The public deserves a hearing for a Medicare appointee

Friday, July 23, 2010

"I CAN'T PLAY political games on these issues. I've got a government to run," President Obama said in explaining his move to sidestep the Senate and use a recess appointment to install Donald Berwick to run Medicare and Medicaid. Mr. Obama's hurry would have been more understandable had he not waited for more than a year to select an administrator for the Centers for Medicare and Medicaid Services. Then again, Senate Republicans had made it pretty clear that they would do their best to block Dr. Berwick's confirmation. With deadlines looming for implementing the new health-care law and the key agency without a confirmed leader since 2006, Mr. Obama chose to use his recess appointment power. As the president told NBC News, "At a certain point we have to go ahead and just make sure that people are in place to deal with the enormous challenges that are ahead."

Okay, but now what? The president has resubmitted Dr. Berwick's nomination, as is the general practice, and Republicans on the Senate Finance Committee have made the reasonable request for a confirmation hearing. The panel did just that with a previous recess appointee, Alan D. Bersin, commissioner of U.S. customs and border protection. In a letter to committee Chairman Max Baucus (D-Mont.), the Republicans said that a hearing was necessary to prevent the recess appointment from "circumventing the open public review that should take place for a nomination of such importance" and noted that Dr. Berwick will be overseeing "numerous and significant changes to federal health programs." In addition, they wrote, the appointment "will have imposed an injustice on Dr. Berwick himself if it results in preventing him from being able to answer the legitimate questions raised about his nomination."

At the time of the recess appointment, Mr. Baucus criticized the president for bypassing a process that "serves as a check on executive power and protects . . . all Americans by ensuring that crucial questions are asked of the nominee -- and answered." In a letter to the committee's ranking Republican, Sen. Charles E. Grassley (Iowa), Mr. Baucus reiterated that he was "disappointed" by the president's move to put Dr. Berwick in place "without the benefits of the full confirmation process envisioned in the Constitution."

Apparently not disappointed enough to schedule a hearing, however. "I believe that the Committee needs to focus on the work before us," Mr. Baucus wrote, adding that he expects Dr. Berwick "to testify before the Finance Committee on health reform and other vital health-care issues before long." General testimony about health reform is not the same as a confirmation hearing. Dr. Berwick, as we have said previously, comes to the job with impeccable qualifications and broad support, including that of three Republican predecessors at the CMS. But he has made numerous controversial statements about which Republicans ought to have been able to question him fully. It's unfortunate that Mr. Baucus and the administration seem disinclined to have that happen, and it lends credence to suggestions that the administration was motivated not only by the asserted need for speed but also by a desire to avoid a public debate about Dr. Berwick's views. Who is playing political games now?

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