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This is excellent use of the recess appointment.

With Congress officially on recess, President Obama will on Wednesday use his ability to make recess appointments to name one of his more controversial nominees: Donald Berwick, nominee to be Administrator of the Centers for Medicare & Medicaid Services (CMS).

The April nomination of Berwick -- president and chief executive officer of the Institute for Healthcare Improvement -- was in trouble and might not have been able to meet Senate confirmation due to comments Berwick made in the past about rationing health care. Even if Berwick could have been confirmed by the Senate, Democrats have little appetite for another round of fighting about changes to the health care system, Democrats said.

In an interview last year with Biotechnology Healthcare, Berwick said society makes decisions about rationing all the time, and that the "decision is not whether or not we will ration care -- the decision is whether we will ration with our eyes open. And right now, we are doing it blindly."
....

The Centers for Medicare and Medicaid Services oversees approximately one third of all health care spending in the United States, more than $800 billion. Becker's nomination had been endorsed by President George W. Bush's two CMS administrators, Mark McClellan and Tom Scully, the American Hospital Association, the AARP, and others.

Berwick's arguments that rationing care on the basis of ability to pay, something no other developed nation relies upon as a delivery system for health care, is a bad idea are only controversial if you're a Republican. Berwick has also expressed admiration for the British health system, saying it had "developed very good and very disciplined, scientifically grounded, policy-connected models for the evaluation of medical treatments from which we ought to learn."

Which, of course, is socialism as far as the neanderthal Republican wing of the Senate is concerned. At any given opportunity over the past several months, they've taken to the Senate floor to bleat about death panels, using his pending appointment as their excuse.

For more discussion on this, see geomoo's diary. - Barbara Morrill

Originally posted to Daily Kos on Wed Jul 07, 2010 at 07:46 AM PDT.

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Comment Preferences

  •  See also geomoo's excellent diary. (10+ / 0-)

    Godwim's Law: As the location of the first typo in a diary nears the top, the probability of a spelling nazi making a comment approaches 1.

    by stunzeed on Wed Jul 07, 2010 at 07:47:27 AM PDT

  •  I am glad to see this. (17+ / 0-)

    It shows guts on the part of the Obama administration. I am also glad to have someone in office who can see the good aspects of the British system. I lived in th UK for two years and my kid has lived there since 2006. While the system is far from perfect, it is far better than ours. I am truly tired about the right-wing lies about the NHS.

    •  Ooh. British system? Say it ain't so, Joe. (2+ / 0-)
      Recommended by:
      blingbling65, EdgedInBlue

      Psst!!!

      Avert your eyes just a hair and take a look at France.

      Free speech? Yeah, I've heard of that. Have you?

      by dinotrac on Wed Jul 07, 2010 at 07:50:08 AM PDT

      [ Parent ]

      •  France? (1+ / 0-)
        Recommended by:
        dinotrac

        You mean we should study what the best Healthcare system in the world is doing and copy it?

        Its so crazy it just might work

        The greatest trick the devil every pulled was convincing half of America the GOP gives a damn about them

        by blingbling65 on Wed Jul 07, 2010 at 08:23:10 AM PDT

        [ Parent ]

        •  Whether we copy it or come up with a uniquely (1+ / 0-)
          Recommended by:
          lgmcp

          American plan that incorporates the best ideas...

          Starting with the world's best health care (at half the price of ours) doesn't seem like an amazingly difficult concept.

          Free speech? Yeah, I've heard of that. Have you?

          by dinotrac on Wed Jul 07, 2010 at 08:30:21 AM PDT

          [ Parent ]

          •  it shouldn't be (1+ / 0-)
            Recommended by:
            dinotrac

            studying what the rest of the world is doing right should have been step one.

            The greatest trick the devil every pulled was convincing half of America the GOP gives a damn about them

            by blingbling65 on Wed Jul 07, 2010 at 08:44:00 AM PDT

            [ Parent ]

            •  Yup, especially since the real lesson from the (0+ / 0-)

              rest of the world is that there is  no one answer. Nations seem to fashion systems based on their own resources and needs, but, somehow, all do a better job than we do.

