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The White House’s announcement today that they will bypass the nomination process of the United States Senate to recess appoint Donald Berwick as head of the Centers for Medicare and Medicaid Services (CMS) is an act of unconscionable hubris.
The White House claims this act is in response to “Washington game-playing”, accusing Republicans of planning to “stall the nomination” as long as possible. This is nothing more than a baldfaced lie. Republicans cannot stall this nomination — it is impossible for them to do so under Senate rules — as not one hearing has been called or scheduled. Even the New York Times doesn’t buy the White House’s explanation, reporting: “The recess appointment was somewhat unusual because the Senate is in recess for less than two weeks and senators were still waiting for Dr. Berwick to submit responses to some of their requests for information.”
In truth, it is the White House that is playing games with the health policy of the nation and the welfare of the American people. In bypassing the traditional process through which the Senate advises and consents to nominees, President Obama is preventing Senators and the people they represent from obtaining any answers from Mr. Berwick, who has repeatedly made claims and statements that raise numerous questions about his suitability for this critical position.
Such questions would have concerned his remarks attacking private-sector solutions to health care problems, in support of “rationing with our eyes open,” and speaking of his affection for the United Kingdom’s National Health Service as “romantic.” In footage discovered and highlighted by the Heartland Institute in May, Mr. Berwick made this audacious statement: “Any health care 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 health care is by definition redistributional.”
Senators have expressed concerns about statements like these, as well as Mr. Berwick’s background. He is a nominee with little management experience poised to head the second largest insurer on the planet, an agency with more funding to disperse than all but the top 15 economies in the world. In fact, the White House’s decision to make this recess appointment is as much a demonstration of their unwillingness to have any debate about Mr. Berwick’s views occur in the public eye as it is of their concern that some in their own party have privately questioned whether he is outside the mainstream.
Such questions are of course appropriate. Thanks to the White House’s decision, they will not be answered. Understand: Mr. Berwick’s position as head of CMS will give him unprecedented power to apply his views on health care policy under President Obama’s new health care regime. Yet thanks to the White House’s game playing, he will not answer one question, not one, before he is ensconced in a position where his radical policy views will ultimately effect the lives and health care of every American.
As we saw in the process of Obamacare’s passage, there is nothing – not precedent, not tradition, not even the most basic expectations of fairness or responsible governance – that will stop President Obama and his allies in their quest to remake American social policy in their image.
Benjamin Domenech is managing editor of Health Care News, a publication of the Heartland Institute. Follow him on Twitter.
{ 25 comments… read them below or add one }
Barack Obama is a radical Marxist ideologue! He is a national tragedy. He is the greatest national catastrophe of our generation. He has brought tyranny to America!
Actually, “unconscionable hubris” is passing off someone else's work as your own.
Recess appointments are just politics as usual.
You sir, are an idiot.
Why the scrubbing of comments?
That's odd, sbernard. I'm a radical Marxist ideologue and I've never seen Obama at the meetings. However, I do plan to bring tyranny to your neighborhood.
Your friend in Christ,
Padre Mickey
I'm a radical feminist and he never comes to our meetings either. Some of us even put off our abortions until after he arrived. It's very inconsiderate. Patricia's water just broke and she can't wait much longer.
So, let me get this straight. A recess appointment by Barack Obama of Donald Berwick is “an act of unconscionable hubris,” right? So that made President Bush equally guilty of unconscionable hubris when he recess appointed (among others) John Bolton? I don't recall you getting all upset about that one…
Marion: Bolton received a hearing before the Senate, and then Democrats wouldn't bring his nomination up for a vote. Berwick has not even had a hearing, and the Republicans are not blocking a vote. Those details matter quite a bit, even if they are inconvenient to your point.
To be fair, Bush did make 171 recess appointments. Ben can't keep up with them all.
Here's a list of over 40.
Bolton, like 170 others, was a recess appointment for Bush. How does that work for your point?
Try to read more carefully. I was not denying that Bolton was not a recess appointment. I said Bolton had a hearing and was obstructed by the Democrats before getting his recess appointment. Berwick has had no hearing and is not being obstructed by the Republicans. Thus, Bush is not “equally guilty of unconscionable hubris” because the situations surrounding the recess appointments are not remotely equal.
Is that not simple enough for you?
