Obama bypasses Senate for new Medicare chief

WASHINGTON (AP) - President Barack Obama bypassed the Senate
Wednesday and appointed Dr. Donald Berwick, a Harvard professor and
patient care specialist, to run Medicare and Medicaid.

The decision to use a so-called recess appointment to install
Berwick as administrator of the Centers for Medicare and Medicaid
Services drew immediate fire from the GOP. Republicans have raised
concerns about Berwick's views on rationing of care and other
matters and said it was wrong for Obama to go around the normal
Senate confirmation process. That view was echoed by a key
Democratic committee chairman, although the recess appointment is a
tool used by presidents of both parties.

Berwick has wide support in the medical community but some
Democrats feared the GOP would use his confirmation hearings as an
opportunity to reopen last year's divisive health care debate.
Obama defended the decision to appoint Berwick and two other
officials, one to a pension board and the other to a White House
science post.

"It's unfortunate that at a time when our nation is facing
enormous challenges, many in Congress have decided to delay
critical nominations for political purposes," Obama said in a
statement Wednesday. "These recess appointments will allow three
extremely qualified candidates to get to work on behalf of the
American people right away."

Senate Minority Leader Mitch McConnell accused Obama of trying
to "arrogantly circumvent the American people" with Congress out
of town for its annual July Fourth break. Berwick could serve
through next year without Senate confirmation.

"Democrats haven't scheduled so much as a committee hearing for
Donald Berwick but the mere possibility of allowing the American
people the opportunity to hear what he intends to do with their
health care is evidently reason enough for this administration to
sneak him through without public scrutiny," said McConnell, R-Ky.

Senate Finance Chairman Max Baucus, D-Mont., whose committee
would have held Berwick's confirmation hearing, also said he was
troubled by the recess appointment. "Senate confirmation of
presidential appointees is an essential process prescribed by the
Constitution that serves as a check on executive power," said
Baucus. Berwick was nominated in April, and Finance Committee staff
was still at work on the vetting process it undertakes prior to
scheduling a confirmation hearing.

Berwick, 63, is a pediatrician, Harvard University professor and
leader of a health care think tank, the Institute for Healthcare
Improvement, that works to develop and implement concepts for
improving patient care. The programs he will oversee - Medicare and
Medicaid for the elderly, poor and disabled, along with the
Children's Health Insurance Program - provide care to about 100
million people, or around 1 in 3 Americans.

The American Hospital Association and AARP were among the groups
that weighed in to support Berwick Wednesday.

"Don has dedicated his career to engaging hospitals, doctors,
nurses and other health care providers to improve patient care,"
said Rich Umbendstock, head of the hospital association. "A
physician and innovator in health care quality, his knowledge of
the health care system makes him the right choice."

Republicans have seized on comments like one Berwick made to 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 say that shows Berwick would deny needed care based
on cost. 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 the 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 approaching.

Obama last made a batch of recess appointments in March. Also
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

(Copyright 2010 by The Associated Press. All Rights Reserved.)

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