President Barack Hussein Obama (mm mmm mmmm) has appointed Dr. Donald Berwick as the head of Medicare and Medicaid without Senate hearings.  

The Centers for Medicare and Medicaid Services controls one-third of all health care spending in the United States, more than $800 billion.  

Obama has made recess appointments for other “pet” nominees, including labor attorney Craig Becker, now on the National Labor Relations Board, and Chai Feldblum, now on the Equal Employment Opportunity Commission.

At the 1 and one half year mark in his presidency, President Bush had made 15 recess appointments.  This end-around will bring Scooter’s total to 18. White House officials have whined that Obama has a total of 189 nominees pending before the Senate, with almost half of them pending for more than three months. 

The decision means Berwick, proclaimed an expert on patient care, can sneak into the post without being confirmed by the Senate, which is in recess for the July Fourth holiday.  He would then be able to hold his position through next year without Senate confirmation.

Republicans had announced that they were going to oppose him over comments he had made on rationing of medical care and other matters. Democrats wanted to avoid a nasty confirmation fight that could expose the fraud that is Obamacare.   Berwick was nominated in April but there was no confirmation hearing scheduled.

White House communications director Dan Pfeiffer offered this little piece of propaganda in a post on the White House blog:

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 .  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.

Game-playing?  Obama is the master.

Obama last made a batch of recess appointments in March, and he’ll make two other less prominent appointments as well as Dr. Berwick.

Also being appointed are:

—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.

Sen. John Barrasso, R-Wyo., issued the following statement:

This recess appointment is an insult to the American people.  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.

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 the Institute for Healthcare Improvement.  He’s drawn support from many Liberal supporters, including the American Medical Association, since his nomination.

This great humanitarian said in an interview last year with Biotechnology Healthcare :

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.

Death Panels.  Hmmm.  Sounds familiar.

Liberals fire back that rationing already is done by insurance companies and Berwick simply wants transparency and accountability in medical decisions.

When all else fails, make the Insurance Industry the scapegoat.

The Democrats really would prefer not to see Berwick testify before the Senate.

Medicare has been without an administrator since 2006,but the administration says the post has to be filled immediately because of its role in implementing Obamacare. Medicare is to be a key testing ground for many parts of the new law, from developing new medical techniques (Eugenics?) to trying out new payment systems, and the White House wants to get Dr. Mengele, err, Berwick in place post haste.

Berwick  also lauded the UK’s National Institute for Health and Clinical Excellence (NICE), which he said had “developed very good and very disciplined, scientifically grounded, policy-connected models for the evaluation of medical treatments from which we ought to learn.”

Berwick chillingly said:

You can say, ‘Well, we shouldn’t even look.’ But that would be irrational. The social budget is limited — we have a limited resource pool. It makes terribly good sense to at least know the price of an added benefit, and at some point we might say nationally, regionally, or locally that we wish we could afford it, but we can’t. We have to be realistic about the knowledge base.

Berwick believes that the degree to which the knowledge base is “linked directly to policy and decision is a matter of choice. You could make it advisory, or you could make it mandatory, or you could make it a policy rule. But to remain ignorant of the cost implications of a drug that is marginally better than what is already out there is simply bad policy.”

The Republican Senators were looking to directly tie Berwick’s praise of the UK’s NICE with some of the more troubling horror stories about the UK Government-run Healthcare System.

Like this story from BigGovHealth.org:

When Linda O’Boyle, 64, was diagnosed with cancer, she decided to pay for additional, private treatment out-of-pocket, hoping to prolong her life. O’Boyle was told that a medication not provided by NHS would increase her chances of fighting the disease. After deciding to use her savings to pay for these outside medications, NHS withdrew their services, including chemotherapy because current government laws ban a patient from combining public and private healthcare. O’Boyle passed away March 26, 2008.

A bunch of Liberal physicians’ groups and health care organizations wrote a letter on Berwick’s behalf, saying:

Unfortunately, some of Dr. Berwick’s speeches and writings have been quoted in ways that misrepresent his beliefs.   Specifically, it has been suggested that Dr. Berwick is an advocate of health care rationing and that he in some way supports the government making health care decisions that should be made by patients and their doctors. This misrepresentation does a disservice to Dr. Berwick who has a long history as a leader in promoting patient-centered care.

After all, who are going to believe, a bunch of Liberal physicians and academics or what you read for yourself?

Berwick, they said, “has consistently prioritized patients’ needs and preferences not only through his best practice initiatives, but also by teaching health professionals how to put patients at the center of health care decision-making through IHI’s health professions training work. In short, Dr. Berwick’s commitment to patient-centered care is about putting control of health care decisions in the hands of informed patients and their families, working in partnership with their physicians.”

In the Economix Blog of June 23, 2009, available at nytimes.com, Berwick was asked, What should the priorities for health care reform be?   He answered:

To align policy changes, we’ll need a shared vision of the care system we want and need. Five characteristics matter most.

First, we need to organize (and pay for) the care of populations, not just the provision of events (like surgery or visits). Second, we should assure that care of individuals is integrated over time and regardless of the setting, especially for people with chronic illnesses. Third, we should design and manage patient care so that it’s highly reliable (the right care, at the right time, every time) and smooth everyone’s journey through the system by ending costly waits and delays. Fourth, we should strictly avoid overusing procedures, drugs, treatments, visits and hospital days that, based on the scientific evidence, cannot help the person getting them.   And, fifth, we should give individual patients and families power, control, information and respect.

If public policy, with public support, insists upon population-based, integrated, scientifically grounded, patient-centered systems of care as the foundation of health care reform, we can both promise universal coverage and pay for it.

It appears Obama has found another fellow traveler to put in a position in his administration.  Universal coverage for everyone…until the government runs out of money, that is.  Then it’s time to wave goodbye to Grandmother as she floats away on the ice floe.

Sources:  dailycaller.com, abcnews.com, BigGovHealth.org, nytimes.com