Thomas Scully

As some of you you may have noticed, I took a short vacation after President Obama signed the Patient Protection and Affordable Care Act passed. It seems that Obama and his advisers didn't. With the ink on the presidential signature barely dry, administration officials announced that Don Berwick would be the president's choice to run the Center for Medicare and Medicaid Services. Who's Berwick? And why is his impending appointment so important?

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Last summer, President Bush and the Republican congressional leadership had a problem. The legislative linchpin of the president's reelection effort, a bill to add prescription-drug coverage to Medicare, lacked the votes in Congress, where conservative Republicans were chafing at the expense. GOP leaders finally secured a bare majority by consenting to the demands of 13 Republican House members, who agreed to vote yes if the cost would not exceed $400 billion over ten years.

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On February 27, 2001, George W. Bush addressed a joint session of Congress. When the president had last ventured to the Capitol for his inauguration 37 days earlier, he had delivered a homily urging the nation to move past the sting of the Florida recount.

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