Don Berwick, the administrator in charge of Medicare and Medicaid, was having dinner in Dupont Circle not long ago with five of his predecessors when the conversation veered to how long he could keep his job.
In the realms of health care, his is a pivotal role: overseeing two entitlement programs that insure nearly one in three Americans, sheperding the profound insurance changes spurred by the new health-care law and serving as chief cheerleader for better care at lower cost.
A pioneer in improving medical quality, but a neophyte in Washington politics, Berwick ran into a buzz saw of Republican opposition over old academic writings when President Obama chose him for the task 16 months ago. A year ago this week, the president slid him into the job without Senate confirmation while Congress was out of town. The “recess appointment” installed Berwick at the helm of the Health and Human Services’ Centers for Medicare and Medicaid Services. But, unless the Senate acts, he cannot stay beyond December.
And so, during the April dinner, he and the former administrators, his “brain trust,” addressed the awkward but central issue: Was there any chance for a confirmation hearing now?
From all five around the table, Democrats and Republicans alike, “the feedback he got was sort of, ‘forget it,’ ” recalled Bruce Vladeck, the Medicare and Medicaid chief under President Bill Clinton and one of three people there who recounted the conversation. The effort would be futile, they said. “Don’t ruin your legacy and make a fight out of it,” one person told him.
Read more at The Washington Post.