Tyranny, I say. And a Marxist to boot. Where will it end?
yes, Berwick has not received a hearing. Do you know why? A Senatorial secret hold. That's right. Some Senator from Bum-fuc-god-knows-where (because it's been a secret hold) won't allow the hearing to occur. Cute aren't they?
Don't forget being a tragedy. And a radical Marxist idealogue, which is distinct from the moderate Marxist monologue, or the conservative Marxist prologue.
Simple enough. I know a hair when it's being split. Bolton was vetted through hearings and because of his extreme right-wing views and open contempt for the organization he was being nominated to serve in, he appropriately couldn't get past the hold on his nomination. So, in a purely political move, Bush put him in anyway, to place a man sympathetic to his own neocon conservatism and hostile isolation from the world. Obama, in a purely political move, has appointed Berwick to a largely administrative position. Why pull this political maneuver now? Because the GOP doesn't really give a rip about Berwick's qualifications for the job — as Democrats genuinely cared about the arrogant and intellectually wanting Bolton's qualifications for a crucial diplomatic job . Rather, the GOP simply wants to use Berwick's philosophical inclination to single-payer health care — not that he could effect anything of the sort from the position he's going to be in — as a whipping post for their campaign to destroy health-care reform legislation before it's implemented and drum up a phony issue for their policy-challenged November candidates who need every rabid Tea Party vote they can get.
So, you are correct, the two moves are not equivalent; the GOP's motives, in all cases, are exponentially more cynical.
This is actually not an accurate statement, and no media source other than you has claimed this is the case — probably because it is an impossibility given the procedure on when such a hold can be placed.
A “secret hold” can be placed to block a nominee from getting a floor vote. It cannot block them from getting a hearing, because there is no unanimous consent demand in order to obtain a hearing, and certainly not one to ask a nominee to submit standard financial information — the point in the process at which Berwick has stood since April.
Only one of the people the president recess appointed yesterday was subject to a secret hold — except it wasn't secret. It was blocked by Sherrod Brown, Democrat of Michigan:
“The White House confirmed late Tuesday that President Barack Obama would bypass the Senate and install his choice to head the government's pension insurer. In May, Sen. Sherrod Brown, D-Ohio, blocked the nomination of Joshua Gotbaum to serve as director of the Pension Benefit Guaranty Corp. because he objects to how Delphi Corp.'s salaried retirees have been treated with the company's termination of its pension plans last year.”
In sum: there was no hold placed on Berwick, nor could there have been under Senate rules given how early he was in the process of legislative approval. I hope that clarifies things.
Perhaps this is because I worked at HHS alongside Dr. McClellan, the CMS administrator at the time, or perhaps it's just because of being professionally in the health policy field, but speaking only for myself, I see Berwick's position as dramatically more significant than Ambassador Bolton's.
I'm not in the foreign policy space, so I think of ambassadors — even ambassadors to the United Nations — as having a far more limited ability to impact Americans. It's my understanding that Bolton was a representative of the views of the president (you seem to acknowledge as much with your “neocon conservatism and hostile isolation from the world” comment — which Bolton would probably reject as a description conflicted out of existence), and that as a permanent representatives at the UN — a non-Cabinet position under George W. Bush — answered to the Secretary of State on all matters.
Within the health policy sphere, the power of the CMS administrator is far more significant going forward, and more significant than when McClellan was in charge. The nature of this position has expanded greatly under the new health care legislation — which is likely why the President sought a think tank fellow viewed as an “idea man” for the job as opposed to an experienced administrator or manager of a large organization. The new CMS administrator will be tasked with applying and determining the path forward for literally hundreds of large and small regulatory changes, which will have a significant impact for doctors, hospitals, and most of all, Medicare and Medicaid patients going forward. This is a position that will profoundly impact the lives of millions of Americans, where Berwick will be placed in charge of an office with a small number of political appointees heading the second largest insurer in the world (after the NHS), with authority over the disbursement of a more than a trillion dollars over the coming year in payments.
I am not sure there is anything that Bolton — or Negroponte, or Danforth, or Susan Rice even today in a Cabinet position — does or could do which could be said to have such a wide-ranging effect.
Your point is valid that the Republicans in the Senate want to use “Berwick's philosophical inclinations to single-payer health care … as a whipping post.” This is of course one of the reasons they supported hearings. But there are also significant issues in other areas where Berwick's views actually do matter, and where he would be in a position to apply them as policy.
