Sometimes the biggest victories are the ones that make the least noise. Lost amid all the excitement over the Rio trip, the anti-obesity campaign, and the March Madness picks was the revelation that Senate Democrats had

given up

any attempt to confirm Donald Berwick as chief of Centers for Medicare and Medicaid Services (CMS). It seems that 42 Republicans had informed the Democratic majority by letter that they would vote for Berwick's confirmation when Hell froze over. (With Wisconsin, that makes two examples of Republicans acting as if they had spines in one month. Will wonders never cease?) Berwick was originally given a recess appointment, another example of Obama's Chicago method of doing things. But that means that he must now leave office by the end of the year.





This would be truly below the fold on Page 5 if not for one single factor: as CMS head, Berwick is Obama's point man on health care, the man tasked with putting ObamaCare into action. Now Obama is left having to start over again from square one. This is as serious a repudiation of ObamaCare as Judge Roger Vinson's decision, and possibly one with even greater ramifications.

Berwick's problem lies in his infatuation with the British National Health Service (NHS). Berwick spent several years in the UK attempting to reform the organization without notable success. All the same, he has publicly declared, "I am romantic about the NHS." As I have said elsewhere, he sings about the NHS the same way that Bryan Ferry sings about his ex-mistresses.

As is often the case with ex-girlfriends, there were a lot of blemishes that Berwick has chosen to overlook. Blemishes including filthy, uncleansed wards, the worst iatrogenic infection rate in Europe (Staffordshire hospitals alone recently lost over 1,200 patients to the hospital-borne staph infection MRSA), months- if not years-long waits for everyday operations, and a deteriorating survival rate for cancer, cardiac, and stroke patients. To these benefits we can add the Liverpool Care Pathway (LCP), which cuts off certain select patients from food and water while loading them up with sedatives in order to free up the beds. (Further insight into the NHS - and its relation to ObamaCare -- can be found in the Obama chapter of my Death by Liberalism.)

Berwick admires the NHS because health-care decisions are made "centrally," and not by ignorant and ill-educated patients themselves. One of the features of the NHS that impressed Berwick most is the National Institute for Health and Clinical Excellence (NICE), a department that decides which treatments and drugs will be allowed the British people. A similar outfit is already operational in the United States.

The most telling statistic concerning the NHS is the number of accidental hospital deaths per year: 95,000. This is the highest in Europe and twice that of the U.S. which has six times the population. To put it into perspective, let's reverse the ratio to see how many accidental deaths the U.S. would have with an NHS-type system. The answer is 450,000 per year.

Little question exists that Obama intends an NHS for the U.S., a single-payer, government-run health care system in which all decisions are made by the bureaucracy (John Conyers admitted as much last week), and that Donald Berwick was supposed to lay the groundwork for it. This is why it is so important that Berwick was ousted before he completes his work. The event marks quite a setback for the administration. No wonder the legacy media failed to cover it.

It remains critical that Berwick actually leaves. Having twisted the rules to get him in, Obama is quite capable of doing the same once again. There's an old Chicago trick, pioneered by Richard J. Daley, in which Da Mare would hire unqualified pals, let them go just before the civil service exam requirements came up, then rehire them. That's how things were done in the Duchy of Chicago, a land Obama is at least as familiar with as he is Indonesia.

This will probably be worth drawing a line in the sand over. An effort that should feature speeches, manifestoes, press conferences, hearings and quite a lot in the way of public education as to exactly what Obama's health-care "reforms" actually have in store for us. In other words, everything that should have been done with Berwick and was not done due to Obama's trickery.

The other point is to undo whatever damage Berwick has already done.

The sad thing about all this is that Donald Berwick is a good man, the farthest thing in the world from one of Obama's purse-snatchers. He has spent a large part of his career devising training programs designed to increase the quality of hospital care and lessen the possibility of accidents. But he is also a seriously misguided man, as pure a case of ideological blindness as we're ever likely to see. He believes impossible things -- that one man can control a health system involving over 300 million people, that a world-class failure in the UK can somehow magically be transformed into a success in the USA, that wishing makes things so. I'm sure there is a worthwhile place for Donald Berwick in this world. But it is not the place that he holds now.