydc.com/2010/02/12/84487/senate-republicans-filibuster.html

Huffington Post should dump ap and carry real news, meaning McClatchy.
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HUFFPOST PUNDIT
ReedYoung
global mean land-ocean temperature 1880 to present
12:53 PM on 07/11/2010
The subject of the story is a recess appointment to a position that's pertinent to medical care in the United States. *If* one gives ap the benefit of the doubt and allows that the opinions of partisan Senators might be relevant to the facts, then the opinion of Senators on *both* sides of the matter are equally valid and Vermont independent Bernie Sanders, who is an advocate of single payer health care, is an example of somebody who is on the opposite side of the health care debate from corporatist extremists Barrasso and McConnell. Ignoring the commentary of the MAJORITY party, when Democrats are in the majority, and giving Repunklicans a megaphone for their talking points, sums up the naked partisan bias of the approximated press.
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HUFFPOST SUPER USER
right Alice
11:07 AM on 07/12/2010
While they did mention that Medicare has been w/o an admin'r since 2006,
they didn't seem to mention what a previous article here stated:

*George W. Bush made 171 recess appointments
*President Obama has now made a total of 18 recess appointments

http://www.huffingtonpost.com/ethan-rome/dr-berwicks-test-results_b_640922.html?page=2&show_comment_id=53226012#comment_53226012

I mean, just for scale and context and everything (good thing they
have megaphones and a dedicated 24/7 network to drown out facts).
yougg
just a citizen
07:19 AM on 07/09/2010
Why don't people understand that health care is already rationed by the for profit health insurers? More care or elaborate care is not necessarily better care. Sometimes less is more.Hopefully this new administrator can make some headway on caring for the elderly. We don't not have enought doctors who specialize in geriatics. In fact geriatics are not not part of the rotation in the training of doctors-and it should be. If you have a doctor who is good with the an elderly person, you have struck gold. The elderly are vastly over medicated. Speaking from personal experience-my mom was having ongoing problems that her doctor was not able address. Out of fustration I contacted her pharmacy and got the pharmicist to review her scripts. The pharmacist was able to shed light on why she was having the problems. Along with some research on the internet I was able to work with the doctor and eliminate 2 of the 11 drugs she was taking. And she was better. All drugs have side effects. The elderly are especially vulnurable.
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HUFFPOST SUPER USER
Pieter Van Dyke
Not at the Table Carlos!!!
07:51 PM on 07/08/2010
The most transpartent presidency of all time...I can see thru all their BS
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HUFFPOST SUPER USER
Jay Jefferson
07:35 PM on 07/08/2010
Naturally when health care costs escalate to more than 12 times what has been estimated the sensable thing to do is to eliminate pro-active approaches to medicine and create the illusion of caring for people until the costs of the medicine are higher than the life is worth. You may ask yourself who determines what a life is worth? With the recess appoint of Berwick it is now known. A lot of damage can be done until 2012 when the appointment expires. America needs death panels to thin the herd of those unfortunate enough to need intensive medical care. Those that are not sickly now will be spared for a longer period of time. This will also help with the soon to be bankrupt Social Security system. By allowing enough Americans to expire a balance can be achieved whereby the payors and payees create a harmony that doesn't overtax the system.
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08:42 PM on 07/08/2010
Dr. Berwick was President and CEO if the Institute for Health Care Improvement (IHI) , and has been working with hospitals across the country (America) to improve the delivery of patient services.

From January 2005 to June 2006 the IHI undertook the 100,000 Lives Campaign, a nationwide initiative launched by the Institute for to significantly reduce morbidity and mortality in American health care. Over 3,000 US hospitals joined this effort.

“The names of the patients whose lives we save can never be known. Our contribution will be what did not happen to them. And, though they are unknown, we will know that mothers and fathers are at graduations and weddings they would have missed, and that grandchildren will know grandparents they might never have known, and holidays will be taken, and work completed, and books read, and symphonies heard, and gardens tended that, without our work, would never have been.” - Donald M. Berwick, MD, MPP

Building on this momentum, the subsequent 5 Million Lives Campaign engaged more than 4,000 US hospitals to prevent five million incidents of medical harm over a two-year period.

http://www.ihi.org/ihi/about

But then all your suppositions are based on third hand, unsubstantiated and anecdotal information information.

