Obama bypassing Senate for new Medicare chief

[a kennedy]

WASHINGTON — Bypassing Republicans eager to grill an administration official over the new health care law, President Barack Obama is planning to appoint the head of Medicare and Medicaid without Senate hearings.

Obama intends to use a so-called recess appointment to put Dr. Donald Berwick in charge of the Centers for Medicare and Medicaid Services, a White House official said Tuesday night. The appointment was expected Wednesday.

The decision means Berwick, an expert on patient care, can assume the post without being confirmed by the Senate, which is in recess for the July Fourth holiday. He could serve through next year without Senate confirmation.

Republicans had indicated they were prepared 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 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," White House communications director Dan Pfeiffer wrote in a post on the White House blog. "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."

full: http://www.msnbc.msn.com/id/38117251/ns/health/

[pinto]

1. Dr. Berwick co-authored this Op-Ed in 8/09 - 10 Steps to Better Health Care

10 Steps to Better Health Care

By ATUL GAWANDE, DONALD BERWICK, ELLIOTT FISHER and MARK McCLELLAN
Published: August 12, 2009

WE have reached a sobering point in our national health-reform debate. Americans have recognized that our health system is bankrupting us and that we have dealt with this by letting the system price more and more people out of health care. So we are trying to decide if we are willing to change — willing to ensure that everyone can have coverage. That means banishing the phrase “pre-existing condition.” It also means finding ways to pay for coverage for those who can’t afford it without help.

Both of these steps stir heated argument, not to mention lobbyists’ hearts. But what creates the deepest unease is considering what we will have to do about the system’s exploding costs if pushing more people out is no longer an option. We have really discussed only two options: raising taxes or rationing care. The public is understandably alarmed.

There is a far more desirable alternative: to change how care is delivered so that it is both less expensive and more effective. But there is widespread skepticism about whether that is possible.

Yes, many European health systems have done it, but we are not Europe. And evidence that places like the Mayo Clinic in Minnesota or the Cleveland Clinic are doing it is likewise dismissed because their unique structures (for example, their physicians work on salary rather than being paid for each service) make them seem as far from Middle America as Sweden is.

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http://www.nytimes.com/2009/08/13/opinion/13gawande.html?pagewanted=1&_r=3&ref=opinion