              Free speech? Yeah, I've heard of that. Have you?

              by dinotrac on Wed Jul 07, 2010 at 08:54:41 AM PDT

              [ Parent ]

    •  Guts? (0+ / 0-)

      Seems kind of wimpy to me.  How bout 200 recess appointments to get a whole lot of people who should have been confirmed long ago?  

      I ain't disagreeing with you so much as I am venting about all the judges, etc, that should have long ago been in place.

      "The man who never alters his opinion is like standing water, and breeds reptiles of the mind". William Blake

      by egarratt on Wed Jul 07, 2010 at 07:51:24 AM PDT

      [ Parent ]

      •  He's trying to move this country (13+ / 0-)

        past Bushism in an incredibly difficult context.  I don't agree with his every decision, but to depict it as wimpy or otherwise cowardly is to play into GOP framing.  He simply doesn't believe that Unitary Executive, even as applied to a benevolent administration, will work well for this country in the long run.  We're in for a long hard slog dismantling Bushism, and there's a guarantee that there will be some mistakes, but the motive isn't fear or cowardliness at all IMO.

        climate.gov---POTUS' New Science-Based Climate Change Agency

        by GN1927 on Wed Jul 07, 2010 at 07:55:24 AM PDT

        [ Parent ]

        •  I totally agree. Pres Obama is very concerned (2+ / 0-)
          Recommended by:
          GN1927, Tulips

          about the Constitution, and the long term effects of what he's doing. Given the unprecedented obstructionism of the republicans, he would be justified to make an unprecedented number of recess appointments. He's very reluctant to do so because he KNOWS that when the republicans eventually regain power, they will use this new precedent to  make UNJUSTIFIED recess appointments. President Obama also KNOWS that the press would not explain the differences in context and would, AGAIN, make FALSE equivalencies.

          The sad thing is, the republicans know this too. I'm afraid they will keep obstructing and give the President no choice to make more recess appointments. And then they will scream "dictatorship" and "un-constitutional" !!

          The KEY is to shame the republicans for their obstructionism and prevent the press from giving them a platform to spout out their nonsense. You know... making the press do real journalism, point out the reality of the totally unprecedented level of obstrutionism by the republicans and stop pushing the bogus false equivalencies.  Judging by what the press has NOT been doing in the last eighteen months, it's a wet dream to think they will finally do their job. I hope the democrats can come up with original solutions to this problem.

        •  This is patently false: (0+ / 0-)

          He simply doesn't believe that Unitary Executive, even as applied to a benevolent administration, will work well for this country in the long run.

          He has gone to court to not only defend some of Bush's excesses wrt the Unitary Executive, he has fought to expand the powers of the executive BEYOND what Bush even attempted.

          http://jonathanturley.org/...

          http://jonathanturley.org/...

          http://jonathanturley.org/...

          There is nothing 'benevolent' or Constitution-loving about an administration which claims the power to assassinate its citizens without due process.  Nothing.  This is one area where Constitutional scholars and civil libertarians are DEEPLY disappointed with this administration.  There is no roll back taking place -- your assertion is pure fiction.  

      •  I am sure that (9+ / 0-)

        he has discussed the possibility of recess appts with many nominees.  I am also sure that lots of them didn't want to go that route because a recess appt. has a limited lifespan and the individual would still be up for regular confirmation with the next Congress.  It is difficult to give up steady employment for a brief and uncertain stint.

        "We think the truth is bad enough. It obviously is." -- Fishgrease

        by gchaucer2 on Wed Jul 07, 2010 at 07:58:21 AM PDT

        [ Parent ]

    •  Remember this? (15+ / 0-)

      Professor Stephen Hawking has defended the NHS after its severe criticism during the American political debate over health care reforms.

      The physicist spoke up for the NHS after the Republican Right claimed it was 'evil' and 'Orwellian' in a direct attack on Barack Obama's plans to overhaul health care in the U.S.