The ignorant engage in fear mongering to make a point.
cureyourosity
INDEPENDENT--cuz the other two parties suck
11:49 AM on 07/08/2010
Hip hip hooray! Once again the Donkey party is about to screw us over. The trillion dollar stimulus to our economy DID NOT WORK as you can read in any paper how unemployment and the lack of jobs are bogging the nation down. Now their great healthcare plan [that wasn't going to increase costs but has] is going to take affect. I can't wait to hear how proud of themselves they'll be when they realize someone is going to decide when they get to see a doctor, or IF their ailments warrant any treatment at all! How else do you think he's going to cut $500 Billion. MANY I'm betting the elderly are going to be in jeopardy!
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01:38 PM on 07/08/2010
You are wrong about the ARRA:

"CBO estimates that in the first quarter of calendar year 2010, ARRA’s policies:

* Raised the level of real (inflation-adjusted) gross domestic product (GDP) by between 1.7 percent and 4.2 percent,

* Lowered the unemployment rate by between 0.7 percentage points and 1.5 percentage points,

* Increased the number of people employed by between 1.2 million and 2.8 million, and

* Increased the number of full-time-equivalent (FTE) jobs by 1.8 million to 4.1 million compared with what those amounts would have been otherwise.

The effects of ARRA on output and employment are expected to increase further during calendar year 2010... "

http://cboblog.cbo.gov/?p=967
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01:45 PM on 07/08/2010
And you are wrong about Dr. Berwick:

"From January 2005 to June 2006 the IHI (where Dr. Berwick was CEO) undertook the 100,000 Lives Campaign, a nationwide initiative launched by the Institute for to significantly reduce morbidity and mortality in American health care. Over 3,000 US hospitals joined this effort.

Building on this momentum, the subsequent 5 Million Lives Campaign engaged more than 4,000 US hospitals to prevent five million incidents of medical harm over a two-year period."

http://www.ihi.org/ihi/about
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09:08 AM on 07/08/2010
Well, looks like he got his Rationing Czar. And he can help in O's whole wealth redistribution scheme as well.
Score one for the "Take from them and give to me" progressives
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HUFFPOST PUNDIT
callinguonit
2012!!!
09:59 AM on 07/08/2010
Berwick may be best-known for his “no needless” list, on which you can expect care to be centered :
• No Needless Deaths
• No Needless Pain or Suffering
• No Helplessness in Those Served or Serving
• No Unwanted Waiting
• No Waste
• No One Left Out”
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HUFFPOST PUNDIT
callinguonit
2012!!!
10:20 AM on 07/08/2010
Sorry, OT: I keep hearing about wealth redistribution.....what theory is this based on? This theory goes on the premise that most of us are wealthy. Not!. If we were we would not be in this economic crisis.
How is the government taking what we don't have in the first place. Millions of people are unemployed...if redistribution means helping others who are temporarily suffering sign me up.
If redistribution of wealth means making sure that a fourth grade child can get his swollen, infected tonsils removed....sign me up for redistribution.
If I can find the newly homeless mother with two young children and no job (because she is hiding out from her crack addicted husband) a home..Sign me up.
Besides the people who have the most to be redistributed.....Buffett, Gates...they are already planning on "giving" away half of their fortune.
"Take from them and give to Me??? If it offends you, truly offends, then never use anything that is supported by local, state and federal taxes. Because you garnered that privilege by taking from others.
Sorry for vent but, I unfortunately deal with cases like this. If it wasn't for local community centers and shelters. I could help no one. Especially when times are rough like they are now.
cureyourosity
INDEPENDENT--cuz the other two parties suck
12:07 PM on 07/08/2010
Interesting. So as many Americans who are not of the top 5% of the "wealthy" continue to lose our jobs and more of our income goes to aid these social services. Who will then help us?! The "poor" who've already taken our resources? You can't borrow your way into wealth or into a better social system. If the majority of the people are taking from those who have earned their money you are asking someone else to pay for your existence and when they can no longer do that-- the system fails. Look around you, it's already failing.
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HUFFPOST SUPER USER
Robert Lovelace
Texan against Perry
05:14 AM on 07/08/2010
Next time a Republican raises a stink about Obama making a recess appointment, remind them that GWB made 46 recess appointments of his own.

http://www.sourcewatch.org/index.php?title=Recess_appointments_made_by_President_George_W._Bush
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07:56 AM on 07/08/2010
That number is incorrect:

"As of October 31, 2008, President Bush had made 171 recess appointments..."

