The decision to use a so-called recess appointment to install Berwick as administrator of the Centers for Medicare and Medicaid Services drew immediate fire from the GOP. Republicans have raised concerns about Berwick's views on rationing of care and said it was wrong for Obama to go around the Senate confirmation process. That view was echoed by a key Democratic committee chairman, although the recess appointment is a tool used by presidents of both parties.
Berwick has wide support in the medical community but some Democrats feared the GOP would use confirmation hearings to reopen the health care debate. Obama defended the decision to appoint Berwick and two other officials, one to a pension board and the other to a White House science post.
Berwick, 63, could serve through next year without Senate confirmation. - AP