      [snip]

      Prof Hawkin, who suffers from Lou Gehrig's disease, said: 'I wouldn't be here today if it were not for the NHS.

      http://www.dailymail.co.uk/...

      The GOP leadership is just so shameless.

      climate.gov---POTUS' New Science-Based Climate Change Agency

      by GN1927 on Wed Jul 07, 2010 at 07:53:03 AM PDT

      [ Parent ]

    •  Guts would be a Van Jones recess appointment. (1+ / 0-)
      Recommended by:
      Odysseus

      Sorry, but that one still stings.

      It's not too late. ;}

      Welcome to the Corporate States of America ®, give us your money, then die quietly.

      by geez53 on Wed Jul 07, 2010 at 08:11:58 AM PDT

      [ Parent ]

      •  Me too - ouch (0+ / 0-)

        Van Jones forced out of a minor [but important] WH position because Glenn Beck mocked him on TV.

        PAUL KRUGMAN: The triumph of prejudices over the evidence is a wondrous thing to behold.

        by mrobinson on Wed Jul 07, 2010 at 08:17:56 AM PDT

        [ Parent ]

        •  Because his (former) outfit attacked Fox (0+ / 0-)

          and the White House keeping him around would have been made into a huge freedom of speech/press issue.  

          Politics is like playing Asteroids - You go far enough to the left and you end up on the right. Or vice-versa.

          by Jonze on Wed Jul 07, 2010 at 08:19:15 AM PDT

          [ Parent ]

      •  Van Jones resigned. eom (0+ / 0-)

        "[R]ather high-minded, if not a bit self-referential"--The Washington Post.

        by Geekesque on Wed Jul 07, 2010 at 08:27:37 AM PDT

        [ Parent ]

        •  Duh...Fer Sher.... ;} ...... (0+ / 0-)

          I'm talkin' ,bout giving him a real job to make up for caving in to the Beck Neanderthalism. One of the smartest, most energetic people to hit DC gets chucked under the bus to placate BecKKK-types? Ain't right i say.

          Welcome to the Corporate States of America ®, give us your money, then die quietly.

          by geez53 on Wed Jul 07, 2010 at 09:13:51 AM PDT

          [ Parent ]

          •  He fell on the sword. (2+ / 0-)
            Recommended by:
            Odysseus, geez53

            Rule #1 for a political appointee is don't become a public liability for the admin, even if it's unfair.

            Van Jones was incredibly noble in his conduct.

            And quite honestly, I think he's better served kicking ass on the outside.

            "[R]ather high-minded, if not a bit self-referential"--The Washington Post.

            by Geekesque on Wed Jul 07, 2010 at 09:28:28 AM PDT

            [ Parent ]

  •  Already diaried. Please delete. :) (6+ / 0-)

    Good news needs to be repeated.

    BP - Proving Oil and Water do mix.
    A Presidency Among the Vuvuzelas.

    by amk for obama on Wed Jul 07, 2010 at 07:50:25 AM PDT

  •  Thanks for pointing this out (4+ / 0-)
    Recommended by:
    askew, lirtydies, lgmcp, elginblt

    I'd even amend it:

    rationing care on the basis of ability to pay, something no other developed nation relies upon as a delivery system for health care, is a bad idea are only controversial if you're a Republican member of the GOP leadership, heartlessly appealing to selfishness and ignorance in a desperate gambit to get back into power.

    This is good news; along with the Medicaid expansion in HCR, these are very historic moves in terms of expanding the social safety net.  I wish that the Medicaid expansion would have received this type of press.

    climate.gov---POTUS' New Science-Based Climate Change Agency

    by GN1927 on Wed Jul 07, 2010 at 07:50:32 AM PDT

  •  Good for Obama (2+ / 0-)
    Recommended by:
    amk for obama, Tulips

    Good to see that he's moving forward, and I expect the Democratic caucus to have his back in the next Congress.

    "Lash those traitors and conservatives with the pen of gall and wormwood. Let them feel -- no temporising!" - Andrew Jackson to Francis Preston Blair, 1835

    by Ivan on Wed Jul 07, 2010 at 07:52:43 AM PDT

  •  May be he should use recess appointments (2+ / 0-)
    Recommended by:
    lirtydies, amk for obama

    to get all the people he needs but can't get because senate has a bunch of assholes.