http://www.fas.org/sgp/crs/misc/RL33310.pdf
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HUFFPOST SUPER USER
Robert Lovelace
Texan against Perry
08:02 AM on 07/08/2010
Thank you for the correction.
Still, the point stands...just more so now.
HUFFPOST SUPER USER
koolwoman
12:35 AM on 07/08/2010
It's about damn time.
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ohiomark
Rush Geek
11:34 PM on 07/07/2010
Obama and his health care minions kept saying that there would be no "rationing" of health care, yet he appoints a man who advocates just that.

http://www.marklevinshow.com/goout.asp?u=http://www.foxnews.com/projects/pdf/070110FairExecutiveSummary.pdf
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12:01 AM on 07/08/2010
“The names of the patients whose lives we save can never be known. Our contribution will be what did not happen to them. And, though they are unknown, we will know that mothers and fathers are at graduations and weddings they would have missed, and that grandchildren will know grandparents they might never have known, and holidays will be taken, and work completed, and books read, and symphonies heard, and gardens tended that, without our work, would never have been.” - Donald M. Berwick, MD, MPP

From January 2005 to June 2006 the IHI (where Dr. Berwick was CEO) undertook the 100,000 Lives Campaign, a nationwide initiative launched by the Institute for to significantly reduce morbidity and mortality in American health care. Over 3,000 US hospitals joined this effort.

Building on this momentum, the subsequent 5 Million Lives Campaign engaged more than 4,000 US hospitals to prevent five million incidents of medical harm over a two-year period.

http://www.ihi.org/ihi/about
01:46 PM on 07/08/2010
Want to bet we don't get screwed by these people who exempted themselves for being part healthcere bill. ......
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HUFFPOST SUPER USER
Ramirez
Proud to be an American
11:32 PM on 07/07/2010
“The decision is not whether or not we will ration care--the decision is whether we will ration with our eyes open.”

Dr. Donald Berwick, in a June 2009 interview with Biotechnology Healthcare.
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11:59 PM on 07/07/2010
Examples of rationing with eyes closed:

Are you limited by your plan to only one physical per year, or one physical every two years? - Rationing

Are you required to receive your primary physician's approval to see a specialist? - Rationing

Has you insurance company ever denied a claim you submitted? - Rationing

Can Insurance companies deny coverage if they determine that your condition is "pre-existing"? - Rationing

Are there annual and lifetime limits on your Health Care Coverage? - Rationing
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HUFFPOST SUPER USER
Robert Lovelace
Texan against Perry
05:10 AM on 07/08/2010
I suffer from cluster headaches. I have to take a medication for them on almost a daily basis. My "health care" company only allows me 9 per refill (at $60 for those 9), yet will only let me refill them every three weeks. My doctor has arranged for two different versions of the pill (regular pill and disolvable), yet that is a total of 18 in a 21 day period. That leaves me three days of suffering and absolute agony.
Rationing.
10:09 PM on 07/07/2010
I'm 68 years old, and this appointment terrifies me. This health bill is so scary, and then to have a man like this appointment running it makes it ten times worse. This is a guy that is in love with the British Health model. OMG, we are really in trouble now.
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HUFFPOST PUNDIT
callinguonit
2012!!!
10:13 PM on 07/07/2010
You shouldn't be worried. look at his record;
Dr. Berwick, a pediatrician, is president and co-founder of the Institute for Healthcare Improvement, a nonprofit organization in Cambridge, Mass. He is also a professor at Harvard Medical School and the Harvard School of Public Health.
R
One of Dr. Berwick’s first tasks will be to work with Congress to avert a 21 percent cut in Medicare payments to doctors, scheduled to occur late this year.
The American Medical Association has praised Dr. Berwick, saying he is “widely known and respected” for his efforts to improve the quality and safety of care. But cuts in Medicare payments could damage the quality of care and prompt doctors to turn away new Medicare patients, doctors say.

Berwick may be best-known for his “no needless” list, on which you can expect care to be centered assuming he takes the job:
• No Needless Deaths
• No Needless Pain or Suffering
• No Helplessness in Those Served or Serving
• No Unwanted Waiting
• No Waste
• No One Left Out
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10:42 PM on 07/07/2010
Dr. Berwick was President and CEO if the Institute for Health Care Improvement (IHI) , and has been working with hospitals across the country (America) to improve the delivery of patient services.

