Donald Berwick, who directed the U.S. health-care overhaul as head of the Medicare and Medicaid programs, resigned, and President Barack Obama nominated Berwick’s top deputy to run the effort.
Berwick’s confirmation as chief of the Centers for Medicare and Medicaid Services has been blocked by Senate Republicans, who say comments he made in the past criticizing the U.S. health system and complimenting the British National Health Service rendered him unfit for the job.
Obama appointed Berwick to his post during a congressional recess after the 2010 health-care law was enacted. The process circumvented Senate confirmation. The U.S. Constitution limits the terms of recess appointments.
“Don Berwick did outstanding work at CMS,” said Jamie Smith, a White House deputy press secretary. “It’s unfortunate that a small group of senators obstructed his nomination, putting political interests above the best interests of the American people.”
Forty-two Republican senators, enough to sustain a filibuster, sent a letter to Obama in March urging him to replace Berwick. “There were very strong concerns from members of the Senate about his appointment,” said Senator Pat Roberts, a Kansas Republican, in an e-mail today through Sarah Little, a spokeswoman.
Senate Democrats never scheduled a confirmation hearing where Berwick’s statements would have been dissected.
Obama nominated Berwick’s chief deputy, Marilyn Tavenner, to replace him. The secretary of Virginia’s Department of Health and Human Resources under former Democratic Governor Tim Kaine, Tavenner was acting administrator of the Centers for Medicare and Medicaid Services from February 2010 until Berwick’s appointment in July of that year.
Tavenner was responsible for overseeing the creation of an office to regulate health plans under the 2010 law, said Health and Human Services Secretary Kathleen Sebelius.
She has also been a nurse and hospital administrator, and her “distinguished career in health care and deep knowledge of our efforts to implement health reform make her the right person for this job,” Sebelius said in an e-mail to her department’s staff.
Berwick formerly led the Institute of Healthcare Improvement, a nonprofit in Cambridge, Massachusetts, that advised hospitals and health systems on ways to improve efficiency and quality. As Medicare chief, he encouraged government bureaucrats and health-care providers to focus on improving care for individuals and the overall health of the U.S. population while lowering health costs.
Praise From Providers
Berwick won praise from private health insurers, who sell plans to the elderly through the Medicare Advantage program, and by hospitals, who are regulated by the agency.
Berwick has “always been willing to listen to the hospital field’s perspective on how to deliver better care to patients,” said Richard Umbdenstock, president of the American Hospital Association in Chicago.
Berwick called his departure “bittersweet” in an e-mail to his staff.
“We are now well on our way to achieving a whole new level of security and quality for health care in America, helping not just the millions of Americans affected directly by our programs, but truly health care as a whole in our nation,” he wrote.