In an effort to avoid a drawn-out nomination battle with Hill Republicans, the White House announced yesterday that President Obama will make a recess appointment of Dr. Donald Berwick to the top spot at the Centers for Medicare and Medicaid Services (CMS). A recess appointment allows the president to move a nominee into position without public confirmation hearings. As I noted last month, Berwick has attracted attention because of his professed love for the British health care system—and, in particular, for its rationing board, NICE. Is Berwick too radical for the job? Probably not—although one never knows what he might have said under questioning. But even still, as Philip Klein argues, his lengthy public record makes it clear enough that Berwick holds far more sympathy for European-style medical systems than he does for the relatively more private system that's ruled in the U.S. And for whatever reason, the Obama administration is now attempting to push through his nomination without asking Berwick to answer for what he's said in the past.