DON BERWICK, the prominent pediatrician and Harvard School of Public Health professor who headed the Centers for Medicare and Medicaid Services, has officially stepped down, another victim of Washington’s hyper-partisan politics.
Berwick had been serving a recess appointment that expired at year’s end. President Obama opted for that temporary arrangement after it became apparent that Berwick was unlikely to win Senate confirmation. Since then, 42 GOP senators have vowed to block a longer term for Berwick. In the sad partisan arithmetic of today’s Senate, that meant the Republicans could sustain a filibuster and keep his nomination from ever coming to a vote.
Berwick’s transgression? In the past, he had spoken favorably of Britain’s National Health Service. What’s more, he had had the temerity to acknowledge the obvious: Financial resources to pay for health care are limited, and therefore it makes sense to compare the effectiveness of various treatments and decide which are worth funding and which are not. That got him caricatured as an enthusiastic proponent of health care rationing.
No matter that Berwick enjoyed the praise of his Republican-appointed predecessors and the respect of most major groups in the health care sphere. Or that he had won strong reviews as a thoughtful, innovative administrator during his 16 months on the job. His successful efforts to encourage more recipients to use Medicare’s managed care option accomplished with minimum complaints a goal that almost every Republican presidential candidate endorses.
Given the vast size of Medicare and Medicaid, the skills of its administrator can easily be the difference between tens of billions of dollars of extra costs or tens of billions in savings.
When senators use procedural maneuvers to deny confirmation votes to qualified presidential appointees, they are on inherently shaky ground. Only the most serious, heartfelt objections can explain an effort to deny a nominee the up-or-down vote they deserve. But the 42 senators who opposed Berwick did so for the most craven of political reasons - to pillory a former academic for comments that could be misconstrued in ways that rile up talk-radio audiences.
This isn’t the first scapegoating of a highly qualified New England academic. Berwick’s plight is reminiscent of that of another accomplished local notable, MIT economist Peter Diamond, a Nobel laureate whose appointment to the Federal Reserve Board of Governors was blocked by Senate conservatives. And, of course, there was the furor over President Obama’s choice of Harvard Law School professor Elizabeth Warren to head the Consumer Financial Protection Bureau that she created. The rejection of these highly intelligent, eminently qualified scholars says little about them. But it is a sad commentary on today’s US Senate.