He's really going to need it when it comes to his Senate confirmation.
The DMCB recalls this article suggesting that the White House seems to have two complimentary styles. On one side is the pragmatic Chief of Staff Emanuel Rahm, while on the other is the partisan top aide David Axelrod. While Mr. Rahm was urging caution on health reform following Republican Scott Brown's Senate victory, it was apparently Mr. Axelrod that successfully argued for a full court press. The rest is, as they say, history. Reform passed, leaving the Democrats resurgent and Mr. Axelrod's role intact.
Which leads us back to the iconoclastic and 'extremist' and outspoken Dr. Berwick. This is less about him and more about boxing in the Republican minority.
Which leads the DMCB to a prediction.
While Dr. Berwick is a genius, he may also be part of David Axelrod's purposeful political calculus that is now practically inviting the Senate Republicans to publicly stymie the able and widely admired Dr. Berwick's appointment to CMS. In fact, Harvard's Dr. Berwick has written and spoken so extensively that there should be little problem for some Senate staffers to find some juicy quotes to take out of context. This will prompt the usual D.C atmospherics that will leave both parties bloodied and each believing that the other lost more support. Scott Brown of Massachusetts may also be squeezed with some tough lose-lose decision-making. In the end, and assuming Dr. Berwick hangs in there, there'll be a recess appointment.
Until then, it will be business-as-usual at CMS. Unfortunately, it will also be business-as-usual in Congress.