    Rabindranath Tagore-"Bigotry tries to keep truth safe in its hand with a grip that kills it."

    by joy sinha on Wed Jul 07, 2010 at 07:53:10 AM PDT

  •  The shock and awe surge against the Republican (1+ / 0-)
    Recommended by:
    amk for obama

    Party is ramping up.  Democrats are about to fight the good fight in a way that will make Republicans' heads spin, and their Party crumble and die.

    Read Teixeira's 2010 report, and see why the GOP is done.

    by Georgeo57 on Wed Jul 07, 2010 at 07:56:50 AM PDT

  •  From Newsweek; "Obama Needs His Own Dick Cheney" (8+ / 0-)

    yeah like he needs a brain tumor or a yeast infection. the argument being that his team is not good at politics and bush's team was....you remember them, they lost the house, senate in 2006 and white house in 2008 and became the most hated crowd to feed off the american people and their resources in decades. why do the pundits write crap like this? Does it not matter that the great dick forced us into an unnecessary war, stifled any attempts to deal with our addiction to oil, deregulated everything he touched and brought his party under the control of no-nothings and zombies?

    appoint away obama, regulate all that needs regulating and pay little or no attention to the clowns in the msm. they are just in it for the money and power just like uncle dickhead was.

    •  It would appear that you don't like the guy? (1+ / 0-)
      Recommended by:
      singe

      Uncle Dickhead I mean...

      "So, am I right or what?"

      by itzik shpitzik on Wed Jul 07, 2010 at 08:07:39 AM PDT

      [ Parent ]

    •  I'll take a Cheney over Emanuel in a heartbeat.. (1+ / 0-)
      Recommended by:
      singe

      What Cheney got was what exactly what he and/or W wanted. And Congress willingly did their bidding.  The fact that what they wanted was bad for everyone else isn't the point.

      Obama had ideas and plans that were good for everyone. Had he a respected and more fearsome man at his side to help push his agenda through, rather than the universally disliked and well known sleezebag Rahm Emanuel - I think we would have seen a more positive outcome than the shithole we're all in now.  

      •  yeah he could have had his own cheney, a (0+ / 0-)

        universally disliked and well known sleezebag...

        •  But Cheney wasn't disliked at first. (0+ / 0-)

          Both sides had a good deal of trust and respect for him.

          With Emanuel -majorities of both parties despised and distrusted him at the outset.

          Richard Clarke would have been a good Cheney and so would several other tough and well respected Democrats.  Think outside your box..

          •  And Dean - could have been a pit bull for Obama. (0+ / 0-)
          •  check your history. (0+ / 0-)

            cheney was a pig in the 1970's. he continued as a pig in and out of the political world for a few decades until bush 2 let him fuck up the country. dean would have not had stature with anyone but the left and had no experience getting any legislation passed in the congress so my guess is he would have gotten little done for obama much as i like him and his ideas, richard clarke had zero experience working legislation through the congress so i am not sure what box you want me to leave or what one you are living in?

            now maybe if biden had been willing to be chief of staff and hillary had been picked as vp we would have had better luck with single payer but this is all conjecture....

  •  A few salient points (7+ / 0-)
    1. All scarce resources are rationed. The capitalistic way is by price mechanism. Any other method than "pay or die" is therefore socialistic in some sense.
    1. Since we mandate that emergency rooms treat anyone who shows up with a critical condition, regardless of ability to pay (or citizenship), we have already decreed that under some circumstances health care is a right, not a privilege. This also means we have decided that we want some level of socialized medicine.
    1. Since the government pays for the aforesaid emergency room visits, we have already have tax payer funded health care.

    As the man says, we either ration by "pay or die", or we ration some other way.

    In theory, there is no difference between theory and practice; but in practice, there always is a difference. - Yogi Berra

    by blue aardvark on Wed Jul 07, 2010 at 08:01:28 AM PDT

    •  You said what I wanted to say. (1+ / 0-)
      Recommended by:
      Odysseus

      Only better.

