President Obama has ignited a political firestorm by using the recess appointment process to make Dr. Donald Berwick administrator of the Centers for Medicare and Medicaid Services. A recess appointment can bypass the Senate confirmation process.

Republicans are charging that Berwick is an advocate of health care rationing and highlighting what they say is an example of his praise of the United Kingdom’s national health system.

Berwick has said that the system “developed very good and very disciplined, scientifically grounded, policy-connected models for the evaluation of medical treatments from which we ought to learn,” according to a version of Berwick’s remarks circulated by Republicans.

Berwick was nominated by President Obama for the CMS administrator post in April. His confirmation was languishing due to Republican opposition.

Dan Pfeiffer, White House communications director, defended the recess appointment move. “CMS has been without a permanent administrator since 2006, and even many Republicans have called on the administration to move to quickly to name a permanent head,” Pfeiffer said. “There’s no question that Don Berwick is the right choice to be our next CMS administrator,” Pfeiffer said.

Berwick is president of the Institute for Healthcare Improvement, Cambridge, Mass.; a clinical professor of pediatrics and health care policy at the Harvard Medical School; and a professor of health policy and management at the Harvard School of Public Health.

Sen. Max Baucus, D-Mont., chairman of the Senate Finance Committee, which was handling Berwick’s nomination, says in a statement that he is “troubled” that Obama has bypassed the “essential” Senate confirmation process.”Despite the recess appointment, I look forward to working with CMS as they implement health reform to deliver the better health care outcomes and lower costs for patients we fought to pass in the landmark health reform law,” Baucus says

Sen. John Kerry, D-Mass., has defended Berwick’s appointment. “Republican lockstep stalling of Don’s nomination was a case study in cynicism and one awful example of how not to govern,” Kerry said in a statement. “Republicans screamed that these federal programs were in trouble, then tried to deny the administration the capable guy the president had chosen to oversee them.” Obama “wasn’t going to let the Republicans thrive in a chaos of their own making,” Kerry says.

Sen. Charles Grassley, R-Iowa, the highest-ranking Republican member of the Senate Finance Committee, says the Obama administration “has taken advantage of the fact that there’s no check on its power, with one-party control of Congress and the White House.”

The Berwick nomination was not being held up by Republicans in Congress “and to say otherwise is misleading,” Grassley says. “I requested that a hearing take place two weeks ago, before this recess. The American people have a right to know about Berwick’s background, his thoughts on rationing and government-run health care, and any potential conflicts of interest. All of that is hidden when the confirmation process is circumvented.”

Sen. Pat Roberts, R-Kan., another member of the Senate Finance Committee, has called the Berwick recess appointment “deeply disappointing,” because Berwick will not “come before the Senate to address questions about his views in support of the British National Health System and government rationing of health care.”