<P> The United States has more political appointees in government than any other industrialized democracy in the world . Even though the United States has one of the largest populations of political appointees in the system, the efficiency of political appointees is constantly shifting . Political appointees are engraved in everyday decisions even making the final call on major events . As of 2013, the Centers for Medicare and Medicaid Services was lacking a Senate - confirmed administrator since 2006 when Marilyn Tavenner was acting administrator . At least 60 positions for appointment remain vacant and 45 positions have remained vacant for more than a year . </P> <P> Judicial vacancies have also become a problem as well with numerous open seats for circuit and district judges left to be filled . At the end of President Obama's first term, thirteen percent of presidential - appointee positions had not been filled . Political appointees also come under heat for their own actions including Ben Bernanke's involvement with private banks and also Michael Brown's involvement in Hurricane Katrina . One study published in the Journal of Public Administration Research and Theory by Nick Gallo and David Lewis evaluated more than 350 managers with a program assessment rating tool ("PART") to determine efficacy and found that programs run by political appointees tended to be less effective . Furthermore, those with previous government experience or appointees who had not worked for a political campaign tended be more effective than appointees with experience in the business or non-profit sectors . Gallo and Lewis stated that they thought careerist and appointees should work in a balanced atmosphere to be more productive and share skills . Professional rapport between careerists and appointees is considered in a study of presidential environmental appointees by Matthew Auer . Auer found that oft - mentioned problems in the appointment system, such as short time - in - office and lack of government experience were less pronounced among top federal environmental appointees, across both Republican and Democratic administrations . </P>

Who approves those who are selected to government positions