Healthcare, immigration, financial industry…America is being re-formed alright. There are a lot of political irons in the fire right now and they’re all pressing. Which ones are more important?

WSJ’s Daniel Henninger says there’s no question.

Barack Obama’s incredible “recess appointment” of Dr. Donald Berwick to head the Centers for Medicare and Medicaid Services (CMS) is probably the most significant domestic-policy personnel decision in a generation. It is more important to the direction of the country than Elena Kagan’s nomination to the Supreme Court.

The court’s decisions are subject to the tempering influence of nine competing minds. Dr. Berwick would direct an agency that has a budget bigger than the Pentagon. Decisions by the CMS shape American medicine.

And this is most important, because those decisions also determine who gets what health care treatments.

Dr. Berwick’s ideas on the design and purpose of the U.S. system of medicine aren’t merely about “change.” They would be revolutionary.

One may agree with these views or not, but for the president to tell the American people they have to simply accept this through anything so flaccid as a recess appointment is beyond outrageous. It isn’t acceptable.

Unusual to find such strongly worded and reasoned criticism in major media, but Henninger does a couple of other things in this commentary that I haven’t seen anywhere else. He posts, line by line, a compendium of Berwick’s statements in speeches and articles of his healthcare views, presenting a startling picture of America’s future in Berwick’s own words. Then he follows that with incisive analysis of what may be more deeply disturbing.

That the Obama White House would try to push this past public scrutiny with a recess appointment says more about Barack Obama than it does Dr. Berwick.

Vilifying Dr. Berwick alone for his views is in a way beside the point. Within Mr. Obama’s circle they all think like this. Defeat Dr. Berwick, and they will send up 50 more who would pursue the same goals.

And it’s those goals we should be concerned with.

If the American people want the world Dr. Berwick wishes to give them, that’s their choice. But they must be given that choice with full, televised confirmation hearings.

Barack Obama, Donald Berwick and the rest may fancy themselves philosopher kings who know what we need without the need to inform or persuade us first. That’s not how it works here…

It should be clear why Berwick is bigger than Kagan. We need a large public debate over these views, over what Mr. Obama has said his health plan would and would not do.

And much, much more over this re-making of America.

Sheila Liaugminas

Sheila Liaugminas is an Emmy award-winning Chicago-based journalist in print and broadcast media. Her writing and broadcasting covers matters of faith, culture, politics and the media....