The recess appointment of Donald Berwick to run Medicare and Medicaid is being hailed as the most important appointment in a generation-more significant than putting Elena Kagan on the Supreme Court. A Wall Street Journal op-ed by Daniel Henninger points out:

The court’s decisions are subject to the tempering influence of nine competing minds. Dr. Berwick would direct an agency that has a budget bigger than the Pentagon. Decisions by the CMS shape American medicine.

Dr. Berwick’s ideas on the design and purpose of the U.S. system of medicine aren’t merely about “change.” They would be revolutionary.

One may agree with these views or not, but for the president to tell the American people they have to simply accept this through anything so flaccid as a recess appointment is beyond outrageous. It isn’t acceptable.

Read the entire piece for: Dr. Berwick’s hostility to the capitalist system, admiration for the awful NHS system in the UK, and belief that doctors shouldn’t have too much autonomy in making medical decisions. The recess appointment, made without the usual circumstances surrounding such appointments, had even Max Baucus up in arms. The editorial:

Barack Obama, Donald Berwick and the rest may fancy themselves philosopher kings who know what we need without the need to inform or persuade us first. That’s not how it works here. That is Sen. Baucus’s point.