In order to move officials into important vacant positions quickly, President Barack Obama issued a recess appointment for Donald Berwick as the head of the Centers for Medicare and Medicaid today.

Obama's move avoids confrontation with the Republicans in the Senate, who, reportedly, have been trying to stall the appointment of Berwick.

"It's unfortunate that at a time when our nation is facing enormous challenges, many in Congress have decided to delay critical nominations for political purposes," Obama said in a statement. "These recess appointments will allow three extremely qualified candidates to get to work on behalf of the American people right away."
Obama also appointed Phillip Coyle as associate director for National Security and International Affairs, and Joshua Gotbaum for director of Pension Benefit Guaranty Corporation.

Republican senators have raised an outcry over the backdoor appointment.

"This recess appointment proves the Obama administration did not have the support of a majority of Democrats and Republicans in the Senate and sought to evade a hearing," said Sen. Pat Roberts (R-Kan.) in a statement.

There has been controversy over Berwick's nomination - opponents argue that the new director wants to "ration" health care in order to cut costs.

"As if shoving a trillion-dollar government takeover of health care down the throat of a disapproving American public wasn't enough, apparently the Obama administration intends to arrogantly circumvent the American people yet again by recess appointing one of the most prominent advocates of rationed health care to implement their national plan," said Republican leader Sen. Mitch McConnell (R-Ky.) in a statement.

Berwick is co-founder and president of the Institute of Healthcare Improvement and a professor at Harvard Medical School. He also holds positions at Boston Children's Hospital and Massachusetts General Hospital.

CMS has not had a permanent leader since October 2006 when Mark McClellan stepped down. Obama appointed Berwick in April, and the new director has received support from hospitals.

Berwick's appointment will last through the end of 2011, a spokesman for the White House told DOTmed News by e-mail.

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