      Just as an add-on to #3, it's not only tax payer funded health care, it's the most expensive, inefficient, ineffective version of tax payer funded health care.

      If we're going to spend those dollars, let's get the most bang for the buck.

      The most violent element in society is ignorance.

      by Mr MadAsHell on Wed Jul 07, 2010 at 08:42:51 AM PDT

      [ Parent ]

  •  So, this is good ... (0+ / 0-)

    but why was the CMS job important enough to do this, but the OLC job not?

    "With all this manure around, there has to be a pony somewhere!" - Count Piotr Vorkosigan

    by jrooth on Wed Jul 07, 2010 at 08:02:37 AM PDT

  •  ponies (0+ / 0-)

    This is only half a pony.

    recess appt of Dawn Johnson = one pony
    recess appt of Goodwin Liu (9th circuit judge) = two ponies

  •  I OBJECT to my tax dollars paying the salary.... (6+ / 0-)

    ...of some public servant who believes in his heart that health care is a public service. (!!!!!!!!)

    I know, I know, we used to have people like that in the government, who actually believed in the programs they were hired to run. I'm just still having trouble getting used to the concept again....

    Sorry. I'll get over it.

    "So, am I right or what?"

    by itzik shpitzik on Wed Jul 07, 2010 at 08:03:57 AM PDT

  •  My gripe re Berwick (0+ / 0-)

    is that Reid did not even schedule a hearing on him, with the nomination pending since April.  I'm all for recess appointments when the need is there, but this looks to be a way to avoid public discussion entirely, which I think is very un-cool.

    •  Why? (1+ / 0-)
      Recommended by:
      Geekesque

      This man is obviously qualified - maybe the most uniquely qualified and the GOP would use him to try and re-open the healthcare debate and demonize and slander him with catchphrases and parsed quotes.  

      They'll still try and do that now, but the shelf life is a lot smaller and there will be no grandstanding grilling of the nominee by GOP peacocks with the cameras rolling.  

      Politics is like playing Asteroids - You go far enough to the left and you end up on the right. Or vice-versa.

      by Jonze on Wed Jul 07, 2010 at 08:08:30 AM PDT

      [ Parent ]

    •  I think the Republican plan (2+ / 0-)
      Recommended by:
      Egalitare, FiredUpInCA

      to make his confirmation into a diatribe on the HCR bill right before mid-terms had something to do with this timing.  I'd say he pulled the rug out from under um and I say "Well done!"

      Here is a test to find whether your mission on earth is finished: If you're alive, it isn't.

      by EdgedInBlue on Wed Jul 07, 2010 at 08:43:41 AM PDT

      [ Parent ]

  •  Bernie's blog - HR is working (2+ / 0-)
    Recommended by:
    askew, lgmcp

    A new study projects billions of dollars in savings from a major investment in community health centers. Bernie’s provision in the new national health care law will double the number of centers providing affordable primary care, dental care, mental-health counseling and low-cost prescription drugs. The George Washington University study said the $11 billion investment will save $180 billion over the next 10 years by keeping people out of expensive hospital emergency rooms.

    Read more:

    PAUL KRUGMAN: The triumph of prejudices over the evidence is a wondrous thing to behold.

    by mrobinson on Wed Jul 07, 2010 at 08:14:56 AM PDT

  •  I love recess appointments. Reminds me of (0+ / 0-)

    Bolton.

    Nations have no permanent friends and no permanent enemies. Only permanent interests.

    by thestructureguy on Wed Jul 07, 2010 at 08:25:36 AM PDT

  •  Europe shows us what change looks like: (0+ / 0-)

    http://www.huffingtonpost.com/...

    I'm sure our bankster-street run Fed will rush to take serious action against the bankster fraudsters.  

    Hell, they may even allow the Consumer Protection Agency to hold a press conference and engage in some finger wagging, if we're lucky!

