President Obama has nominated Dr. Donald Berwick as the head of the Centers for Medicare and Medicaid Services, which supervises the two Great Society programs. He was experienced in health policy and was supposed to be a perfect candidate for the job. Dr. Berwick is a pediatrician and Harvard professor, who had worked hard to improve patient safety and achieve better quality outcomes.

The Institute for Healthcare Improvement has been run by him. His confirmation by the Senate would seem straightforward, but he has stirred controversy, as he is in love with Britain's health care system. He is fond of National Health Service, which leaves him "starry-eyed". People usually praise it, but Dr. Berwick, in a 2008 speech said, "I love it".

The deficiencies of government healthcare management are the most apparent in Britain's creation of the National Institute for Clinical Excellence by Prime Minister Tony Blair, in 1999. NICE has targeted high-end surgical procedures, medical devices and drugs. Its decisions on funding as well as defunding have been controversial.

Dr. Berwick said, "NICE is extremely effective and a conscientious, valuable, and - importantly - knowledge-building system. NICE has developed very good and very disciplined, scientifically grounded, policy-connected models for the evaluation of medical treatments from which we ought to learn".