Could the White House have saved Berwick?

Ever since Medicare chief Don Berwick left the Obama administration four days ago, he’s been on mini-media blitz.

The former Medicare head, who resigned in November after Senate Republicans blocked his permanent nomination, was the subject of a New York Times profile Saturday. That was followed by a lengthy Sunday morning interview with MSNBC’s Chris Hayes and, today, a column by Joe Nocera praising Berwick as “the most qualified person in the country to run Medicare at this critical juncture.”

Berwick has come across as a health policy wonk in these interviews. He discusses his academic work on the “triple aim” of health reform: improving health care quality and patient experience while reducing costs. He doesn’t delve much into the politics of his nomination. When Chris Hayes asked him what it was like to be “castigated” for his views on health policy, he demurred.

“My overall time has been wonderful,” Berwick said. “I feel very lucky to have had this experience and don’t have any burden about this.”

All of this has Democrats asking: Where was this side of Berwick when the White House nominated him to head Medicare?

When the White House nominated Berwick last April, Republicans quickly seized on his praise for the British National Health System and accused him of supporting “rationing.” Berwick never got a confirmation hearing; the White House recess appointed him two months later after it became apparent that he wouldn’t survive a Senate confirmation vote.

When the Senate did call Berwick up to testify for the first time it was already November, six months after his recess appointment. Time ran an item titled about his hearing titled “Breaking: Don Berwick To Answer Questions.”

Could Democrats done more to introduce Berwick to the public and address Republicans’ charges? Sen. Tom Harkin, chair of the Health, Education and Labor Committee, certainly thinks so. “If it had been in my committee, he would have had a hearing,” Harkin told the Hill’s Julian Pecquet in a recent interview. “I would let the Republicans make fools of themselves and I would have shown what credentials he has. And then let’s have a vote.”

The vote almost certainly would not have succeeded. And, as a Senate Democratic aide explained to the Hill, Democrats worried a hearing could do more harm than good. “Given that the votes were never there, Democrats were 100 percent correct not letting Republicans turn the Berwick nomination into a circus where they attempt to torch health care yet again,” the aide said. “The end of Don Berwick’s tenure lies solely at the feet of Republicans, who made clear he was going nowhere from the start.”

After Berwick did come into office, he became progressively more available to the media. The topics were decidedly wonky; an August 2010 press call, one month into his tenure, focused on changes to Medicare Part D premiums. He would later defend his comments about the British National Health Service in an interview with my colleague Amy Goldstein. More recently, Berwick and I spoke at length for a recent story about a $1 billion program to increase the health care workforce earlier this month.

The CMS administrator has won accolades from nearly all professional health associations. As Health Affairs put it recently, “It’s difficult to find any stakeholder groups that express anything less than glowing praise for Berwick’s performance at CMS.”

In the end, none of those interviews or endorsement seemed to have mattered that much. Whether it was a matter of politics or policy, Republicans have remained firmly opposed to his position. Forty-two Republican Senators signed onto a letter vowing to block his permanent appointment.

On MSNBC, Berwick recounted a meeting with Sen. Jon Kyl, a Republican who sits on the Finance Committee that would have handled his nomination. “His first words to me were, ‘Dr. Berwick, I haven’t seen a single thing you’ve said or written that I agree with,’” Berwick recalled. “That’s not a framework for a conversation.”