By ROBERT PEAR
WASHINGTON — Dr. Donald M. Berwick, the official in charge of Medicare and Medicaid, who became a symbol of all that Republicans dislike in President Obama’s health care policies, said on Wednesday that he was resigning.
Drew Angerer/The New York Times
Dr. Donald M. Berwick met with opposition from Republicans.
Mr. Obama first nominated Dr. Berwick in April 2010, but he never received a Senate confirmation hearing. More than 40 Senate Republicans urged the White House to withdraw the nomination last spring, and many vowed to block confirmation.
White House officials and Democrats in Congress often praised Dr. Berwick, but did not make aggressive efforts to help him win confirmation.
Mr. Obama said he would nominate Dr. Berwick’s principal deputy, Marilyn B. Tavenner, to succeed him as administrator of the Centers for Medicare and Medicaid Services.
Ms. Tavenner, the secretary of the Virginia Department of Health and Human Resources when Tim Kaine was governor, is more of a manager and less of a visionary than Dr. Berwick, who has been working for more than two decades to transform the health care system and raise the quality of care.
Republicans caricatured Dr. Berwick as an advocate of health care rationing because of comments he had made before coming to Washington. He had, for example, lavishly praised the British health care system. In an interview with a biotechnology journal in 2009, he said, “The decision is not whether or not we will ration care — the decision is whether we will ration with our eyes open.”
Jamie E. Smith, a deputy White House press secretary said: “Don Berwick did outstanding work. It’s unfortunate that a small group of senators obstructed his nomination, putting political interests above the best interests of the American people.”
Debra L. Ness, president of the National Partnership for Women and Families, an advocacy group, said that with Dr. Berwick’s resignation, the government was losing “a visionary leader, a champion for patients,” who knew how to improve care while reducing costs.
Richard J. Umbdenstock, the president of the American Hospital Association, said Dr. Berwick had provided invaluable leadership in carrying out the new health care law.
But Senator John Barrasso, Republican of Wyoming, said: “Dr. Berwick came in under a cloud, and he is leaving under the same cloud, because of the way the president appointed him. It was a disservice to Dr. Berwick and to the American people for the president to make a recess appointment, rather than requiring Dr. Berwick to come before Congress to explain his opinions on Medicare, Medicaid and the new health care law.”
On the few occasions when he testified before Congress, Dr. Berwick held his own, defending the health care law against criticism from Republicans. But his strained relations with Republicans limited his effectiveness as an advocate for the administration on Capitol Hill — a big part of the administrator’s job.
The Centers for Medicare and Medicaid Services finances health care for one in three Americans, spends more than the Pentagon and has a pervasive influence on medical care, regulating hospitals, doctors, health plans and almost every other type of health care provider.
The agency has not had a regular Senate-confirmed administrator since October 2006, when Dr. Mark B. McClellan stepped down. Mr. Obama’s failure to nominate anyone during the yearlong fight over health care puzzled many in Congress.
Ms. Tavenner, a nurse, worked for more than two decades at the Hospital Corporation of America, first as a nursing supervisor, then as a hospital executive and eventually as president of the company’s outpatient services group. She served on the boards of the American Hospital Association and the Virginia Hospital and Healthcare Association.
If Ms. Tavenner has a confirmation hearing, she is sure to be asked many questions about the new health care law.
“Any nominee to a federal agency with this much power and authority over the lives of millions of Americans must be carefully scrutinized,” said Senator Orrin G. Hatch of Utah, the senior Republican on the Finance Committee, which would be responsible for reviewing the nomination.
Ms. Smith, the White House spokeswoman, said Ms. Tavenner would build on Dr. Berwick’s “incredible record of accomplishment,” and she added, “We hope that the Senate will act quickly to confirm her.”
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