Here’s an interview that Donald Berwick, President Obama’s appointee charged with cutting  $500 billion from Medicare, gave in October 2006:

Effective leaders know their deficiencies. How do you address yours? I don’t feel like a leader, so it’s very hard for me to project myself into that situation. But inattention to detail is my biggest defect. I’m always leaning forward into something new. I can create a mess. Luckily, I have people who are willing to create the detail around the idea or, if they’re really smart, know which ideas to ignore. The second defect is more personal uncertainty than you would probably believe. Every time I put an idea out, despite my enthusiasm, I’m very, very unsure about whether it’s OK or not. And the third is that I want everyone to like me, and yet I’m aware that when you’re pushing for change, that isn’t always going to happen. To be more effective as a leader, I would probably want to thicken my skin.

H/t Ramesh Ponnuru.

Berwick was given a recess appointment today — despite having never been brought up for a hearing before a solidly Democratic Senate. With or without input from the people’s representatives, he will head CMS until the end of 2011.