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I have written here in opposition to the appointment of Donald Berwick to head Medicare/Medicaid because of his explicit support of health care rationing.  In a Washington contolled overwhelmingly by Democrats, President Obama was unable to convince the Senate to approve Berwick for the job.  So, he’s making a recess appointment, allowed under the law, which will be valid for about a year.  From the story:
With Congress officially on recess, President Obama will on Wednesday use his ability to make recess appointments to name one of his more controversial nominees: Donald Berwick, nominee to be Administrator of the Centers for Medicare & Medicaid Services (CMS).

The April nomination of Berwick — president and chief executive officer of the Institute for Healthcare Improvement — was in trouble and might not have been able to meet Senate confirmation due to comments Berwick made in the past about rationing health care. Even if Berwick could have been confirmed by the Senate, Democrats have little appetite for another round of fighting about changes to the health care system, Democrats said.

Appointing Berwick as an office temp demonstrates vividly how badly the president and the Dems  have lost the debate.  It is an act of utter weakness and a loosening grip.

Because of the 08 election results, Obama still has power to do this kind of thing.  But Berwick had better only rent.  Just as John Bolton was soon gone from the UN after he received a recess appointment from President Bush, Berwick goes into the job a very lame duck.  This time next year the agency will be again hanging out the old help wanted sign.

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