The Obama administration's premature recess appointment of Dr. Donald Berwick to head CMS is further evidence that the process for selecting and confirming senior administration appointees is broken. In trying to defend the move, White House adviser David Axelrod said on ABC's "This Week" that the CMS job is "too important" to wait for Dr. Berwick to have his hearing.
Axelrod is right that the position of CMS administrator is an extremely important job, but if the White House truly believed that were the case, then President Obama should have nominated Dr. Berwick towards the beginning of the administration, and not waited until after the health care bill passed to send his name forward. Furthermore, it is precisely because the position is so important that we need to have a confirmed head at the top of this crucial $500 billion agency. Not being confirmed can limit the effectiveness of top appointees by harming their credibility with agency career staff, and with Congress.
Our confirmation process clearly needs to be improved, but circumventing the process, as the Obama administration did in this case, does not make the situation any better.