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Monsieur Berwick, It’s Not OK

July 8, 2010

If President Obama’s 18th (eighteenth) recess appointment Donald Berwick had to apply for the job as head of Centers for Medicare & Medicaid Services (CMS) he surely wouldn’t get it. In fact, it’s hard to imagine him getting any job via the normal application route considering his emphasising of character traits that no human resources employee wants to hear about:

I don’t feel like a leader, so it’s very hard for me to project myself into that situation. But inattention to detail is my biggest defect. I’m always leaning forward into something new. I can create a mess. Luckily, I have people who are willing to create the detail around the idea or, if they’re really smart, know which ideas to ignore.

The second defect is more personal uncertainty than you would probably believe. Every time I put an idea out, despite my enthusiasm, I’m very, very unsure about whether it’s OK or not. And the third is that I want everyone to like me, and yet I’m aware that when you’re pushing for change, that isn’t always going to happen. To be more effective as a leader, I would probably want to thicken my skin.

Try going to a job interview and telling your potential employer that you’re usually careless about details, don’t consider yourself as a leader and are very insecure. You won’t be improving the jobless statistics anytime soon.

But, whatever, this is not a private sector employee we’re talking about, it’s a government poobah. When was the last time you saw a competent government poobah? Exactly. So nothing new here. Even the president is just a visionary, too busy inspiring Hop’n’Change-seeking generations of people around the globe to be bothered with mere details regarding the consequences of his unprecedented, historic history making. Obama couldn’t have found a head of CMS more like him. To paraphrase Berwick: They can both create a mess.

The French Cowboy only hopes that the people surrounding Monsieur Berwick will indeed be smart enough to know which of his “ideas” should be ignored. The reason Obama is circumventing the normal appointment process with Berwick is that this guy wouldn’t survive the confirmation hearings. He’s a vocal fan of the British National Health Service (NHS) and unashamedly argues that socialised health care is a wonderful thing while fully acknowledging that it necessarily entails bureaucratic rationing of care (aka Death Panel). I don’t think that this opinion can be entirely explained with Berwick’s disinterestedness in details.

So, while you, Monsieur Berwick, are “very, very unsure about whether it’s OK or not”, let the French Cowboy help you and tell you that it’s definitely not OK.

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