    November Slogan: Pragmatic Moderation Corporations Can Believe In

    by Johnathan Ivan on Wed Jul 07, 2010 at 08:27:20 AM PDT

  •  And the Old Mule Horn Sounds Off (0+ / 0-)

    As if shoving a trillion-dollar government takeover of healthcare down the throat of a disapproving American public wasn't enough, apparently the Obama administration intends to arrogantly circumvent the American people .... blah, blah, blah -- McConnell said in a statement.

    There will come a day of judgment, and our Republican friends know that. That, Mr. President, is why they are terrified. - Sheldon Whitehouse

    by RhodaA on Wed Jul 07, 2010 at 08:31:59 AM PDT

  •  Kaiser's resource guide to Berwick (0+ / 0-)

    Here is a test to find whether your mission on earth is finished: If you're alive, it isn't.

    by EdgedInBlue on Wed Jul 07, 2010 at 08:38:55 AM PDT

  •  Getting payoffs from the HCR bill (1+ / 0-)
    Recommended by:
    FiredUpInCA

    really depends upon having robust implementation through Medicare and Medicaid.  This is a key position and I'm thrilled that the R's inevitable sabotage attempts have been stymied.  Obama's been sparing with the confrontational tactics, but this is a good example of USING some of that dry powder.

    "The extinction of the human race will come from its inability to EMOTIONALLY comprehend the exponential function." -- Edward Teller

    by lgmcp on Wed Jul 07, 2010 at 08:40:16 AM PDT

  •  Rationing (1+ / 0-)
    Recommended by:
    Mr MadAsHell

    Yeah. Present health care is rationed on your ability to pay (and on your insurance company's ability to obfuscate). But he didn't say that. He said "blindly."

    We should learn from his mistake. Whenever the idea of rationing is mentioned, we should state bluntly that presently health care is rationed on ability to pay.

    Corporations are people; money is speech.
    1984 - George Orwell

    by Frank Palmer on Wed Jul 07, 2010 at 08:42:19 AM PDT

    •  That would only work (0+ / 0-)

      on those who do not need to be convinced, such as those on these forums.

      The sad fact is that most of the American populace, when presented with the truth about how our health care is currently rationed, would say "and that's how it should be!"

  •  Typo! (0+ / 0-)

    The word "neanderthal" has a strike out.

    The most violent element in society is ignorance.

    by Mr MadAsHell on Wed Jul 07, 2010 at 08:44:21 AM PDT

  •  Another Opportunity (0+ / 0-)

    When the inevitable email forwards about death panels and socialist medicine start to arrive, have this and geomoo's diary hotlisted for a quick return forward to the emailers.  

    Time to have some fun here.  I have my own friends and relatives who identify with the teabag crowd.  After forwarding them a few Daily Kos diaries, they leave me alone about political issues now.  Some of them have even changed their opinions based on the brain stretching exercises I have provided.

    Don't look back, something may be gaining on you. - L. "Satchel" Paige

    by arlene on Wed Jul 07, 2010 at 08:49:11 AM PDT

  •  nonetheless (0+ / 0-)

    it's still a bad idea to try and argue this point in the winger terminology of 'rationing'

    "a lie that can no longer be challenged becomes a form of madness" -Debord

    by grollen on Wed Jul 07, 2010 at 09:18:42 AM PDT

    •  The More Info the Better (0+ / 0-)

      Wingers aren't delicate little flowers.  Maybe they can't handle the truth, but it doesn't hurt (or maybe it does hurt a little like a vaccination) to see a different point of view.  

      Don't look back, something may be gaining on you. - L. "Satchel" Paige

      by arlene on Wed Jul 07, 2010 at 09:56:44 AM PDT

      [ Parent ]

  •  We have to get away from using the word... (0+ / 0-)

    rationing of healthcare...sure we can ration the federal outlays for the subsidy of the purchase of healthcare, but people should in consultation with their doctor purchase whatever healthcare they want and/or need...

    If we keep talking about rationining healthcare...we will lose the healthcare debate really fast in this country...

    Obama - Change I still believe in

    by dvogel001 on Wed Jul 07, 2010 at 10:49:47 AM PDT

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