Observers puzzled over Obama's failure to appoint CMS head

Though President Obama has repeatedly said that Medicare and Medicaid costs are the "biggest threat" to the nation's financial future, to the surprise of everyone in politics, he still hasn't named a new head for CMS. After years of struggles, the agency needs lots of changes, and once Obama appoints new a head, that leader could be making those changes and expanding the agency's role. But that won't happen until CMS has a new czar.

CMS, which as we all know runs both programs, provides health insurance to 98 million people, pays 1.2 billion claims a year and has an annual budget of more than $700 billion. More than that, it influences just about every hospital, physician's office, laboratory and private health plan in the country.

Obama officials, not surprisingly, say they're not holding out, but rather, that they're just holding out for the right person. Obama has considered safety and quality guru Dr. Donald M. Berwick, Dr. Glenn Steele of Geisinger Health and Dr. Nicholas Wolter of Billings Clinic in Montana, but none have made the grade for some reason.

Some say that the Obama folks are waiting to see how health reform shakes out. In that case, we may end up waiting a lot longer than we'd hoped to see CMS with strong leadership again.

To learn more about this issue:
- read this piece in The New York Times