From January 2005 to June 2006 the IHI undertook the 100,000 Lives Campaign, a nationwide initiative launched by the Institute for to significantly reduce morbidity and mortality in American health care. Over 3,000 US hospitals joined this effort.

“The names of the patients whose lives we save can never be known. Our contribution will be what did not happen to them. And, though they are unknown, we will know that mothers and fathers are at graduations and weddings they would have missed, and that grandchildren will know grandparents they might never have known, and holidays will be taken, and work completed, and books read, and symphonies heard, and gardens tended that, without our work, would never have been.” - Donald M. Berwick, MD, MPP

Building on this momentum, the subsequent 5 Million Lives Campaign engaged more than 4,000 US hospitals to prevent five million incidents of medical harm over a two-year period.

http://www.ihi.org/ihi/about

This man appears to be the world leader in improvement of patient care. Oh, and IHI did all this work with a staff of 110.
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Yellowstonedemocrat
lives in Yellowstone
09:54 PM on 07/07/2010
Read it and weep, Rethugs! HAHAHAHAHAHAH.

Y ou soooooo have it coming for holding up so many appointments and obstructing everything.
09:18 PM on 07/07/2010
Bravo!

I'd also urge him to resrot to the nuclear option. We have too many things on the plate - like the future of the planet - We can't let a bunch of Senators, bribed by lobbyists, destroy what this country needs to have done.
HUFFPOST PUNDIT
criticallydampedroots
09:06 PM on 07/07/2010
ONE HUNDRED PERCENT to avoid a public hearing about the views of Berwick! Republicans were not holding up his hearing at all, in fact the Republicans asked for the hearing to be MOVED UP in the schedule.

"But it’s not the case with Berwick, whose recess appointment is getting most of the attention.

Sen. John Kerry, D-Mass., echoed the president's suggestion, saying that “Republican lockstep stalling of Don’s nomination was a case study in cynicism and one awful example of how not to govern.”

BUT REPUBLICANS WERE NOT DELAYING OR STALLING BERWICK’S NOMINATION.

Indeed, they were eager for his hearing, hoping to assail Berwick’s past statements about health care rationing and his praise for the British health care system.

“The nomination hasn’t been held up by Republicans in Congress and to say otherwise is misleading,” said Sen. Chuck Grassley, R-Iowa, the ranking Republican on the Senate Finance Committee, which would have held Berwick’s hearing.

Grassley said that he “requested that a hearing take place two weeks ago, before this recess.”
" http://blogs.abcnews.com/politicalpunch/2010/07/president-obama-attacks-congress-for-delaying-his-nominees-is-he-right.html
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09:29 PM on 07/07/2010
The Republicans are holding up 180 appointees, keeping the Administration from doing it's job for the American People.

Bush made 110 Recess Appointments in his first term, and 171 in total.

Obama has made 18 so far.
09:58 PM on 07/07/2010
If Mr. Bush had to have 171 recess appointments and Obama only 18 the democrats must have really been keeping the Bush admin., from doing the job for the American people,no?
HUFFPOST SUPER USER
koolwoman
12:48 AM on 07/08/2010
Yeah, why are the Repubs screaming. ? It's o.k. for them but not for us? Typical Repubs.
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HUFFPOST PUNDIT
callinguonit
2012!!!
10:20 PM on 07/07/2010
Your link is to a blog..But in any case it says that "But it's not the case with Berwick"...an admission that it has been the case again and again. Obama finally got a TSA director in April. He had lost two other nominees as they tired of the drawn out process and feet dragging of the Republicans.
Obama has his third choice of TSA director. Why because they could not continue to put their lives on hold and realized that the Republicans had no intention of allowing the process to move. This would have been the case, if and win, he came up for nomination. However, it has been stressed that this position needed to be filled.
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12:20 AM on 07/08/2010
The TSA director was not confirmed until June 25th.
stateretiree
Yes, I know my micro-bio is empty!
08:46 PM on 07/07/2010
Having just gone through having to make an end of life decision, I appreciate that we were given excellent advice. It is not easy, but you have to put aside your selfishness and think of your loved one. Would they want to continue to live the way they are and what quality of life do they have? How much poking and prodding are you willing to put them through just to keep the shell of what they used to be with you. I know that my loved is where they wanted to be and has been made whole again!!! Just hope and pray that if you are ever faced with this type of decision, that you can think beyond yourself.
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HUFFPOST PUNDIT
callinguonit
2012!!!
09:52 AM on 07/08/2010
I'm sorry for your loss.