Healthcare reform debate: Is it “czar” or “czarina”?

September 25, 2009

It is day four of the Senate Finance Committee consideration of a sweeping overhaul of the $2.5 trillion U.S. healthcare system in an effort to rein in soaring costs and expand medical coverage to millions of uninsured people. The debate has turned to White House czars. RUSSIA

This is a hot topic among conservatives who complain that these White House positions wield great power but are not subject to public scrutiny or Senate confirmation. As advisers to the president they also cannot be called to testify before Congress.

Republican Senator John Ensign proposed an amendment to the healthcare legislation that requires Senate confirmation of any White House health czar, in this case Nancy Ann Deparle, counselor to the president and Director of the White House Office of Health Reform. The problem with requiring Senate confirmation is that there is no government position called “czar,” argued opponents to the measure.

“The concept of czar is a term of fiction,” said Democratic Senator John Kerry.

The term is basically a creation of the media not wanting to spell out the long titles given to these positions by presidents.

Democrats also argued that Senate confirmation of presidential appointments often takes months if not years and dozens of positions go unfilled well into any president’s administration.

Just this week Republicans said they would hold up Health and Human Services appointments until the Centers for Medicare and Medicaid Services rescinded a “gag order” over a Humana Inc. letter to its Medicare beneficiaries saying that proposed spending cuts in the bill would reduce their benefits.

Democratic Senator Tom Carper as a former governor of Delaware remarked about how important it was for a chief executive to have advisers who can coordinate polices with the various agencies. Making those positions subject to Senate confirmation would create a new layer of bureaucracy as the president would appoint people to do the job while the person with the title awaited confirmation.

The committee defeated the amendment in a strictly party-line vote. The real question here, though, is would Nancy Ann Deparle be called a “czar” or a “czarina”?

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Photo credit: Reuters/Alexander Demianchuk (sand sculptures of Russian czars in St. Petersburg)


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There is a very powerful action group that are watching with a growing sense of awareness of possible cuts to their benefits,THE SENIORS.They are not tied to the support of a particular political dogma when it comes to health care, that they have payed for all their lives. If the democrats think they can gave health care to illegals at the expense of our grandparents this is going to sink them and the rest of their stupid entitlement ideas.

Posted by brian lee | Report as abusive

The words “czar” and “czarina” should never be part of the American lexicon, yet by the way things are going, I can’t help but wonder if we are fast becoming an imperial power much like old Russia.

Posted by Mufaso | Report as abusive

I fully agree! The ones in the highest positions have lost the drive to actually do good for our country! all they care about is keeping their position (cushy job..) on they’re invisible pedestal! We need to change them out at least every 8 years if not back to the way it was when our country first began! where delegated “officials” would leave their state to speak on the behalf of his own states views for only a little more then 2 years of service to the government. That way we keep fresh new minds that are willing to voice their states opinion with out their own view thrown in! For if they’re only working for 2 years there would be little need for competition or other selfish changes to propositions and bills. Simply their is no higher position to gain only to do the job you were chosen to do!

Posted by Trea | Report as abusive

Brian, time and again it has been said that none of the health care bills being worked on provide health care for illegals. You must have it confused with that CA. law that allows illegals to collect state benefits.

Posted by Eric H | Report as abusive