The White House announced late Tuesday that President Barack Obama will bypass the Senate and appoint Dr. Donald Berwick to oversee Medicare and Medicaid. This type of recess appointment is nothing new; presidents from both parties have frequently made them. But this particular behind the scenes, out of the spotlight appointment not only gives Dr. Berwick the job, it saves the administration from public hearings that would have renewed the debate on Obamacare.

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President Obama nominated Dr. Berwick in April but no confirmation hearing had been scheduled. Speculation was that the president and his cronies were afraid of a public discussion on health care rationing, a topic on which Dr. Berwick has spoken publicly saying in an interview last year, "The decision is not whether or not we will ration care — the decision is whether we will ration with our eyes open. And right now, we are doing it blindly."

That fear was just confirmed in the recess appointment announcement made by White House communications director Dan Pfeiffer on the White House blog: "Many Republicans in Congress have made it clear in recent weeks that they were going to stall the nomination as long as they could, solely to score political points." (source) It's certainly understandable why President Obama wouldn't want the Republicans to score any more points - he and his Democratic crew are already way behind on points with the mid terms elections coming soon.

Meanwhile Mr. Pfeiffer is attempting to spin the recess appointment as "moving forward to protect seniors' care." No attempt to score political points there, right? He also claims that "with the agency facing new responsibilities to protect seniors' care under the Affordable Care Act, there's no time to waste with Washington game-playing." Medicare has been without an administrator since 2006 so they aren't fooling anyone with the alleged need for speed.

Senator John Barrasso (R-Wyoming), who is also a physician, issued a statement on the appointment which read in part, "This recess appointment is an insult to the American people. Dr. Berwick is a self-professed supporter of rationing health care and he won't even have to explain his views to the American people in a congressional hearing. Once again, President Obama has made a mockery of his pledge to be accountable and transparent." (source)

Transparency is a lost cause with this administration but accountability is just four months away.