Recess maneuver: White House fills key health policy job without having to talk about rationing

It is not all that surprising really.

When presidents get tired of waiting for Congress to act on an appointment, sometimes they take matters into their own hands and just go ahead and make the hire without any input.

And that is what the White House says happened earlier this month when President Barack Obama made a recess appointment, naming Harvard University professor Dr. Donald Berwick to oversee the massive changes to Medicare and Medicaid.

No harm, no foul, you might think. After all, it is not like he is in charge of all health care reform decisions.

But the Berwick appointment is not one Americans want to see more of -- especially if they are already not too thrilled with the president's health care reform agenda. And don't be too quick to believe the quick appointment was made because of Republican filibustering either. GOP leaders say they were waiting for answers to questions they submitted to Berwick. The Obama administration was only too happy to get this one through with as few questions -- or hearings -- as possible.

Dr. Berwick is a health policy expert, according to his supporters, and has credentials to back up that claim. But what should concern anyone who wants to see more people with real-world experience in the president's administration is that addendum that he is yet another Harvard professor.

Harvard professors are smart -- they are some of the brightest minds in the country -- but there are not the only bright minds in the country. And many of them, in their hearts, are academicians or theorists, with real-world experience in their past, but certainly not in their present.

Professors, in general, study the real world, they do not always function in it. So, while they have ideas about how things should be run, they can be pretty theoretical about the way the world is actually run.

Dr. Berwick might have an impressive resume, but he is about to take on a task that is gargantuan in proportion and will have to fix a system that in many ways is fraught with bureaucratic waste and fraud. He will need real world smarts -- and practical solutions -- and he will have to be able to win the confidence of the American people.

And yet, he has not had to answer a single question or to explain a single one of his views.

And, by the way, Berwick is a proponent of rationed health care and favors the British model for health care delivery.

That got your attention, didn't it?

Rationing health care is determining what procedures should and should not be offered to patients based on their health status and other factors.

Remember, that was a direction most Americans emphatically said they did not want to go -- having the government determine what care will be offered to each patient.

So, there might be reason to keep a close eye on this appointment.

And while we are talking about it, perhaps it is time for President Obama to move on to another university's faculty.

Otherwise, Washington, D.C., is going to become a branch office for the Harvard University faculty lounge.

Published in Editorials on July 16, 2010 11:37 AM