- The Washington Times - Tuesday, July 6, 2010

When the White House announced Dr. Donald Berwick as President Obama’s choice to lead the $800 billion Medicare and Medicaid agency in April, officials hailed his long list of credentials, including current roles as a professor at Harvard Medical School and the Harvard School of Public Health.

“He is also a pediatrician, adjunct staff in the Department of Medicine at Boston's Children's Hospital …” the White House announcement of the nomination of Dr. Berwick to lead the Centers for Medicare and Medicaid Services (CMS) states.

But Dr. Berwick hasn’t seen a patient in years. And the two Harvard professor positions listed on his White House biography as well as another position as a senior scientist at the Brigham and Women’s Hospital in Boston are essentially “honorary professorships,” which require two or three seminars or meetings a year, The Washington Times has learned.

On Wednesday, Mr. Obama bypassed the Senate and appointed Dr. Berwick to run Medicare and Medicaid, the Associated Press reported. The recess appointment allows him to skip what could have been difficult confirmation hearings in the Senate, and would be effective through the end of the current Congress.

“It’s unfortunate that at a time when our nation is facing enormous challenges, many in Congress have decided to delay critical nominations for political purposes,” Mr. Obama said in a statement Wednesday. “These recess appointments will allow three extremely qualified candidates to get to work on behalf of the American people right away.”

In all, Dr. Berwick disclosed holding more than a dozen current positions on a government ethics filing, though one full-time paying job: his 40-hours-per-week position as the president and chief executive of the nonprofit Institute for Healthcare Improvement (IHI), where he earned nearly $900,000 in salary, bonus and deferred compensation last year.

Through a spokesman, Dr. Berwick referred questions about his outside positions to the White House.

A former Senate Finance Committee counsel said Dr. Berwick’s list of outside positions warrants scrutiny.

“The yawning gap between what the White House says the nominee does, as opposed to what he actually does, should raise very serious questions to the [Senate] Finance Committee,” said Dean Zerbe, former senior counsel and tax counsel on the committee for Sen. Charles E. Grassley, Iowa Republican.

Like all incoming political nominees, Dr. Berwick must fill out a detailed financial-disclosure report that includes a list of all positions, paid and unpaid. Several outside positions included on his ethics filing clearly appear to be voluntary and unpaid, such as his membership on various boards and committees at organizations like the American Hospital Association.

The Washington Times last week inquired about several additional positions listed on the form: two Harvard professor positions, another as “courtesy staff in pediatrics” at the Children’s Hospital in Boston and a senior scientist at Brigham and Women’s Hospital.

In response to a query from The Times about why no compensation was reported with those positions, a White House spokesman described them as “essentially honorary professorships,” where he holds two or three lectures, seminars or meetings a year.

IHI (the Institute for Healthcare Improvement) is clearly the focus of his work, and his leadership there is the reason he was nominated,” White House spokesman Reid H. Cherlin said.

“We’ve always been upfront about that, and we have no reason not to be,” he said. “But of course, he is, in fact, a pediatrician. And it’s not uncommon for folks of this stature to have adjunct-type affiliations - and, of course, we disclose them.”

On his ethics disclosure, Dr. Berwick reported receiving no compensation from any of those jobs. He does, however, disclose payment to the Institute for Healthcare Improvement by Harvard for teaching a course called “Quality of American Health Care.” Separately, he lists an outside position as a course instructor at Harvard.

The standard U.S. Office of Government Ethics form filled out by Dr. Berwick instructs nominees to list all positions held outside of the government, but instructs nominees to exclude positions “solely of an honorary nature.”

Neither the White House announcement of Dr. Berwick’s nomination nor the ethics filing makes clear the honorary nature of the positions.

The White House announcement states, “Dr. Berwick currently serves as President and CEO of the Institute for Healthcare Improvement, and is a professor at Harvard Medical School and the Harvard School of Public Health.”

The White House further described Dr. Berwick as “Clinical Professor of Pediatrics and Health Care Policy at the Harvard Medical School and Professor of Health Policy and Management at the Harvard School of Public Health.”

“He is also a pediatrician, adjunct staff in the Department of Medicine at Boston's Children's Hospital and a consultant in pediatrics at Massachusetts General Hospital,” the announcement stated.

Dr. Berwick has won broad support from health care groups such as the American Hospital Association, AARP and the Catholic Health Association, among others. He’s also been endorsed by previous CMS administrators from Democratic and Republican administrations.

“Through his work at the Institute for Healthcare Improvement, Don has led a movement to engage hospitals, doctors, nurses and other health care providers in the continuous quest to provide better, safer care,” the American Hospital Association announced in a statement shortly after Dr. Berwick’s nomination.

But Republicans have raised questions about Dr. Berwick, pointing to his past writings and speeches. Sen. Pat Roberts, Kansas Republican, has called him a “known advocate of government rationing of health care,” while supporters say critics have taken Dr. Berwick’s words out of context.

Dr. Berwick would be in charge of implementing many of Mr. Obama’s health care reforms. He also would have a lot more responsibility, for a lot less money, than his current job at IHI.

As CMS administrator, Dr. Berwick would be paid $165,300 per year and oversee an agency with a budget of about $800 billion.

During 2009, Dr. Berwick received a base salary of $509,600, a $88,200 bonus and $275,849 in deferred compensation through a contribution by the institute to a special supplemental executive retirement plan. IHI has approximately 130 employees, according to IRS filings. Officials at the institute say Dr. Berwick’s compensation plan was approved by a board, based on comparable positions and reviewed by lawyers and auditors.