The Senate today, by a vote to 78 to 17, confirmed Sylvia Mathews Burwell as secretary of Health and Human Services (HHS), succeeding Kathleen Sibelius, who will be remembered as the architect of and its many travails.

Ms. Burwell, 48, moves over from the West Wing, where she serves as President Obama's budget director, a post to which she was confirmed unanimously just this past year. She is a Harvard graduate and Rhodes scholar who also served in President Bill Clinton's administration.