Assume for the sake of argument your view is correct — that Bolton and Berwick are equivalent nominees, except that in your view Berwick is more qualified for the job (I would dispute this, as the man is an intellectual technocrat with no experience managing large organizations or budgets, as opposed to an experienced administrator). Then at the very least you will concede that unlike Bolton, Berwick has not completed the base expectations for any nominee applying to be in a government position — namely, he has answered no questions from the Senate, either in hearings or in response to standard questions regarding potential financial conflicts of interest?
Had Berwick gone through this standard process and been blocked from a floor vote, I would not call a recess appointment “hubris”, even if I disagree with the appointment, because he would have already been vetted by the Senate process. We would know, in other words, that there are no conflicts of interest, no financial concerns, no questions to be answered about the funding of IHI.
For the sake of comparison, consider acting administrator Kerry Weems, an experienced 24-year civil servant with nothing in the way of views as controversial as Bolton or Berwick, who was vetted thoroughly for the CMS Administrator job in 2007 — and then was blocked by Senate Democrats, for no particular reason at all. In that case, you're talking about a non-controversial, thoroughly vetted career bureaucrat who's merely being used as a political pawn.
If that was the case with Berwick, than everything you say would be correct. Unfortunately, it is not.
If you can't take the heat, stay out of the blogosphere, I'd say. (http://is.gd/djX3P)
Trying to airbrush the past is never going to work in this day and age, Ben. Time to be a grown-up and acknowledge your past screw-ups, and not just try to play whack-a-mole to suppress the truth.
Hmmmm…..
Erasing comments….. Hubris….. Plagiarism….. I suppose that in-depth home schoolin' is what made it all possible – that and the nepotism thingey of course.
I love that your comment avatar is plagiarized — so meta!
Thank you for your response. I am pleased that you now acknowledge the
Republicans' — and, to be fair, insurance-industry beholden Democrats
– interest in having Mr. Berwick come to the Hill is motivated at least
in part by political calculation.
As to Mr. Berwick's qualifications and your experience in that field, I
would assume that unless you knew him personally or worked with him you
wouldn't know any more than I would whether he can handle the managerial
burdens of his appointment. He may be sensationally qualified, or not,
but after observing Republican leadership embrace obstructionism as a
core value of the party since Obama took office, a leadership that sees
health care as a chance to create a Waterloo for the President, I doubt
his lack of managerial experience would be more than an incidental part
of their concerns in a hearing. It might occupy more of your own
concern, and if so, congratulations.
I won't presume, as you presume, to argue Mr. Berwick's fitness for the
job. I don't know him and I don't work in his field. But, his
“radical'' viewpoints aside — or Marxist, if you'd like to upgrade to
Rush Limbaugh's rhetorical hyperbole — he has somehow managed to garner
endorsements from an eyestrain-inducing number of organizations and
businesses (there's a document link in this swampland article :
http://tiny.cc/m80ve), a list that somehow manages to include AFL-CIO
and Wal-Mart Inc. ! I'll just rather simplistically defer to the list.
You could probably come up with a long list of organizations that would
denounce him but I wonder how much of the list would represent doctors,
nurses or health care practitioners (as opposed to “providers'').
Like you, I don't work in the diplomatic field, either. Like you, I just
have opinions about Mr. Bolton, and those opinions include the notion
that at a time when the Bush Adminstration had radically enlarged the
scope and added hundreds of billions of dollars to the expense of the
war on terror and desperately sought to keep flagging international
support and financial aid for its efforts the job of U.N. Ambassador
might have gone to someone capable of engaging rather than offending
potential partners — however much Bolton's neoconservative brand of
nationalism might have squared with the president's. And, by the way, I
meant “isolation'' more as a symbolic than specific historical
reference; as in “my way or the highway'' foreign policy where the U.S.
dictates to the rest of the world rather than the classic isolationism
philosophy. I accept your critique.
Whatever, my comparison of Bolton to Berwick's appointment was not
intended to equate the magnitude of their jobs because it is an obvious
apples-to-oranges comparison. My point is that his background as what
you dismissively describe as a “technocrat'' and what others might
call “policy wonk'' at least puts him in the arena of applying and
enforcing transformative health care policy whereas Bolton's contempt
for international cooperation seemed to make him less suitable for the
job he was handed. My point was more that the political maneuver of an
interim recess appointment is equivalent, and that my cynicism regarding
Republican politics suggests, to me, that hearings are, yes, absolutely
an opportunity to stall the implementation of the new health care policy
as long and as far as possible by scuttling its leadership and a device
for reigniting the health-care reform debate for political advantage in
November.
