According to Politico, President Obama will be forced to abandon his controversial nomination of Donald Berwick as the administrator of the Centers for Medicare and Medicaid Services (CMS). Politico reports that “Senate Democrats have given up on confirming Don Berwick as CMS administrator in the wake of a letter from 42 Republican senators opposing the nomination,” as “there's no way for Berwick to get the 60 votes needed to clear the Senate.”
As with his various “czars,” President Obama had previously circumvented the Senate confirmation process (despite having a Democratically controlled Senate) to install Berwick in his post. He had done so by issuing a “recess appointment,” but that appointment expires at the end of this year.
As I wrote last spring, the Berwick nomination is one of the clearest indicators of where we are headed if ObamaCare is not repealed:
As everyone knows by now, Obamacare would raise, not lower, health costs. This is the consensus view of the CBO, Medicare’s chief actuary, and the American people. However, another consensus view — shared by nearly everyone outside of the Obama White House and the Democratic Congress — is that the number one goal of health policy should be to cut costs. So, if you combine a health care overhaul that won’t cut costs, with a pressing need to cut costs, where are we headed?
President Obama’s pick to fill the top post at Medicare and Medicaid provides a strong indication. We’re going down the only cost cutting road that government can travel. More exactly, we’re heading toward a nation-defining fork in the road. In one direction lies repeal; in the other, rationed care. In one direction, liberty; in the other, consolidated power.
President Obama’s pick to head the massive Centers for Medicare and Medicaid Services, Dr. Donald Berwick, is a Harvard doctor with a stated fondness for nationalized medicine. He plainly wasn’t picked for his large-scale executive or managerial experience. He’s currently a professor, a pediatrician, and the CEO of a nonprofit whose website reports it has “a staff of over 100 dedicated and talented people.” No, he was presumably picked because he and President Obama see eye-to-eye: Both share the same academic approach to problem-solving, both think our health-care system should be run through Washington, and both support a strong degree of bureaucratic control over questions of life and death. If confirmed by the Senate, he would become head of an agency with a budget larger than that of the Department of Defense.”
Lest anyone think I was exaggerating, Berwick has written that the British health-care system is “more likely to succeed” than the American one; that he feels “an optimism about the [British] NHS [National Health System] that is hard to find in the UK nowadays”; that he thinks “nationalized health care was a wise choice in 1948 and that it remains so now”; that “the social budget” — the social budget! — “is limited”; and that “[t]he decision is not whether or not we will ration care — the decision is whether we will ration with our eyes open.” This is who President Obama wants to have running Medicare, Medicaid, and significant portions of ObamaCare.
It looks like the Constitution’s confirmation process will serve as a bulwark against President Obama’s desires in this instance, although it’s unlikely that his next nominee will hold views that are radically different from Berwick’s or his own. (That new nominee almost certainly will, however, have been more careful about publicly expressing those views). But Obama’s failure to get his Berwick nomination through the Democratic Senate doesn’t change the fact that Obama chose someone like Berwick in the first place, or the fact that he circumvented the usual process to install him in the short-term. Nor does it change what the Berwick nomination tells us about the direction in which Obama thinks ObamaCare would and should take American health care.