President Obama’s controversial appointment of Dr. Donald Berwick as administrator of the Centers for Medicare & Medicaid Services (CMS) during the congressional recess this past summer is drawing battle lines in the war for confirmation. Sen. Max Baucus (D-Mont.), chairman of the Senate Finance Committee, told reporters this week that the Senate will never vote for Berwick. This coming after 42 Republicans sent a letter to Obama asking that he withdraw the nomination.
Meanwhile, some Democrats have joined the opposition. Arguments against Berwick have included his:
· comments praising the United Kingdom’s National Health Service;
· emphasis on cost controls;
· pay-for-performance healthcare model (i.e., physician gets paid for quality care, not on a per-visit, per-procedure basis); and
· lack of managerial skills.
This is not to say that Berwick doesn’t have his supporters outside of the White House. Reports indicate that representatives of the American Hospital Association, Medical Group Management Association, America’s Health Insurance Plans, and the American Public Health Association (APHA) are committed to his confirmation (but they don’t get to vote). As reported in Modern Healthcare, APHA Executive Director Georges Benjamin comments: “CMS is a large organization and it’s a complex agency. It’s also a public health agency. It’s also a quality and safety agency. It needs somebody who has the vision and skills to pull that all together. I think Don is the guy to do it.”
President Obama promises to stick with his nominee. However, CMS Deputy Marilyn Tavenner appears to be the frontrunner if Berwick leaves office by remaining unconfirmed at the end of the year.
And so it continues. Will Berwick have a chance to sway his detractors? Or will the clock just run out?