PAL52: You're a good dancer. I'll give you that. Remember how this started?
It is perhaps unprecedented — and at least extremely unusual — for someone to get a recess appointment without a hearing. It is certainly unprecedented for the party of the president to be preventing that hearing. (Harry Reid merely has to issue a memo or pick up the phone, he has done neither.)
That's not splitting hairs, that's destroying your counterpoint that “Bolton, like 170 others, was a recess appointment for Bush.” So, upon assessing the smoking wreckage of what you thought was a killer riposte, you change the subject to: Republicans ” in all cases, are exponentially more cynical” in their political maneuverings than Democrats.
Not much of an argument. More of a whine. What would your attitude have been if, say, Bush had told Gen. Petreaus to forget about that testifying before Congress stuff after the “General Betray Us” ad came out and it was clear that Democrats were going to use his appearance on the Hill to bash the president and the surge (which is exactly what happened)?
I don't get you liberals. You have the White House, you have large majorities in both houses of Congress, and still you are unhappy. You whine when a nearly powerless opposition party dares to … well … oppose your policies.
It's one thing to take your ball and go home after a few minutes of “rough play” in a game already rigged in your favor. It's quite another to not even put your ball in play in the rigged game and have the commissioner simply declare you the winner. Both are annoying, but the latter is also cowardly.
Conservatives arguing principle is beyond laughable in the wake of the
preceding administration. Was the summary firing of eight U.S. attorneys
for purely political purposes precedented? Or just “extremely
unusual?'' As for testifying and stuff like that, what about the White
House asserting executive privilege and refusing subpoenas after being
exposed for those firings?
You conservatives have had control for so long that you expect to keep
writing legislation and passing laws — and whine about it endlessly
when you don't get your way — even after you've managed to fumble away
both houses of Congress and the White House. Even after diluting the
stimulus bill and hobbling health-care reform with concessions to
corporate interests, conservatives (including conservative Democrats,
the number of which, by the way, nicely puts the lie to your claim of a
powerless minority) still have the chutzpah to claim that they aren't
being listened to. Obama has been endlessly accommodating to
conservatives since the minute he walked into office. If you choose to
believe instead the “radical'' rhetoric pushed by Mr. Domenech and his
kindred spirits at FoxNews and on every third station on the AM radio
dial, then g'ahead. Enjoy. You seem far too smart to fall for that.
As for the Petraeus hearings — and I know you know the difference
between hearings to gain an appointment and hearings to report on what
you're doing once you're on the job, which Petraeus was doing and which
Berwick will be subject to — you might at least try to lay off the
usual conflation tactic. It's a particularly lame device. The
embarrassing and stupid “Betray Us'' ad was wholly disconnected from
the Democratic Party and roundly denounced.
My complaint as a liberal is not so much with the conservatives and
their compulsive obstruction — it's the only thing they do well any
more so why expect anything different? — as it is with a president and
Congressional leadership that clings to the idea that the opposition is
somehow interested in behaving decently and sharing power in a time of
great crisis. Perhaps this extremely unsual/unprecedented recess
appointment is the first sign of awakening to that reality.
Thanks for the dance. You're not so bad yourself.
Ah. At first I thought I was conversing with someone who was merely speaking out of total ignorance of the Senate vetting process or American health policy. Now that you've revealed yourself as just another typical leftist troll ready to bring up every anti-Bush item, no matter how completely unrelated, do carry on. The tin foil is clearly wrapped a bit too tight for your own good.
Ben Domenech, who uses tracing paper for early drafts of his posts, is kind of thin-skinned about his youthful indiscretions. In a post today, that he may or may not have actually written all by his own bad self without lifting relevant portions from other people, he calls the recess appointment of Donald Berwick as head of the Centers for Medicare and Medicaid Services by President Obama an “act of unconscionable hubris”.
I pointed out in his comments that copying other people’s work and passing it off as your own and thinking you could get away with it was a little more closely aligned with what most would call an “act of unconscionable hubris”. Apparently this has led to a difference of opinion between Ben and myself and I have been saddled with the “The site has blocked you from posting new comments” Label of Doom which is one way of saying that Ben and I will continue to agree to disagree about how douchey he is.
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