An Open Letter Regarding Dr. Berwick's Nomination

The Disease Management Care Blog has written to its U.S. Senator, Pat Toomey (R-PA) regarding his recent signature on a letter to President Obama urging that Dr. Berwick's nomination to lead CMS be withdrawn. An edited copy of the letter is below:

The Honorable Pat Toomey
B-40B Dirksen Senate Office Building
Washington, DC 20510

Dear Senator Toomey:

As a Pennsylvania physician and voter, I am writing concerning the March 3 letter to President Obama that you co-signed along with 42 other U.S. Senators regarding Dr. Berwick’s nomination as the CMS Administrator. In that letter, you ask the President to withdraw Dr. Berwick’s nomination because of several concerns.

I urge you to reconsider and support the Senate’s prompt consideration of Dr. Berwick’s nomination. I am confident that when his credentials and track record are reviewed, that you and a majority of US Senators may find him to be an excellent choice for CMS Administrator.

I’ve outlined each of the concerns mentioned in the letter and address each one below:

A “contentious” nomination: It’s safe to say that any selection by the Democratic Administration in this time of hyper-partisan jujitsu would have been roundly condemned by the opposition as one step short of an impeachable offence. It’s obvious to any voter that there is plenty of blame to go around for the contentiousness.

Failure to respond to repeated requests for information: Now that the Congressional playing field is more level (thanks, in part, to your recent election) and Washington has heeded the call for more cooperation, isn’t it safe to assume that future requests will be honored? Why not ask again and see what happens?

Recess appointment: I would submit that that is a symptom, not the problem. Giving Dr. Berwick’s nomination the serious and deliberate consideration it deserves could be one step toward reducing the misuse of recess appointments in the years to come.

Past record of controversial statements: Most that are being mentioned in the press are the result of being taken out of context or being selectively quoted. The sum total of Dr. Berwick’s commentary over decades of scholarly work is insightful, evidence-based and rhetorically moderate.

Lack of insurance experience and management ability: Ask any physician, and they will tell you that there is much about CMS that is broken. That may be precisely why an outsider is the best person at this time. In addition, Dr. Berwick, over the course of his storied career, has advised and partnered with countless health insurers on initiatives that promote high value care. Last but not least, Dr. Berwick’s recent public comments suggest he handling the steep learning curve quite nicely.

I’d like to also point out that Dr. Berwick’s recent appearances at a number of forums including The Brookings Institution and the National Advocacy Conference of the AMA demonstrated that he has good insight, can garner the support from a wide political spectrum and, most of all, is his own man. There is little that is truly “political” about him.

As a voter who is dismayed at the lack of cooperation inside the beltway, I can’t help but wonder if part of the calculus in opposing Dr. Berwick’s nomination is the political advantage of seeing Mr. Obama humbled. While I share many concerns about Mr. Obama’s decision making, I urge you to fight those battles elsewhere and spare CMS from the gamesmanship.

Let Dr. Berwick come forward. You may be in for a pleasant surprise. Heaven knows your voting supporters could use one.

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March 7 update: Senate Democrats have given up on confirming Don Berwick as CMS administrator in the wake of a letter from 42 Republican senators opposing the nomination, sources tell POLITICO.