Why did Obama appoint him, rather than take him through the confirmation process? It is because the Republicans vowed to block his nomination through extended hearings and use politics to keep him out. Medicare has been leaderless since 2006 and urgently needs reform. Medicare is a mess and must be fixed before health care reform can occur.
Yes, Berwick is a proponent of health regulations that "weigh public welfare against the choices of private consumers". Those are fighting words to those who are against health reform and who are happy with the status quo. Don Berwick doesn't sugar coat the problems our nation is facing and he believes in a system where decisions are transparent - and the people who make them are accountable.
That sounds pretty good to me.