Led by Orrin Hatch (R-UT) and Mike Enzi (R-Wyo) 42 Senators signed off on a letter Thursday encouraging President Obama to withdraw Donald Berwick's nomination to head the Centers for Medicare and Medicaid Services (CMS). Republicans would need only 41 votes to prevent his confirmation.

Dr. Berwick came under fire from Republicans last July when Obama installed him during a summer recess, bypassing the usual confirmation process. The Harvard professor, dubbed a "rationer-in-chief" by the opposition, was able to avoid scrutiny until November 16 when he finally appeared before the Senate Finance Committee. His most recent appearance on February 10 prompted Republican Senators to draft a rejection letter explaining their concerns:

Don Berwick is a contentious choice to head an agency with a budget larger than the Defense Department's and implement the vast majority of the $2.6 trillion health law.  The White House's handling of this nomination - failing to respond to repeated requests for information and circumventing the Senate through a recess appointment - has made Dr. Berwick's confirmation next to impossible...In the spirit of cooperation, the President should withdraw his nomination

Both Congress and more than 100 million Americans that will be affected by this partisan health care reform plan need to know who is minding the store at CMS.  But there are just too many questions about what Dr. Berwick and CMS are doing or will do with the unprecedented power they have been given to reshape our health care system.

Any healthcare funding plan that is just, equitable, civilized and humane must, redistribute wealth from the richer among us to the poorer and less fortunate. Excellent healthcare is by definition redistributional.

There are strengths and weaknesses in every health care system around the world, and we need to learn from each other,..the American system needs its own solution.