WASHINGTON-With the U.S. Capitol shuttered this week for the Independence Day holiday, President Barack Obama decided to celebrate his temporary independence from Congress by making a controversial recess appointment for a top medical post.
In a move that will impact the healthcare choices for millions of Americans, the White House Wednesday named Harvard professor Donald Berwick, a strong advocate of England's national health system, the new administrator of the Centers for Medicare and Medicaid Services.
Presidential recess appointments do not require Senate approval. And Senate Republicans in recent weeks have made it clear that they would not support Berwick's nomination.
The congressional circumvention means that the nation's senior care will now be under the direction of a staunch supporter of European-style socialized medicine. As the top administrator for Medicare and Medicaid, Berwick, whose appointment will last until late 2011, will take a lead role in carrying out the nation's new healthcare law.
Berwick has attacked the free market system and called England's socialized medical services superior to those in the United States. He has said "any healthcare funding plan that is just, equitable, civilized, and humane must, must redistribute wealth from the richer among us to the poorer and the less fortunate. Excellent healthcare is, by definition, redistributional."
Not surprisingly the move angered Republicans.
"Here they go again, thumbing their noses at the American people, jamming through a controversial nominee," said Sen. Lamar Alexander, R-Tenn., the GOP's third ranking senator. "No questions on behalf of the American people from senators. Not a single confirmation vote."
White House communications director Dan Pfeiffer responded to attacks over the appointment by claiming that Republicans "were going to stall the nomination as long as they could, solely to score political points."
In a post on the White House blog, Pfeiffer wrote, "With the agency facing new responsibilities . . . under the Affordable Care Act, there's no time to waste with Washington game playing."
But conservatives called the White House's recess appointment itself a Washington game-playing tactic made to score political points with liberal voters.
"Donald Berwick is another example of President Obama's extreme liberal agenda, and only the latest in President Obama's numerous missteps related to healthcare in America," said Family Research Council Action's Tom McClusky.
Just last year, in the midst of the heated healthcare overhaul debate, Berwick tackled the issue of rationing, saying it is "not whether or not we will ration care-the decision is whether we will ration with our eyes open."
This appointment comes a little more than a year after Obama tried to downplay any intent to increase the government's role in healthcare.
"I believe-and I've taken some flak from members of my own party for this belief-that it's important for our reform efforts to build on our traditions here in the United States," Obama said in June of last year at an American Medical Association conference. "So when you hear the naysayers claim that I'm trying to bring about government-run healthcare, know this: They're not telling the truth."
But Berwick has repeatedly bashed the market-based medical traditions of the United States while praising England's system of single-payer, regulated care under its National Health Service (NHS) and National Institute for Clinical Excellence (NICE).
Berwick has called NICE "not just a national treasure . . . it is a global treasure."
"I am romantic about the NHS; I love it," he has said. "All I need to do to rediscover the romance is to look at healthcare in my own country."
But the British system has been criticized for putting in the hands of bureaucrats instead of doctors the final decisions on best treatment practices. This has resulted in life-threatening inefficiency, critics argue: In the past two years the number of people waiting over three months to see a doctor in the NHS has increased by 50 percent.
Twila Brase, president of Citizens' Council on Health Care, said the recess appointment means that the American people will be denied public Senate hearings where Berwick would have to explain the problems surrounding the British system.
"We are disappointed that President Obama chose to avoid the transparency of the Senate confirmation process," Brase said.
Now 43 million Medicare recipients will be dependent on the controversial funding and treatment decisions Berwick is likely to make with his new position.