What Constitution?

They don't seem bound in the slightest by the basic law of the land. They do what they want to do with apparent impunity. They flaunt the will of the people, ignore the letter of the law, deny the obvious duplicity in their words, and remake this once-great nation into something that becomes more frightening with each day that passes.

Senior members of the executive branch are subject to the advice and consent of the Senate. That is a form of the oversight responsibility of the legislature which enacts the laws which the executive is supposed to administer. It insures that qualified personnel are directing the programs, spending the money wisely and applying the legislation in the manner which the Congress intended.

Occasionally conditions arise in which it is critical that a position be filled and it is impractical to wait for the Congress to be in session. That is when a recess appointment might be used. The catch with this one is that the position has been vacant since 2006. No critical time constraint appears involved.

Harvard Doctor to Remodel Medicare and Medicaid

Remember when the Messiah intoned that if you were happy with your current medical insurance situation you could keep it? That didn't apply to the millions of seniors who participate in Medicare Advantage programs. But this goes beyond that.

the “recess appointment” was needed to carry out the new health care law. The law calls for huge changes in the two programs, which together insure nearly one-third of all Americans.

Remember when the charge was made that the healthcare reform bill was going to inevitably lead to rationing? It might have been hyperbole to call it "death squads" but getting more people covered for less money has got to mean curtailing services somehow.

What does this new czar bring to the table and why does he fear a Senate confirmation hearing?

Dr. Berwick has championed the interests of patients and consumers. At the same time, he has spoken of the need to ration health care and cap spending, has supported efforts to “reduce the total supply of high-technology medical and surgical care” and has expressed great admiration for the British health care system.

We in the US have been fortunate that we have an abundance of modern state-of-the-art medical gear like MRIs, PET, CAT, labs and diagnostic aids. Dr. Berwick apparently sees great savings by reducing availability of those items and lowering us to the status of the rest of the world. If that doesn't spell rationing, I don't know what does.

One of Dr. Berwick’s first tasks will be to work with Congress to avert a 21 percent cut in Medicare payments to doctors, scheduled to occur late this year.

The law requiring cuts in Medicare payments to healthcare providers has been around since 1990. For twenty years now the Congress has waived the provision to maintain the reimbursements to doctors. They did it without the help of Dr. Berwick apparently.

What ever became of "government of the people, by the people and for the people..."? Has it indeed perished from this earth?