When criticisms of Berwick's philosophy are aired, look for plenty of references to “rationing” and “socialized medicine.” As if those terms don't already apply to our system. Remind me, who's the payer for Medicare, Medicaid and the Veterans Affairs health system?
In his declaration last week that Berwick's nomination was dead, Baucus noted a letter to Obama signed by 42 GOP senators repeating some of those criticisms. But they say more about the status quo in Washington than about the merits of the current CMS administrator.
Regarding the Berwick nomination fight, Baucus is quoted as saying, “The Republicans won.” Perhaps, but given the charges leveled and the path this entire appointment and nomination process has traveled, a more accurate statement is that, once again, the American people have lost. A look at some statements in the letter from the Senate Republicans reminds us of the bitter discourse in which our politics remain steeped.
Toward the top of the letter, Obama is reprimanded for his “decision to appoint Dr. Berwick by recess appointment,” which was “completed before a hearing could be held thereby short-circuiting the ability of the Senate to consider his nomination.” Later, the appointment is called an “end-run around Congress.”
One reading of that: How dare the president use such a partisan and unsavory maneuver? It's as if recess appointments are rare and illegitimate.
Which of course is disingenuous. Such appointments have been made by presidents dating back to George Washington. And they were a favorite tactic of another George—George W. Bush made at least 171 of them during his presidency, including highly controversial selections for the federal bench.
It is certainly true that the Democrats—especially Baucus—could have convened a hearing for Berwick before his appointment and anytime since. That exercise, while likely a waste of effort, would have at least been an attempt at bipartisanship. Again, another lost opportunity.
Later in the letter, Berwick is criticized for a “general lack of experience managing an organization as large and complex as CMS,” which “should disqualify him” from being confirmed. Berwick's lack of experience in the health insurance arena also was raised.
While this magazine has never been a cheerleader for Berwick, in his past roles or as CMS chief, nobody should question his dedication to patient safety and extensive industry experience as a physician and executive.
Also, why not raise the same question about the qualifications of members of Congress to oversee an enterprise as vast as the U.S. economy? Talk about lack of experience.