Healthcare reform debate: Is it “czar” or “czarina”?
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.
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said they would hold up Health and Human Services appointments until the Centers for Medicare and Medicaid Services rescinded a “gag order” over a Humana Inc. letter to its Medicare beneficiaries saying that proposed spending cuts in the bill would reduce their benefits.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”?
Photo credit: Reuters/Alexander Demianchuk (sand sculptures of Russian czars in St. Petersburg)