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Big challenges ahead for Berwick

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Bill Radke: Today, President Obama appointed the man who will run Medicare and Medicaid, two of the biggest landmines in the federal budget. Now, normally the Senate would have to confirm the appointment, but when the president first nominated Donald Berwick back in April, Republicans blasted — some say distorted — Berwick’s views on cutting health care costs. Clearly, he was not going to make it through a confirmation process, so today the president got around the Senate by using what’s called a “recess appointment.”

Marketplace’s John Dimsdale says the challenge over Berwick’s nomination is nothing compared to what he’ll face on the job.

John Dimsdale: Health reform counts on savings from Medicare and Medicaid. The new law offers incentives for hospitals and doctors to deliver better quality services more efficiently and punishes those that don’t.

Donald Berwick’s appointment was praised by many in the health care industry, including Chip Kahn of the Federation of American Hospitals.

Donald Berwick: He’s actually gotten into hospitals to improve care at the grass roots level. Don’s been there and Don’s done it.

Berwick is a pediatrician, a Harvard professor and heads a think tank dedicated to efficient health care delivery. His opponents in the Senate fear the only way he can cut costs is by rationing services to Medicare and Medicaid recipients.

But Robert Berenson, a former Medicare/Medicaid official during the Clinton administration says there are other ways to reduce costs.

Robert Berenson: There’s just too many studies that show that there’s wasted spending, that it wouldn’t be rationing to reduce spending for the things that don’t serve anybody’s purposes.

But Joseph Antos at the American Enterprise Institute worries Berwick’s aggressive push for health care efficiency could lead him to withhold necessary medical services.

Joseph Antos: He has a very long record of statements and actions that indicate that he really believes that we should plunge forward with this kind of an approach. Many people are concerned about that.

Berwick’s other challenge will be to institute dramatic changes in the delivery of Medicare and Medicaid with an agency that has fewer staffers now than it did in 1980, and has been without an administrator since 2006.

In Washington, I’m John Dimsdale for Marketplace.

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