The saga of Donald Berwick as administrator of the Centers for Medicare & Medicaid Services took an interesting, if not sadly predictable, turn last week. Opponents of his patron, President Obama, called for Berwick to be pulled from consideration for renomination.
If the president could stick out his tongue and appoint Berwick during a Congressional recess last summer, well, the lawmakers in the minority in Washington could return the compliment. Forty-two Republican U.S. Senators, to be exact, did just that when they sent a letter to Obama. It cited Berwick’s lack of experience running a major insurance operation and past statements that rankled political conservatives as proof positive he was unfit for the job.
Berwick needs Senate confirmation by the end of the year or, by law, must leave office. Mildly interested friends of mine were dumbfounded to learn that just 41 Senators (out of 100) were needed to block such an appointment. So much for majority rule. But we digress. Obama’s opponents appear to have more than enough firepower to derail the nomination.
What happens from here is uncertain, except that the White House has said the nomination will stand. No surrender. And that’s the way it should be. If Obama believes in his man, let him stand up to scrutiny during confirmation hearings. Obama got his head start with the backdoor appointment last year. So far, Berwick has faced congressional inquisitors on a limited basis, on other topics, reasonably well.
Give this until fall for hearings to begin and Berwick will have had more than a year to prove himself. Of course, some politicians and apparatchniks never prove themselves in some people’s eyes. But why not give it a try if you’re the administration? The worst that could happen would be that Berwick gets pilloried in public. But over what? So far, he’s done nothing worse than implement the administration’s plans. No statements about modeling the American healthcare system after Britain’s. And no other mumblings like those from the past that have Republicans hypothesizing and hyperventilating all at the same time. The “smoking gun” they want to wave around the room hasn’t been fired—not since Berwick was given the scepter anyway.
If after hearings, Berwick gets booted, so be it. By accepting the post, he surely must have known he’d need his big boy pants at some point. If the end result of his tenure as CMS chief becomes showing once again that obstructionism is a less arduous way to govern than using creativity or independent thinking, well, then the effort would not have been totally in vain.
